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198 Cardio Diabetes Medicine 2017

by the stimuli of cytokines/ TNFalpha/ Interleukin-1/ The level of hsCRP in all three group of subjects with
Viral products/ Bacterial component/ yeast products diabetes was significantly more than in the healthy
can activate more than 160 specific inflammatory. controls but, patients with Low bodyweight Type 2
and immune target genes by specific binding with DM had significantly lower levels of serum hsCRP
NF-κB decameric consensus sequences in DNA . A compared to obese patients with Type 2 DM. In Low
recent gene profiling study showed that high glucose bodyweight Type 2 diabetics, values of serum hsCRP
treatment of monocytes leads to increased expres- were found to have significant positive correlation
sion of multiple inflammatory cytokines, chemokines with age and waist hip ratio.
and related factors many of which are regulated by Low bodyweight, standard weight and obese subjects
pro-inflammatory transcription factor, nuclear fac- with diabetes had lower values of serum adiponectin
tor Kappa B (NF-Κb) synthesis. Significant positive as compared to healthy controls. Reduced adiponec-
correlation between NF-κB expression in peripheral tin levels in patients with Type2 DM is well recognized
blood mononuclear cells and HbA 1c levels has been in world literature. Statistical significant difference in
reported previously, wherein exposure to hy- the values of adiponectin between Obese Type2DM
perglycemia induced activation of the transcription and Low Bodyweight Type2DM subjects ( p = 0.01)
factor NF-kappaB in ex vivo-isolated peripheral blood suggest a lesser proinflammatory load in the latter..
mononuclear cells .
Lean habitus is mostly due to lack of fat depot and
The levels of expression of NF-κB in peripheral blood central adiposity rather than nutritional deficiency.
mononuclear cells were found to be higher in diabet- The above observation is an expected aberration in
ic subjects as compared to healthy controls. Interest- subjects with Low Bodyweight Type2 DM and com-
ingly, statistical significance of difference was seen patible with our earlier observations of low Homocys-
only between standard bodyweight diabetics and teine, high Glucokinase and brisk hepatic metabolic
healthy controls , but not between Low bodyweight state in Low Bodyweight Type2 diabetics (7,8).
diabetics and healthy controls . The most revealing ob-
seravation was that the expression of NF-κB was lowest The expression of NF-κB was lowest in Low Body-
in Low Bodyweight Type2 diabetics as compared to weight Type2 diabetics as compared to both standard
both Group B and C while the value of optical density weight and obese. This also indicates that, the lower
observed in them was near similar to that observed level of inflammatory stress experienced by subjects
in healthy controls (Table 4). with Low Body weight type 2 DM as compared to the
standard weight and obese diabetics.

Conclusion :
Observation of lower hsCRP, relatively lower levels
of adiponectin (probably due to sparse fat pool) and
lower expression of NF-κB which is similar to that ob-
served in healthy controls, supplement to the already
observed lipid profile which is not conducive for ath-
erogenesis, and low plasma levels of homocysteine
in explaining the lesser prevalence of MVD in Low
Table- 4 : Values of inflammatory markers in plasma of Type Body Weight Type 2 DM.
2 diabetics Low body Weight, Standard Body Weight and
Obese and healthy controls
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GCDC 2017