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Biomarker profile varies with type 2 diabetes progression, development
Early preclinical and clinical phases of type 2 diabetes, disease complications and progression may be differentiated by markers of inflammation and immunity, according to recent study findings published in Diabetes Care.
“With the current study, we characterized the immune and inflammatory response of subjects with prediabetes and diabetes in a large population-representative sample,” the researchers wrote. “This representative setting offers the possibility to investigate the complete spectrum of the disease from normal metabolic homeostasis over the subclinical to the manifest disease and [help] to differentiate between biological effects versus a simple progression of the disease.”
Philipp S. Wild, MD, MSc, of the University Medical Center Mainz in Germany, and colleagues evaluated data from 15,010 adults aged 35 to 74 years from the population-based Gutenberg Health Study to profile the immune and inflammatory responses in this population with prediabetes and diabetes. Overall, 7,584 men and 7,426 women were evaluated, with 1,425 having prediabetes and 1,299 having diabetes.
HbA1c concentration and history of diagnosis were used to classify glucose status. Samples were analyzed for white blood cells, granulocytes, lymphocytes, monocytes, platelets, C-reactive protein, albumin, fibrinogen and hematocrit. A subcohort also was evaluated for interleukin-18, IL-1 receptor antagonist (IL-1RA) and neopterin concentrations.
There were varying dynamics in biomarkers from a normoglycemic profile in participants with prediabetes and those with diabetes: A gradual increase was noted for white blood cells, granulocytes, monocytes, IL-1RA, IL-18 and fibrinogen; a subclinical disease increase was seen for lymphocytes and C-reactive protein; an increase from prediabetes to diabetes was apparent only for neopterin; and no variation was found for glucose status.
C-reactive protein, IL-1RA and fibrinogen had the largest relative differences in participants with diabetes, and the largest difference was in C-reactive protein for participants with prediabetes.
An association was found between glucose status and several inflammatory and immune markers, independent of cardiovascular risk factors and comorbidities. The markers also varied among the participants with diabetes for disease severity and the presence of disease-specific complications.
“In summary, we demonstrated the variation of the inflammatory and immune biomarker profile with the development and progression of type 2 diabetes in a large and population-representative sample including 15,010 subjects,” the researchers wrote. “The biomarkers of inflammation and immunity show varying dynamics with the advancing disease, enabling differentiation of the early preclinical and clinical phases of the disease (ie, prediabetes), diabetes complications and disease progression by intensity of medical treatment.” – by Amber Cox
Disclosure: Wild reports financial ties with the Federal Ministry of Education and Research and the German Center for Cardiovascular research. Please see the full study for a complete list of all other authors’ relevant financial disclosures.