Proinflammatory lymphokine and hormone levels in men with type 2 diabetes mellitus
Background. It is well known that the development of insulin resistance as the main factor of metabolic syndrome (MS) is accompanied by an imbalance in the cytokine system: an increase in the level of interleukin6 (ІЛ6), tumor necrosis factorα (TNFα) and a decrease in ІЛ10, ІЛ4. One of the causes of insulin resistance in men may be a decrease in testosterone production, since its sufficient amount increases the sensitivity to insulin. The purpose of the study: to evaluate the level of proinflammatory lymphokines and hormones in patients with type 2 diabetes mellitus (DM), MS and androgen deficiency. Materials and methods. We examined 76 men aged 35 to 68 years (29 — with MS and 47 — with type 2 DM). The level of proinflammatory lymphokines, estradiol, free and total testosterone was determined in the blood serum using radioimmune method, the content of TNFα, ІЛ6, leptin — by immuneenzyme methods. Insulin resistance was determined by the HOMA index. Diagnosis of MS was established based on the АТР III — NCEP criteria. The control group included 21 apparently healthy men. Results. Patients with type 2 DM and metabolic syndrome and those without MS had elevated levels of TNFα and ІЛ6, cortisol, aldosterone, adrenocorticotropic hormone (ACTH) and insulin. The conducted studies showed the presence of androgen deficiency in all groups of patients. More significant signs of androgen deficiency were observed in the examined men with MS and type 2 DM. The level of insulin and adrenocorticotropic hormone are directly proportional to the body mass index. In patients with MS and without MS, we observed only a tendency to increase in leptin level. There is a tendency to increase in the level of estradiol in men with type 2 DM and MS. Conclusions. Results of the study correspond to the hypothesis about the leading role of proinflammatory lymphokines of the immune system in the origin of type 2 DM. In this case, the cause of DM is dysfunction of not fatty tissue, bur heterospecific link of immunity.
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