Prediction of the development of carbohydrate disorders in patients with arterial hypertension based on an assessment of the levels of interleukin-10 and glycosylated haemoglobin

Abstract

The purpose of study was to develop a diagnostic algorithm for prediction of type 2 diabetes mellitus (T2DM) based on a comprehensive study of carbohydrate metabolism and serum activity of interleukin-10 (IL-10) in patients with arterial hypertension (AH). The study involved 69 patients with AH. The levels of fasting plasma glucose (FPG, mmol/L), insulin, HbA 1c (%) were determined by biochemical method, HOMA index was calculated. The level of IL-10 (pg/mL) was determined by ELISA. A discriminant analysis was used to identify the dependencies that explain the mechanisms of T2DM development in patients with AH. As the result of evaluation of carbohydrate metabolism, 30 patients were diagnosed with T2DM (FPG > 7.0; oral glucose tolerance test (OGGT) ≥ 11.1, HbA 1c ≥ 6.5)), 39 patients had prediabetes (FPG 5.6–6.9, OGGT – 7.8–11.0, HbA 1c 5.7–6.4%). The level of IL-10 was increased in patients with AH and prediabetes (90.8 (90.6–91.1), P < 0.05). At the same time, patients with AH combined with type 2 DM were characterized by the decrease of IL-10 level (77.4 (75.5–79.3), P < 0.05). According to the results of discriminant analysis, aimed to search for signs that allow to differentiate prediabetes from T2DM, it was found that IL-10 and HbA 1c are exactly the required signs: – T2DM = 5216 × IL-10 + 2,643 × HbA 1c −211,174; – Prediabetes = 6114 × IL-10 + 3,059 × HbA 1c −29,053. The obtained data suggest that increase of IL-10 level in patients with arterial hypertension and prediabetes can serve as a protective response and an early marker of carbohydrate metabolism disorders. Changes in IL-10 and HbA 1c levels are the most important prognostic factors that reflect the development of carbohydrate metabolism disorders in patients with hypertension.