Abstract
BackgroundA surge in pro-inflammatory markers, Il-6 and TNF-α, has been associated with type 2 diabetes mellitus (T2DM). However, there is no data on the dynamics of these markers in T2DM Ghanaian populations. The aim of this study was to determine variations in the levels of IL-6 and TNF-α in T2DM patients. This study also examined the associations of IL-6 and TNF-α with anthropometric measurement and the effect of co-morbidity with hypertension using rural and urban dwellers in the Ashanti region, Ghana.MethodsA nested case–control design using participants aged 25–70 years consisting of 77 T2DM ± hypertension patients and 112 controls were selected from a larger study on Research on Obesity and Diabetes among African Migrants (RODAM). Anthropometric measurements, blood pressure and body fat percentage were measured. Fasting blood samples were analyzed for glucose, IL-6 and TNF-α levels.ResultsThe median level of IL-6 was significantly higher (p < 0.0001) among rural dwellers compared to urban dwellers. Inversely, urban dwellers had significantly higher (p = 0.0424) median level of TNF-α compared to rural cases. No significant differences were observed in IL-6 (p = 0.3571) and TNF-α (p = 0.2581) among T2DM patients compared with T2DM ± hypertension patients. A weak negative correlation was found between IL-6 and BMI in urban T2DM.DiscussionThe average level of IL-6 was higher in rural T2DM participants compared with those in urban setting. However, higher levels of TNF-α was observed among the study participants with T2DM in urban settings compared to those of rural. In this study, we observed that co-morbidity of hypertension had no significant effect on the levels of IL-6 and TNF-α. We are of the opinion that higher physical activity levels among rural particpants and high obesity levels in urabn participants explain the observation but needs more numbers to validate.ConclusionThis study revealed that IL-6 levels were higher among rural dwellers than urban while TNF-α levels were higher in urban dwellers than rural in patients with T2DM. There was no association of body fat percentage and body mass index with IL-6 and TNF-α levels. Co-morbidity of hypertension with T2DM had no effect on IL-6 and TNF-α levels.
Highlights
A surge in pro-inflammatory markers, Il-6 and tumour necrosis factor α (TNF-α), has been associated with type 2 diabetes mellitus (T2DM)
This study revealed that interleukin 6 (IL-6) levels were higher among rural dwellers than urban while TNF-α levels were higher in urban dwellers than rural in patients with T2DM
There was no association of body fat percentage and body mass index with IL-6 and TNF-α levels
Summary
A surge in pro-inflammatory markers, Il-6 and TNF-α, has been associated with type 2 diabetes mellitus (T2DM). Previous studies conducted to assess variations in inflammatory markers associated with type 2 diabetes in urban populations have indicated a significant difference in the levels of interleukin 6 (IL-6) and tumour necrosis factor α (TNF-α) [10, 11]. IL-6 and TNF-α have been observed to have a positive association with obesity in urban dwellers [12] Most of these studies conducted on inflammatory markers associated T2DM have predominantly sampled urban populations [10, 13] without comparing the effect of lifestyle and environmental differences on these marker levels in rural settings of same geographical areas. To date, no study has been conducted on the dynamics of IL-6 and TNF-α among the T2DM Ghanaian population
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