DOI: 10.1515/folmed-2017-0021
ORIGINAL ARTICLE, MEDICINE
Association between Type 2 Diabetes, Obesity and Key Immunological Components of IgE-mediated Inflammation Raditsa N. Sokolova1, Rumyаna K. Yankova1, Tsvetana I. Abadjieva1 ,Tatyana A. Popova2,3, Maria V. Ivanovska2,3, Mariana A. Murdjeva2,3, Maria M. Orbetzova4, Svetlan M. Dermendzhiev5, Maria V. Pavlova4 1
Department of Dermatology and Venereology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria 3 Division of Immunological Assessment of PTSD, Technological Center for Emergency Medicine, Plovdiv, Bulgaria 4 Second Department of Internal Medicine, Endocrinology Section, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria 5 Second Department of Internal Medicine, Section of Occupational Diseases and Toxicology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria 2
Correspondence: Raditsa N. Sokolova, Department of Dermatology and Venereology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv, Bulgaria E-mail:
[email protected] Tel: +359 897053088 Received: 20 July 2016 Accepted: 11 Oct 2016 Published Online: 31 Jan 2017 Published: 27 June 2017 Key words: type 2 diabetes, Th2 cytokines Citation: Sokolova RN, Yankova RK, Abadjieva TI, Popova TA, Ivanovska MV, Murdjeva MA, Orbetzova MM, Dermendzhiev SM, Pavlova MV. Association between type 2 diabetes, obesity and key immunological components of IgE-mediated inflammation. Folia Medica 2017; 59(2):159-164. doi: 10.1515/folmed-2017-0021
Background: Changes in lifestyle and obesity in recent decades have brought about a dramatic increase in type 2 diabetes mellitus (DM2) and allergic diseases. Clinical and epidemiological studies associate obesity with epidemics of allergic diseases. The link between obesity and DM2 with immunological components of IgE-mediated allergic inflammation is not yet conclusively established. Aim: To examine the key immunological components of IgE-mediated allergic inflammation in patients with DM2 and their relationship with glycemic control and anthropometric indicators. Materials and methods: Fifty-five patients with DM2 and 32 healthy controls with normal weight and body mass index (BMI) of 18-24.9 kg/m2 were included in the study. Th2-cytokine profile (serum levels of IL-4 and IL-5, pg/ml) and total serum IgE IU/ml were assessed in all participants in the study using ELISA. In patients with DM2, levels of glycated hemoglobin (HbA1c%) in the blood were also measured. Results: Serum levels of IL-4 and IL-5 are significantly higher in patients with DM2 compared to the control group. Serum levels of IL-4 and IL-5 positively correlated with BMI as well as serum levels of IL-4 with waist circumference. Total serum IgE positively correlated with HbA1c. Conclusion: Obesity and poor glycemic control in patients with DM2 affect key immunological components of IgE-mediated allergic inflammation and possibly alter the immune response to allergens and antigens.
BACKGROUND
DM2 is a metabolic disorder characterized by hyperglycemia, insulin resistance and relative lack of insulin.1 The increase of the number of patients with DM2 worldwide is associated with the epidemic of obesity.2 Clinical and epidemiological studies have found association between obesity and increasing incidence of allergic diseases in last decade.3-5 Obesity probably induces changes in the immune response concerning disorders in Th1/Th2 immune profile by skewing of the immune system towards Th2.6 Changes in the serum levels of Th2 cytokines IL-4 and IL-5 and total IgE are not sufficiently studied
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in patients with DM2. In this study we investigated the Th2 cytokine profile and total IgE in patients with DM2 and healthy controls with normal weight, and their relationship with glycemic control and anthropometric parameters. MATERIALS AND METHODS
STUDY POPULATION Fifty-five patients with DM2 and 32 healthy controls with normal BMI (18-24.9 kg/m2) were included in the study. The patients with DM2 were previously diagnosed with DM2 and duration of illness > 6
Folia Medica I 2017 I Vol. 59 I No. 2 Unauthenticated Download Date | 7/13/17 3:11 PM
R. Sokolova et al
months. The study received the approval of the Medical University, Plovdiv Ethics Committee and obtained prior written informed consent of patients with DM2 and those of the control group. We met all requirements of the Helsinki Declaration of Patients Rights. Studies were carried out according to the requirements of Good Clinical Practice (Good Clinical Practice). The demographic data are presented in Table 1.
rank correlation coefficients (rs) was used. All analyses were performed using SPSS v. 20.0. P < 0.05 was assumed for the level of statistical significance. RESULTS
Table 1 presents the demographics and the anthropometric parameters of the studied contingent, and the mean HbA1c% levels in DM2 patients. The mean age of patients with DM2 was significantly higher
Table 1. Demographic and anthropometric parameters, and HbA1c in patients with DM2 Diabetic patients Mean ± SD*
Non-diabetic healthy controls Mean ± SD
Number (n)
55
32
Age (years)
59.15±8.225
50.34±16.122
0.032
34.224±7.026
22.130±1.876
0.000
108.31±14.765
76.16±7.314
0.000
Parameters
BMI
(kg/m2)
Waist circumference (cm) HbA1c (%)
p-value**
7.789±1.169
*Mean and standard deviation, **p
