The association of oxidative stress and pro-inflammatory cytokines in diabetic patients with hyperglycemic crisis

• Published in: Journal of diabetes and its complications Vol. 28; no. 5; pp. 662 - 666
• Main Authors: Li, Juan, Huang, Minglian, Shen, Xingping
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014; Elsevier Limited
• Subjects: Adult; Aged; Blood Pressure; Cytokines - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Ketoacidosis - drug therapy; Diabetic Ketoacidosis - metabolism; Diabetic Ketoacidosis - physiopathology; Endocrinology & Metabolism; Female; Glucose; Humans; Hyperglycemia; Hyperglycemia - drug therapy; Hyperglycemia - etiology; Hyperglycemia - metabolism; Hyperglycemia - physiopathology; Hyperglycemic crises; Inflammation Mediators - blood; Insulin; Insulin - therapeutic use; Insulin resistance; Male; Metabolic disorders; Middle Aged; Oxidative Stress; Pro-inflammatory cytokines; Pro-inflammatory cytokines; Oxidative stress; Hyperglycemic crises
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2014.06.008

Abstract Aims To investigate the relationship between oxidative stress and serum levels of pro-inflammatory cytokines in diabetic patients with hyperglycemic crisis. Methods Seventy-three patients presenting to hospital with diabetic ketoacidosis or non-ketotic hyperglycemia were studied. Superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, total antioxidant capacity (TAC), 8-iso-prostaglandin F2α (8-iso-prostaglandinF2α, 8-iso-PGF2α), tumor necrosis factor receptor-I (TNF-RI), interleukin -1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were measured in all patients. The patients were then given an intravenous infusion of insulin 0.1U • kg-1 • h-1, as well as fluids, symptomatic therapy and parenteral and intravenous nutrition. Results 1. Before treatment, SOD and TAC were significantly lower (P < 0.05), whereas MDA and 8-iso-PGF2α were significantly higher (P < 0.05) in patients with hyperglycemic crises compared to controls. After treatment, SOD and TAC significantly increased (P < 0.05), while MDA and 8-iso-PGF2α significantly decreased (P < 0.05). 2. TNF-RI, IL-1β, TNF-α and IL-6 were significantly higher, both before and after treatment, in patients with hyperglycemic crises compared to controls (P < 0.05). 3. Before treatment, IL-6 and TNF-α were positively correlated with 8-iso-PGF2α (r = 0.32, r = 0.36, P < 0.05) in patients with hyperglycemic crises. After treatment, IL-6 and SOD were negatively correlated within patients (r = − 0.33, P < 0.05). Multiple regression analysis indicated that 8-iso-PGF2α affects the level of serum IL-6. Conclusion Patients with hyperglycemic crises have significantly increased oxidative stress and dysregulated serum pro-inflammatory cytokines that can be effectively treated by intensive insulin therapy.