Srpski Arhiv za Celokupno Lekarstvo (Jan 2019)
Chronic inflammation and lipid profile parameters in obese subjects with normal and disturbed glucose metabolism
Abstract
Introduction/Objective. In different states of increased chronic inflammation, like obesity and diabetes, early changes in lipid metabolism could represent an adaptive response aimed at diminishing the elevated inflammatory reaction. The aim of study was to investigate the impact of glucose tolerance status on relationship between chronic inflammation and lipid metabolism parameters. Methods. The study consisted of four groups (n = 30 for each group): obese individuals with disturbed glucose metabolism (subjects with newly diagnosed type 2 diabetes (T2DM)) before and after metformin treatment initiation, obese subjects with normal glucose tolerance (NGT) and a control group of healthy normal weight subjects. Appropriate anthropometric measurements and laboratory tests were carried out in all participants. Results. Among the sub-group of obese subjects, the association of highly sensitive C reactive protein (hsCRP) with triglycerides and lipoprotein (a) (Lp(a)) was especially pronounced in the group of T2DM subjects before treatment initiation. In this group, the level of inflammation was the highest and correlation coefficients of triglycerides and Lp(a) with hsCRP were significantly different compared with the group of obese without diabetes (r = 0.21 vs. r = -0.36; p = 0.0172) for triglycerides and (r = -0.17 vs. r = 0.36, p = 0.0324) for Lp(a). Correlations of hsCRP with triglycerides and Lp(a) in groups of NGT obese subjects and T2DM subjects after treatment initiation did not differ significantly. Treatment with metformin changed the relationship of hsCRP with triglycerides and Lp(a) to the one which is similar to the relationship observed in obese NGT subjects (r = 0.21 vs. r = 0.38; p = 0.2449) for triglycerides and (r = -0.17 vs. r = -0.27, p = 0.3562) for Lp(a). Conclusion. In subjects with newly diagnosed T2DM, who have the highest level of inflammation, it is probable that the increase in triglycerides is a part of the anti-inflammatory response, whereas Lp(a) is probably produced and used in the reduction of elevated inflammation.
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