Intensification of oxidative stress and inflammation in type 2 diabetes despite antihyperglycemic treatmentReportar como inadecuado

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Cardiovascular Diabetology

, 7:20

First Online: 22 June 2008Received: 06 March 2008Accepted: 22 June 2008


IntroductionThe metabolic deregulation associated with diabetes mellitus DM causes secondary pathophysiologic changes in multiple organ systems. Endothelial injury is induced by oxidative stress OS and inflammation. We have previously shown that DM type 2 patients are exposed to increased OS and inflammation contributed in part by primed peripheral polymorphonuclear leukocytes PMNLs.

AimsTo characterize the effect of oral medication on PMNL priming, on PMNL-related and on systemic inflammation, in correlation to changed diabetes parameters in patient with newly diagnosed type 2 DM.

MethodsPMNLs were separated from DM patient-s prior and following treatment with either metformin Glucophage, or Thiazolidinedione rosiglitazone and from healthy control subjects HC. Rate of superoxide release from phorbol ester-stimulated PMNLs and CD11b on PMNLs assessed PMNL priming. White blood cells WBC and PMNL counts and apoptosis reflected PMNL-related inflammation. CRP, fibrinogen, transferrin and albumin blood levels reflected systemic inflammation.

ResultsBoth metformin and rosiglitazone treatments reduced significantly the high levels of glucose and HbA1c, and slightly improved lipid profile during 2 months. PMNL priming parameters, higher compared to HC, increased after 2 months of metformin treatment. Rosiglitazone treatment decreased PMNL priming. ALP, higher in DM, significantly decreased following 2 months of both treatments. Systemic inflammation markers fibrinogen, CRP, higher in DM, decreased following both treatments. Transferrin and albumin were similar to HC. PMNL-related inflammation markers were higher in DM; however, only PMNL apoptosis decreased after both treatments. Monocyte counts, higher in DM compared to HC, decreased following both treatments. Serum insulin levels, higher in DM compared to HC, decreased following both treatments. PMNL-related priming and inflammation parameters positively correlated with HbA1c.

ConclusionThe present research adds new facet in evaluating anti-hyperglycemic treatment in type 2 DM patients. Despite sufficient glycemic control using both treatments, some PMNL-related parameters deteriorated. Thus, anti hyperglycemic treatment should be favored due to its combined anti-PMNL priming and anti-inflammatory effect, in addition to its anti-hyperglycemic characteristics, according to the correlation among these parameters. Such combined treatment may reduce morbidity and mortality common in DM patients.

AbbreviationsDMDiabetes mellitus

HbA1cglycosylated hemoglobin A

HChealthy control subjects

OSoxidative stress

PMAphorbol 12-myristate 13-acetate

PMNLspolymorphonuclear leukocytes

ROSreactive oxygen species

SODsuperoxide dismutase.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-7-20 contains supplementary material, which is available to authorized users.

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Autor: Raymond Farah - Revital Shurtz-Swirski - Olga Lapin


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