Hyperglycaemia, oxidative stress and inflammatory markers

Chronic sustained hyperglycaemia also results in micro- and macrovascular complications occurring through a number of mechanisms of which oxidative stress (OS) and inflammatory changes via the innate immune system have increased in interest for medical diagnostics.[1,2] Impaired fasting glucose(IFG) may lead to the development of T2DM and cardiovascular disease (CVD), associated with increased OS[3] along with the ensuing chronic subclinical inflammatory processes apparent with developing insulin resistance.[4] The challenge is to prevent complications associated with IFG of which ~30% will remain undiagnosed for a significant period of time.[5] The InternationalDiabetes Federation have recognized the importance of the traditional biomarkers (general biochemistry): blood glucose (BGL), haemoglobin A1c(HbA1c), and lipid studies along with lifestyle improvement and drug treatment regimens to combat T2DMand CVD. There is also a recognition that lower blood glucose levels (<7.8 mmol/l) have lower rates of all major end point diabetic complications.[6] However, pathophysiological processes already occur with minor increases in BGL. Traditional biomarkers as predictors for T2DM Introduction: The increasing prevalence of hyperglycaemia implicates a state of oxidative estress and inflammation. Traditional and emerging biomarkers associated with increasing hyperglycaemia were assessed to clarify their role they play in hyperglycemia. Results: 309 participants attending a rural diabetic screening program were categorised into control and quintile groups based upon glucose levels: 1st quintile - <4.5 mmol/L and 4th,5th quintile - >6.1 mmol/L. Significant results were obtained for anthropometric data and biochemical markers - glucose, HbA1c and total cholesterol (P < 0.001); oxidative stress:glutathione (P < 0.001), glutathione:glutathione disulfide and 8-hydroxy-2-deoxyguanosine(P < 0.05). Interleukin -1ß and inflammatory marker ratios IL-6/IL-10, IL-1ß/IL-10, MCP-1/IL-10,IGF-1/IL-10 and IL-6/IL-1ß were significant (P < 0.05). Conclusion: This study provided further evidence that inflammatory and oxidative stress biomarkers may contribute to diagnostic information associated with preclinical increases in BGL. Further, we have provided a unique study in the analysis of ratios of inflammatory biomarkers and correlations with increasing BGL.KEYWORDSType 2 diabetes mellitus;impaired fasting glucose;prediabetes; cardiovasculardisease; oxidative stress; riskfactors; body mass index;glutathione; glutathionedisulphide; 8-hydroxy-2'-deoxyguanosine; interleukin1ß; interleukin-6; interleukin10; monocytechemoattractant protein 1;insulin like growth factor 1IntroductionAlterations to homeostatic disturbances in glucosemetabolism and resultant hyperglycaemia are causativefactors for Type 2 diabetes mellitus (T2DM).