Assessment of complex treatment influence on systemic inflammation in overweight type 2 diabetes patients

Abstract

Objective: Introduction: Long-term systemic inflammation may cause type 2 diabetes. Medications used to treat type 2 diabetes don't target inflammation therefore it's necessary to study how hypoglycemics can improve patient prognosis through modification of systemic inflammation. The aim: Our goal was to assess influence of liraglutide in complex therapy on proinflammatory cytokine levels in overweight patients with type 2 diabetes and compare it with metformin.

Patients and methods: Meterials and methods: The study included 80 overweight patients with type 2 diabetes. We studied clinical parameters as well as antropometric: height, weight, BMI, abdomen circumference; hsCRP, proinflammatory cytokine (TNF-α, IL-1β, IL-6) levels. Patients were treated according to an individualized treatment plan which included eating habit modification and dosed physical exercise. First and second groups were comparison groups. Patients in the first group received metformin as primary treatment up to 2500 mg/day (n=20). Patients in the second group received liraglutide up to 1.8 mg/day (n=30). Patients in the third (main) group received a combination of metformin (up to 2500 mg/day) and liraglutide up to 1.8 mg/day (n=30).

Results: Results and conclusions: Main group achieved a decrease in BMI from 28,48&#177;2,1 kg/m2 to 23,9&#177;1,8 kg/m2 (р<0,05), whereas such decrease in the liraglutide monotherapy group was from 28,59&#177;2,5 kg/m2 to 25,87&#177;2,3 kg/m2 (р<0,05) and from 28,65&#177;3,2 kg/m2 to 27,46&#177;2,8 kg/m2 (р>0,05) in the metformin monotherapy group. Liraglutide was more efficient in lowering inflammatory cytokine concentrations with TNF-α and IL-6 being more sensitive to its effects. Main group saw a decrease in TNF-α levels from 10,14&#177;0,6 to 7,49&#177;0,33 pg/ml (<0,001) and IL-6 levels from 11,12&#177;0,7 to 7,84&#177;0,62 pg/ml (<0,001).

Keywords: body mass index; diabetes; inflammatory cytokines; liraglutide; overweight.