Integral criteria of chronic meta-inflammation in patients with hyperglycemia

Currently, there is no doubt that type 2 diabetes mellitus (T2DM) is associated with local and systemic manifestations of meta-inflammation, which is considered as one of the variants of low-grade inflammation.

Aim of the study was to develop and test a scale for assessing chronic systemic meta-inflammation in patients with prediabetes and T2DM based on a comparative analysis of inflammation biomarker levels.

Material and methods. Two groups of patients were studied: prediabetes (n = 26, fasting serum glucose level of 6.1–6.9 mmol/L and/or postprandial glycemia 7.8–11.0 mmol/L, and glycated hemoglobin content <6.5 %) and T2DM (n = 63). The control group consisted of blood donors (n = 89). To verify meta-inflammation, an integral criterion was used, including blood plasma content of C-reactive protein, cytokines (IL-6, IL-8, TNFα), cortisol, D-dimers.

Results and discussion. Systemic meta-inflammation developed in 57.7 % of patients with prediabetes and in 74.6 % patients with T2DM, but was not detected in the control group. At the same time, in 7.7 and 19 % cases with prediabetes and T2DM, respectively, meta-inflammation in intensity can be characterized as systemic hyperinflammation, when the levels of individual proinflammatory cytokines increased by ten folds relative to the upper normal limit.

Conclusions. Systemic meta-inflammation develops in most, but not all patients with prediabetes and T2DM. In some patients, however, its intensity goes beyond low-grade inflammation and is rather characterized as systemic hyperinflammation, with its characteristic “cytokine storm” phenomenon.

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