Determination of risk factors associated with inflammation in hypertensive patients with type-2 diabetes mellitus in a Palestinian Diabetes Study

Abstract

Objective

To determine the risk factors associated with inflammation in hypertensive patients with type-2 diabetes mellitus.

Methods

A total of 164 hypertensive patients with type 2 diabetes patients aged 38–60 years were selected from 7 primary healthcare centers in Gaza city, Palestine. Interview questionnaire were employed to collect data related to age, gender, smoking habits, and physical activity pattern. Laboratory biochemical tests included fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), interleukin 6 (IL-6), high sensitive C reactive protein (hs-CRP), and adiponectin were estimated in all patients.

Results

The study involved 118 (72%) women and 46 (28%) men; the mean of age was 53.7 ± 0.46 years. A tertile of inflammation feature with hs-CRP was developed. The highest tertile of hs-CRP was significantly associated with women, higher obesity indices, metabolic dysregulation involving lipid profile markers, FBG and blood pressure, IL-6, and lower adiponectin. After adjusting for age, gender, smoking habits, and physical activity; the risk factor of high level of hs-CRP were the increased body mass index [OR: 1.17, p = .018], IL-6 [OR: 2.22, p = .025] and FBG [OR: 1.01, p = .007], as well as reduced adiponectin [OR: 0.81, p = .002].

Conclusion

The inflammation state was affected by obesity and had been related to altered adipokines levels of IL-6 and adiponectin, as well as affected by the glycemic control, as evidenced by higher serum level of FBG.

Keywords:

• Obesity
• inflammation
• diabetes
• hypertension
• adipokines
• adiponectin
• interleukin 6
• C-reactive protein
• blood glucose

Transparency

Declaration of funding

The authors have no funding to declare.

Declaration of financial/other relationships

The author declares that there is no significant competing financial, professional or personal interests that may influence the performance or the presentation of the work described in this manuscript. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors would like to extend their sincere gratitude to the participants for their willingness to participate in this study, and to the Palestinian Ministry of Health for granting the permission to conduct the fieldwork. In addition, the author would also like to thank the Faculty of Medicine and Health Sciences at Universiti Putra Malaysia for the use of its library. This article is present as a preprint on a repository website and can be accessed on https://www.biorxiv.org/content/10.1101/613711v1.

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethical approval and consent to participate

All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by Universiti Putra Malaysia (reference no. [FPSK_Mac (13)04]) and ethically approved by the Helsinki Committee for Ethical Approval of Gaza, Palestine (no. PHRC/HC/11/13).

Informed consent

Informed consent was obtained from all individual participants included in the study.