title: Fatigue symptoms relate to systemic inflammation in patients with type 2 diabetes.
abstract: Fatigue is frequent in patients with diabetes and this symptom appears to be more prominent in type 2 rather than type 1 diabetic subjects. Chronic inflammation represents one characteristic of type 2 diabetes that may contribute to fatigue symptoms. This possibility was assessed in a sample of 20 type 2 diabetic patients relatively to a group of 20 type 1 diabetic subjects. Specific dimensions of fatigue, including general fatigue, physical fatigue, reduced activity, mental fatigue and reduced motivation, were assessed using the Multidimensional-Fatigue-Inventory (MFI). Biological assays comprised the measurement of serum inflammatory markers [high-sensitive C-reactive-protein (hsCRP), high-sensitive interleukin-6 (hsIL-6), high-sensitive tumor-necrosis-factor-α (hsTNF-α) and neopterin]. Clinical parameters including indexes of adiposity were collected. In comparison to type 1 diabetic subjects, patients with type 2 diabetes exhibited higher fatigue scores, notably in the dimensions of general fatigue, physical fatigue and reduced activity, together with greater levels of inflammatory markers that correlated with indexes of adiposity. Regression analyses controlling for diabetes duration, insulin treatment status, glycemic control and fasting status, indicated that levels of inflammatory markers, in particular hsIL-6, hsCRP and neopterin, were associated with MFI fatigue dimensions in type 2 diabetic patients. Mediation analyses revealed that adiposity did not significantly account for the relationship of inflammatory markers with fatigue scores albeit coefficient regressions decreased somewhat when this variable was controlled for in regression models. These findings indicate that systemic low-grade inflammation relates to fatigue symptoms in patients with type 2 diabetes and suggest the involvement of inflammatory processes in the pathophysiology of diabetes-related fatigue.
authors.affiliation: INRA, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, F-33076 Bordeaux, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lasselin
authors.forename: Sophie
authors.initials: S
authors.lastname: Layé
authors.forename: Sandra
authors.initials: S
authors.lastname: Dexpert
authors.forename: Agnès
authors.initials: A
authors.lastname: Aubert
authors.forename: Concepcion
authors.initials: C
authors.lastname: Gonzalez
authors.forename: Henri
authors.initials: H
authors.lastname: Gin
authors.forename: Lucile
authors.initials: L
authors.lastname: Capuron
mesh_terms: D050154:Adiposity / Q000502:physiology; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha