title: Evaluation of TNF-α and IL-6 Levels in Obese and Non-obese Diabetics: Pre- and Postinsulin Effects.
abstract: BACKGROUND
  Type 2 diabetes (T2DM) mellitus is a serious implication of obesity. The effect of insulin therapy on levels of inflammatory markers among obese and non-obese diabetics has been inadequately studied.
  
  
  OBJECTIVE
  The study aimed to analyze the preinsulin and postinsulin levels of tumor necrosis factor α (TNF-α) and IL-6 in nonobese and obese T2DM patients.
  
  
  METHODS
  We assessed TNF-α and IL-6 levels in healthy controls (n=10) and diabetic patients (obese and nonobese; n=20 each) and analyzed the postinsulin effect on TNF-α and IL-6 levels after 24 and 48 weeks. TNF-α and IL-6 levels were also correlated with fasting plasma glucose of obese and nonobese diabetic patients after insulin therapy.
  
  
  RESULTS
  There is augmentation of TNF-α and IL-6 levels in diabetic patients and augmentation is more in obese than in nonobese diabetics. The obese group showed a significant decrease (P value<0.05) after 24 weeks of insulin therapy and an extremely significant decrease (P<0.001) in TNF-α and IL-6 levels after 48 weeks of therapy. The nonobese group showed an extremely significant decrease (P<0.001) in TNF-α and IL-6levels after 24 and 48 weeks both.
  
  
  CONCLUSIONS
  There is augmented inflammation in diabetes and it is more in obese diabetics. Insulin therapy tends to counter this inflammation, but the response is delayed in obese diabetics.
authors.affiliation: Department of Biochemistry, Government Medical College, Haldwani, Uttarakhand, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Goyal
authors.forename: Abul Faiz
authors.initials: AF
authors.lastname: Faizy
authors.forename: Sheelu S
authors.initials: SS
authors.lastname: Siddiqui
authors.forename: Monil
authors.initials: M
authors.lastname: Singhai