Acta Diabetologica

, Volume 48, Issue 2, pp 113–119

Circulating pro-inflammatory cytokines and adiponectin in young men with type 2 diabetes

  • Sheng-Chiang Su
  • Dee Pei
  • Chang-Hsun Hsieh
  • Fone-Ching Hsiao
  • Chung-Ze Wu
  • Yi-Jen Hung
Original Article


This study was designed to investigate plasma circulating pro-inflammatory cytokines, adiponectin and high-sensitive C-reactive protein (hsCRP) in young men with type 2 diabetes. New-onset young men with type 2 diabetes (young diabetes, YDM; age between 10 and 25) were recruited and divided into a non-obese group (NOYDM, body mass index, BMI ≦ 25 kg/m2, N = 23) and an obese group (OBYDM, BMI ≧ 25 kg/m2, N = 24). Twenty-four non-obese non-diabetic young men served as controls. Hemoglobin A1c, fasting glycemic index, lipids, adiponectin, hsCRP, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined. Insulin sensitivity and β-cell function were calculated using the homeostasis model assessment method (HOMA-IR and HOMA-β, respectively). Compared to controls, significantly greater HOMA-IR (7.9 ± 1.9 and 10.4 ± 2.5 vs. 1.5 ± 0.3, P < 0.001) and fasting insulin (103.3 ± 21.1 and 209.9 ± 24.4 vs. 48.5 ± 6.7 pmol/l, P < 0.01 and P < 0.001, respectively) were observed in NOYDM and OBYDM. There were significantly lower plasma adiponectin and higher hsCRP and TNF-α levels in OBYDM, whereas higher TNF-α and IL-6 were shown in NOYDM. Spearman rank correlation analysis demonstrated significant correlations between BMI and adiponectin (R = −0.44, P < 0.005), CRP (R = 0.28, P < 0.05), TNF-α (R = 0.42, P < 0.005) and IL-6 (R = 0.33, P < 0.01) in all YDM. Among measured cytokines, only adiponectin was significantly correlated with HOMA-IR, this correlation was abolished when adjusted for age and BMI (R = −0.24, P = 0.12). YDM not only exhibits insulin resistance, but also has inflammatory and atherogenic properties. BMI might be a major determinant of those markers.


Pro-inflammatory cytokines Adiponectin Young diabetes 


  1. 1.
    Fajans SS (1990) Scope and heterogeneous nature of MODY. Diabetes Care 13:49–64PubMedCrossRefGoogle Scholar
  2. 2.
    Pinhas-Hamiel O, Standiford D, Hamiel D, Dolan LM, Cohen R, Zeitler PS (1999) The type 2 family: a setting for development and treatment of adolescent type 2 diabetes mellitus. Arch Pediatr Adolesc Med 153:1063–1067PubMedGoogle Scholar
  3. 3.
    Scott CR, Smith JM, Cradock MM, Pihoker C (1997) Characteristics of youth-onset noninsulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus at diagnosis. Pediatrics 100:84–91PubMedCrossRefGoogle Scholar
  4. 4.
    Gortmaker SL, Dietz WH Jr, Sobol AM, Wehler CA (1987) Increasing pediatric obesity in the United States. Am J of Dis Child 141:535–540Google Scholar
  5. 5.
    Pei D, Hung YJ, Chen HD et al (2004) The insulin sensitivity, glucose effectiveness and acute insulin response to glucose load of non-obese adolescent type 2 diabetes. Diabetes Res Clin Pract 66:253–261PubMedCrossRefGoogle Scholar
  6. 6.
    Pei D, Hsiao CF, Hung YJ et al (2006) The insulin sensitivity, glucose sensitivity, and acute insulin response to glucose load in adolescent type 2 diabetes in Taiwanese. Diabetes Metab Res Rev 22:26–33PubMedCrossRefGoogle Scholar
  7. 7.
    Gungor N, Bacha F, Saad R, Janosky J, Arslanian S (2005) Youth type 2 diabetes: insulin resistance, beta-cell failure, or both? Diabetes Care 28:638–644PubMedCrossRefGoogle Scholar
  8. 8.
    Haffner SM (2006) The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol 97:3A–11APubMedCrossRefGoogle Scholar
  9. 9.
    Hu FB, Meigs JB, Li TY, Rifai N, Manson JE (2004) Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 53:693–700PubMedCrossRefGoogle Scholar
  10. 10.
    Matsushita K, Yatsuya H, Tamakoshi K et al (2006) Comparison of circulating adiponectin and proinflammatory markers regarding their association with metabolic syndrome in Japanese men. Arterioscler Thromb Vasc Biol 26:871–876PubMedCrossRefGoogle Scholar
  11. 11.
    Koh KK, Han SH, Quon MJ (2005) Inflammatory markers and the metabolic syndrome: insights from therapeutic interventions. J Am Coll Cardiol 46:1978–1985PubMedCrossRefGoogle Scholar
  12. 12.
    Weyer C, Funahashi T, Tanaka S et al (2001) Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 86:1930–1935PubMedCrossRefGoogle Scholar
  13. 13.
    Vikram NK, Misra A, Pandey RM, Dwivedi M, Luthra K (2004) Adiponectin, insulin resistance, and C-reactive protein in postpubertal Asian Indian adolescents. Metab Clin Exp 53:1336–1341PubMedGoogle Scholar
  14. 14.
    Mishima Y, Kuyama A, Tada A, Takahashi K, Ishioka T, Kibata M (2001) Relationship between serum tumor necrosis factor-alpha and insulin resistance in obese men with Type 2 diabetes mellitus. Diabetes Res Clin Pract 52:119–123PubMedCrossRefGoogle Scholar
  15. 15.
    Carey AL, Bruce CR, Sacchetti M et al (2004) Interleukin-6 and tumor necrosis factor-alpha are not increased in patients with Type 2 diabetes: evidence that plasma interleukin-6 is related to fat mass and not insulin responsiveness. Diabetologia 47:1029–1037PubMedGoogle Scholar
  16. 16.
    Kern PA, Ranganathan S, Li C, Wood L, Ranganathan G (2001) Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance. Am J Physiol Endocrinol Metab 280:E745–E751PubMedGoogle Scholar
  17. 17.
    World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1: diagnosis and classification of diabetes mellitus. World Health Organization, GenevaGoogle Scholar
  18. 18.
    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419PubMedCrossRefGoogle Scholar
  19. 19.
    Prando R, Cheli V, Melga P, Giusti R, Ciuchi E, Odetti P (1998) Is type 2 diabetes a different disease in obese and nonobese patients? Diabetes Care 21:1680–1685PubMedCrossRefGoogle Scholar
  20. 20.
    Pickup JC, Chusney GD, Thomas SM, Burt D (2000) Plasma interleukin-6, tumour necrosis factor alpha and blood cytokine production in type 2 diabetes. Life Sci 67:291–300PubMedCrossRefGoogle Scholar
  21. 21.
    Katsuki A, Sumida Y, Murashima S et al (1998) Serum levels of tumor necrosis factor-alpha are increased in obese patients with noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 83:859–862PubMedCrossRefGoogle Scholar
  22. 22.
    Kazumi T, Kawaguchi A, Hirano T, Yoshino G (2004) Serum adiponectin is associated with high-density lipoprotein cholesterol, triglycerides, and low-density lipoprotein particle size in young healthy men. Metab Clin Exp 53:589–593PubMedGoogle Scholar
  23. 23.
    Weiss R, Dziura J, Burgert TS et al (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374PubMedCrossRefGoogle Scholar
  24. 24.
    Nemet D, Wang P, Funahashi T et al (2003) Adipocytokines, body composition, and fitness in children. Pediatr Res 53:148–152PubMedGoogle Scholar
  25. 25.
    Choi KM, Lee J, Lee KW et al (2004) Comparison of serum concentrations of C-reactive protein, TNF-alpha, and interleukin 6 between elderly Korean women with normal and impaired glucose tolerance. Diabetes Res Clin Pract 64:99–106PubMedCrossRefGoogle Scholar
  26. 26.
    Hotamisligil GS (1999) Mechanisms of TNF-alpha-induced insulin resistance. Exp Clin Endocrinol Diabetes 107:119–125PubMedCrossRefGoogle Scholar
  27. 27.
    Cheung AT, Ree D, Kolls JK, Fuselier J, Coy DH, Bryer-Ash M (1998) An in vivo model for elucidation of the mechanism of tumor necrosis factor-alpha (TNF-alpha)-induced insulin resistance: evidence for differential regulation of insulin signaling by TNF-alpha. Endocrinology 139:4928–4935PubMedCrossRefGoogle Scholar
  28. 28.
    Sattar N, Wannamethee SG, Forouhi NG (2008) Novel biochemical risk factors for type 2 diabetes: pathogenic insights or prediction possibilities? Diabetologia 51:926–940PubMedCrossRefGoogle Scholar
  29. 29.
    Sacheck J (2008) Pediatric obesity: an inflammatory condition? JPEN J Parenter Enteral Nutr 32(6):633–637PubMedCrossRefGoogle Scholar
  30. 30.
    Yeste D, Vendrell J, Tomasini R, Broch M, Gussinyé M, Megia A, Carrascosa A (2007) Interleukin-6 in obese children and adolescents with and without glucose intolerance. Diabetes Care 30(7):1892–1894 (Epub 2007 Apr 6)PubMedCrossRefGoogle Scholar
  31. 31.
    Tsigos C, Papanicolaou DA, Kyrou I, Defensor R, Mitsiadis CS, Chrousos GP (1997) Dose–dependent effects of recombinant human interleukin-6 on glucose regulation. J Clin Endocrinol Metab 82:4167–4170PubMedCrossRefGoogle Scholar
  32. 32.
    de Rekeneire N, Peila R, Ding J et al (2006) Diabetes, hyperglycemia, and inflammation in older individuals: the health, aging and body composition study. Diabetes Care 29:1902–1908PubMedCrossRefGoogle Scholar
  33. 33.
    Dandona P, Weinstock R, Thusu K, Abdel-Rahman E, Aljada A, Wadden T (1998) Tumor necrosis factor-alpha in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab 83:2907–2910PubMedCrossRefGoogle Scholar
  34. 34.
    Straub RH, Hense HW, Andus T, Scholmerich J, Riegger GA, Schunkert H (2000) Hormone replacement therapy and interrelation between serum interleukin-6 and body mass index in postmenopausal women: a population-based study. J Clin Endocrinol Metab 85:1340–1344PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Sheng-Chiang Su
    • 1
  • Dee Pei
    • 2
  • Chang-Hsun Hsieh
    • 1
  • Fone-Ching Hsiao
    • 1
  • Chung-Ze Wu
    • 3
  • Yi-Jen Hung
    • 1
  1. 1.Division of Endocrinology and Metabolism, Department of Internal MedicineTri-Service General Hospital, National Defense Medical CenterTaipeiTaiwan, ROC
  2. 2.Division of Endocrinology and Metabolism, Department of Internal MedicineCardinal Tien HospitalXindianTaiwan, ROC
  3. 3.Division of Endocrinology and Metabolism, Department of Internal MedicineTaipei Medical University-Shuang Ho HospitalTaipeiTaiwan, ROC

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