Abstract: FR-PO664

IL-6 Assessment as a Non-Traditional Risk Factor for Cardiovascular Risk and Hospital Admission in Type 2 Diabetes Patients with Diabetic Nephropathy

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Pimentel, Ana Pocinho, Centro Hospitalar do Algarve, Faro, Portugal
  • Mendes, Filipa B., Centro Hospitalar do Algarve, Faro, Portugal
  • Pereira, Luisa H., Centro Hospitalar do Algarve, Faro, Portugal
  • Silva, Ana Paula, Hospital de Faro E.P.E, Faro, Portugal
  • Neves, Pedro Leao, CHA, Faro, Portugal
Background

Oxidative stress and inflammatory cytokines in diabetic nephropathy are major triggers regarding the development of microvascular complications of type 2 diabetes. Interleukin-6 (IL-6) is one proinflammatory cytokine, implicated in the pathogenesis of diabetic nephropathy where vascular inflammation and fibrosis are the rule with influence on the development of cardiovascular disease. The aim of this study is to verify the relationship between plasmatic IL-6 and non-traditional cardiovascular risk factors, inherent comorbidities, mineral metabolism parameters, insulin resistance score of type 2 diabetic (DM) patients with nephropathy and hospital admissions due to ischemic heart disease (IHD).

Methods

Retrospectively data from a cohort of 175 type 2 DM patients followed in an outpatient clinic from January 2008 to August 2011 were obtained, including Homeostatic Model Assessment (HOMA) for insulin resistance, homocysteine, fibrinogen and brain natriuretic peptide (BNP) levels and Charlson Comorbidity Index (CCI) was calculated. The patients were divided into groups using serum IL-6. Group 1 (N=113) was defined as having IL-6 <4.9pg/mL and group 2 (N=62) had IL-6 ≥4.9pg/mL.

Results

Statistically significant differences were found between the groups (p<0,003) with higher values of IL-6 being associated with greater CCI, higher phosphorus and PTH level, but also HOMA, BNP, diastolic pressure and albumin-creatinine ratio. CCI (OR 3.714 95% CI (1.6-8.2) p=0.001) and IL-6 (OR 1.5 95% CI (1.104-2.486) p=0.015) were predictive factors in terms of hospital admission for IHD, and using a generalized linear model, higher values of IL-6 were predictive for acute coronary syndrome (ACS) (Wald=0.1219; CI 95% (0.14-0.59) p=0.01) with an AUC=0.79, p=0.0001.

Conclusion

In type 2 diabetic patients, elevated serum levels of IL-6 are associated with the presence of non-traditional cardiovascular risk factors, as well as higher insulin resistance, worst mineral metabolism parameters and more comorbidity. In our cohort study, IL-6 levels were predictive of ACS and hospital admission for IHD.