Impact of malnutrition on systemic immune and metabolic profiles in type 2 diabetes
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(2020) 20:168
RESEARCH ARTICLE
Open Access
Impact of malnutrition on systemic immune and metabolic profiles in type 2 diabetes Anuradha Rajamanickam1* , Saravanan Munisankar1, Chandra Kumar Dolla2, Kannan Thiruvengadam2 and Subash Babu1,3
Abstract Background: While obesity and overweight status are firmly established risk factors for Type 2 diabetes mellitus (T2DM), a substantial proportion of diabetic individuals, especially in Africa and Asia, are often underweight or normal weight. However, very little is known about the immunological and metabolic profiles of these individuals. Methods: This study aimed to assess the relationship between malnutrition and Type 2 diabetes mellitus (T2DM). We examined a variety of analytes associated with the immunological and metabolic profiles of T2DM individuals with low (< 18.5 kg/m2) or normal (18.5–24.9 kg/m2) body mass index (BMI). To this end, we measured plasma levels of HbA1c, glucose, insulin, glucagon, adipocytokines and Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in T2DM individuals with low BMI (LBMI) or normal BMI (NBMI) with small sample size n = 44 in each group. Results: LBMI individuals exhibited significantly higher levels of HbA1c, random blood glucose, insulin and glucagon compared to NBMI individuals. Similarly, LBMI individuals exhibited significantly higher levels of adiponectin and adipsin and significantly lower levels of leptin in comparison to NBMI individuals. LBMI individuals also exhibited significantly lower levels of the Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in comparison to NBMI individuals. Finally, while the metabolic parameters exhibited a significant negative correlation with BMI, the immunological parameters exhibited a significant positive correlation with BMI. Conclusions: Malnutrition is associated with a significant modulation of glycemic, hormonal and cytokine parameters in T2DM. Hence, the biochemical and immunological profiles of T2DM is significantly influenced by BMI. Keywords: Malnutrition, Type 2 diabetes mellitus, Adipocytokines, Pancreatic hormones, Cytokines
Background Globally, there are an estimated 425 million people living with T2DM (Type 2 Diabetes Mellitus) and the prevalence is projected to increase to 629 million by 2045 [1]. The highest increase in prevalence is expected to occur in low and middle-income countries (LMIC), * Correspondence: [email protected] 1 National Institute of Health-NIRT-International Center for Excellence in Research, Chetpet, Chennai 600031, India Full list of author information is available at the end of the article
where malnutrition is co-prevalent [1]. While obesity and overweight status are known risk factors for development of T2DM, there is emerging evidence that T2DM also occurs in individuals in normal or underweight individuals, especially in LMIC [2–4]. A recent analysis reported that the prevalence of T2DM in normal or underweight individuals ranged from 1.4 to 8.8%, which was not very different from that in the general pop
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