Role of Tumour Necrosis Factor-Alpha and Adiponectin in Insulin Therapy Failure in Type 2 Diabetic Patients

Abstract

Background: Tumour necrosis factor alpha (TNF-α) and Adiponectin are both Pro and anti-inflammatory cytokines that play major roles in the pathogenesis and therapeutic management of many metabolic diseases. Aim: This study aimed at evaluating the role of TNF-α and Adiponectin amongst Insulin-Treatment Failure and insulin therapy success in type 2 Diabetic Mellitus subjects using enzyme-linked immunosorbent assay (ELISA). Methodology: The study was conducted at the Diabetic unit of the Cité verte hospital, Yaounde, Cameroon, between February 2023 and March 2024. A case-control study was conducted with 80 enrolled participants (41 insulin-treated patients with poor glycemic control and 39 patients with good glycemic control on insulin. The TNF-α, adiponectin and glycated haemoglobin were measured on whole blood specimens using immunoassay techniques. The Graph Pad Prism 5.0 and EPI Info 7.1. software was used for the analysis of data. Results: TNF-α and Glycated haemoglobin (HbAIc) mean levels were higher in insulin-treated patients with poor glycemic control (TNF-α: 19.4 ± 8, HbAIc: 35.26 ± 11pg/ml) compared to patients with good glycemic control (TNF-α: 17.1 ± 6 pg/ml, HbAIc: 21.5 ± 5 pg/ml) with p < 0.001. The Adiponectin mean levels were lower in subjects with treatment failure (5.62 ± 4 pg/ml) compared to patients with treatment success (6.33 ± 6 pg/ml), was not statistically significant, p=0.0818. A negative correlation was observed between TNF-α and Adiponectin in subjects with treatment failure, with r=-0.03, which was not statistically significant, p=-0.08. Conclusion: The variation of TNF-alpha and Adiponectin in uncontrolled patients on insulin therapy and well-controlled patients could justify their implications in the pathogenesis of type 2 diabetes. The increased levels of TNF-α, HbAIc, combined with the low levels of adiponectin, could be exploited as signalisation biomarkers for monitoring Insulin treatment failure and other metabolic dysregulation and inflammation.