Increased central adiposity may not underlie the marked elevation of IL-6 in Diabetes Mellitus patients in South-West Nigeria

Background: Chronic inflammation is linked to disorders of obesity, insulin resistance and DM2. This reflects as increase in proinflammatory cytokines including IL-6. In Nigeria, there is no study that has measured IL-6 in diabetics, in spite of having the highest number of diabetics in Africa. Methods: The twenty-eight DM2 patients and 13 controls recruited for this study had their BP, BMI, waist circumference (WC) and waist-hip-ratio (WHR) measured. They also had fasting plasma IL-6, fasting plasma glucose, total cholesterol (TC), Triglyceride (Tg), high density lipoprotein cholesterol (HDL-C), urea, creatinine, aspartate transaminases (AST), alanine transferases (ALT), total protein (TP) and albumin determined. Results: Mean age was 51.83 years ± 13.28, with diabetics significantly older than controls (56.61yrs. ±9.62 vs. 41.54 years ± 14.53) P < 0.05. The mean IL-6 in diabetics (194.77pg/ml ± 166.16) was significantly higher than controls’ (26.29pg/ml ± 6.65) at p < 0.01. No significant difference in mean BMI in diabetics and controls. But WC and WHR of diabetics (100.75cm ± 18.47; 1.01 ± 0.14) were significant higher than in controls (88.77cm ± 13.36; 0.88 ± 0.07) at p < 0.05 (WC; p value 0.043) and p < 0.01(WHR; p value 0.002). Among diabetics, there were significant correlations between IL-6 and Tg (p<0.01, r = 0.007**), IL-6 and LDL-C (p<0.05, r = 0.028*), IL-6 and AST (p<0.05, r = 0.041*) and IL-6 and ALT (p<0.01, r = 0.004**) Conclusion: Elevated IL-6 in DM2 patients in South West Nigeria correlates with liver transaminases and not increased markers of central adiposity

First trimester sex hormone-binding globulin predicts gestational diabetes mellitus in a population of Nigerian women

There has been a steady rise in the disease burden of Gestational Diabetes Mellitus (GDM) in the sub-Saharan African region over time. Diagnostic testing for GDM is currently recommended at 24 − 28 weeks of gestation, leaving a narrow window for intervention before delivery. Hence the need for early prediction and preventive intervention. The performance of first trimester serum sex hormone-binding globulin (SHBG) assay as a predictor of GDM was determined by binary logistic regression. Women with GDM (n = 49) had a significantly lower mean first trimester SHBG level (104.7 ± 61.6 nmol/L) than did those without GDM (n = 180; 265.2 ± 141.5 nmol/L; p < .001). First trimester SHBG was significantly negatively correlated (rpb = −0.460, p value = <.001) with subsequent development of GDM and an area under receiver operator characteristics (ROC) curve of 0.874 (p < .001). A cut-off value of 158.0 nmol/L predictive of GDM had a diagnostic sensitivity of 81.5%, a specificity of 80.1%, and an overall diagnostic efficiency of 80.3%.IMPACT STATEMENT What is already known on this subject? GDM is associated with high risk of various complications and is commonly diagnosed at 24–28 weeks of gestation, leaving a narrow window for intervention. The performance of current maternal clinical and demographic risk factor-based prediction approaches is unreliable. Thus, more favourable prediction approaches need to be developed. Previous studies have suggested that SHBG, a readily assessable marker, has potential to predict GDM; however, these studies have mostly involved Caucasian and other non-African populations. What the results of this study add? SHBG may serve as a reliable first trimester screening tool for GDM development in Nigerian women with singleton pregnancies. This study demonstrates that first trimester SHBG can predict GDM development in sub-Saharan African women despite racial, ethnic and geographical differences. What are the implications of these findings for clinical practice and/or further research? Effective first trimester prediction of GDM using SHBG may enable preventive interventions, thereby mitigating the high burden of the disease in the sub-Saharan African region. It may also provide relevant information that may guide adaptation of current management guidelines to ensure effective management of GDM in the region