Serum Tnfα Levels Are Inversely Associated With Insulin Sensitivity in Diabetic Retinopathy Patients

Abstract

background: Diabetic retinopathy is the most important microvascular complication of diabetes mellitus and the inflammation have potent role in the pathogenesis and development of the disease .Tumor necrosis factor alpha is a prominent proinflammatory cytokine that mediated in all inflammatory process so it has unwanted role in diabetic complication, retina inflammation and endothelia disturbance. So the prediction of the TNFα role in the retinopathy will help to find the major treatment approach.Objective: this study conducted to evaluate the effect of TNFα in diabetic retinopathy and to find the association between TNFα and insulin sensitivity.Material & method: this study involved 120 persons were 40 healthy control subjects and 80 diabetic patients which divided into 40 type2 diabetic patients with retinopathy and 40 type2 diabetic patients without retinopathy .The serum level of TNFα ,insulin and lipid profile was measured for all patients and controls and used the SPSS program for the statistic calculation.Results: The serum level of TNFα was significantly higher in diabetic retinopathy patients in comparison to diabetic only patients and control subjects. Also there was negative correlation between TNFα and insulin sensitivity, the lipid profile was significantly higher in diabetic patient compared to control subject and the LDL cholesterol was significantly high in diabetic retinopathy patients in comparison to diabetic only and control subjects.Discussion: The inflammation play prominent role in the development of diabetic complication. TNFα is the most important inflammatory marker that present in the serum of diabetic patients. The TNFα affect mainly on the glucose and lipid metabolism and it worsen the insulin resistance and it correlate inversely with insulin sensitivity and due to this effect it will lead to develop of diabetic complication.Conclusion: The serum TNFα level was elevated in type2 diabetic patients and it may have role in developed the complication of diabetes and it was inversely correlated with insulin sensitivity.