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Acute phase ketosis-prone atypical diabetes is associated with a pro-inflammatory profile: a case-control study in a sub-Saharan African population

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Abstract

Background

It is unknown whether inflammation plays a role in metabolic dysfunction on ketosis-prone diabetes (KPD). We aimed to assess the inflammatory profile in sub-Saharan African patients with KPD during the acute ketotic phase as well as during non-ketotic hyperglycemic crises.

Methods

We studied 72 patients with non-autoimmune diabetes: 23 with type 2 diabetes mellitus (T2D), and 49 with KPD, all admitted in hyperglycemic crisis (plasma glucose ≥250 mg/dl). The T2D and KPD groups were matched by sex, age, and Body Mass Index. KPD was sub-classified into new-onset ketotic phase (n = 34) or non-ketotic phase (n = 15). We measured TNF-α, MCP-1, MIP1-α, IL-8, MIP1-β, and VEGF in the serum of all participants.

Results

TNF-α and IL-8 were higher in participants with KPD compared to those with T2D (p = 0.02 TNF-α; p = 0.03 IL-8). TNF-α and IL-8 were also higher in the ketotic phase KPD group compared to the T2D group (p = 0.03 TNF-α; p < 0.001 IL-8) while MIP1-α was lower in people with ketotic phase KPD compared to their T2D counterparts (p = 0.03). MIP1-α was lower in the ketotic phase KPD group compared to the non-ketotic phase KPD group (p = 0.04). MCP-1 was lower in non-ketotic phase KPD compared to T2D (p = 0.04), and IL-8 was higher in non-ketotic phase KPD compared to T2D (p = 0.02).

Conclusions

Participants with KPD had elevated pro-inflammatory cytokines compared to their T2D counterparts. Ketotic phase KPD is associated with a different pro-inflammatory profile compared to non-ketotic phase KPD, and the inflammatory profile appears to be comparable between non-ketotic phase KPD and T2D patients.

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Acknowledgments

We are grateful to all the participants of the study.

Funding

ELY received a fellowship grant from L’ INSTITUT SERVIER and from Service of Action and Cooperation of the French embassy in Cameroon.

Author information

Authors and Affiliations

  1. Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, PO Box 87, Yaoundé, Cameroon

    Eric Lontchi-Yimagou, Babara Atogho-Tiedeu, Jean Claude Mbanya & Eugène Sobngwi

  2. Unit of Hormonal Biology, Department of Biochemistry, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), 1 avenue Claude Vellefaux, 75010, Paris, France

    Philippe Boudou & Jean-Francois Gautier

  3. Inserm UMRS 1138, Cordeliers Research Centre, University Paris-6, 75006, Paris, France

    Jean Louis Nguewa & Jean-Francois Gautier

  4. Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa

    Jean Jacques Noubiap

  5. University hospital of Birmingham, Birmingham, UK

    Vicky Kamwa

  6. National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon

    Eric Noel Djahmeni, Martine Etoa, Gaelle Lemdjo, Mesmin Yefou Dehayem, Jean Claude Mbanya & Eugène Sobngwi

  7. Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

    Marcel Azabji-Kenfack

  8. Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

    Jean Claude Mbanya & Eugène Sobngwi

Authors
  1. Eric Lontchi-Yimagou
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  2. Philippe Boudou
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  3. Jean Louis Nguewa
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  4. Jean Jacques Noubiap
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  6. Eric Noel Djahmeni
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  7. Babara Atogho-Tiedeu
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  8. Marcel Azabji-Kenfack
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  9. Martine Etoa
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  10. Gaelle Lemdjo
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  11. Mesmin Yefou Dehayem
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  12. Jean Claude Mbanya
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  13. Jean-Francois Gautier
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  14. Eugène Sobngwi
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Contributions

ELY, ES, JFG and JCM: study design and conception, data collection and analysis, and drafting of the manuscript. PB, JLN: data analysis and drafting of the manuscript. JJN, VK, END, BAT, MAK, MT, GL, MYD: data interpretation, editing and review of the manuscript. All authors read and approved of the final manuscript.

ELY, ES, JFG and JCM are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Eric Lontchi-Yimagou.

Ethics declarations

Ethics approval and consent to participate

This study was performed in accordance with the guidelines of the Helsinki Declaration and was approved by the National Ethics Committee of Cameroon. All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Lontchi-Yimagou, E., Boudou, P., Nguewa, J.L. et al. Acute phase ketosis-prone atypical diabetes is associated with a pro-inflammatory profile: a case-control study in a sub-Saharan African population. J Diabetes Metab Disord 17, 37–43 (2018). https://doi.org/10.1007/s40200-018-0336-8

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  • DOI: https://doi.org/10.1007/s40200-018-0336-8

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