Inflammatory Response in Relationship with the Degree of Hyperglycemia and Expression of Viral Immune Products in Diabetes Mellitus Patients
Authors: Olaniyan Mathew Folaranmi , Ojediran Tolulope Busayo 
Published: December 2021

Background:
Diabetes mellitus (DM) is characterized by hyperglycemia which may cause dysfunction in immune response, which may affect the control of infectious agents. The objective of this study is therefore to determine inflammatory response in relationship with the degree of hyperglycemia and the expression of viral immune products in DM patients.

Methods:
The study population therefore included 151 DM patients (female 71; male 80; aged 43–76 years) and 100 (female 50; male 50; aged 40–76 years) apparently healthy nondiabetes control subjects. All subjects were negative to Giemsa thick blood film staining and Ziehl–Neelsen staining for acid fast bacilli. HIVP24 antigen antibody (Ag Ab), anti hepatitis C virus (HCV), and hepatitis B envelope antigen (HBeAg) were determined in the subjects by ELISA, while blood glucose was measured spectrophotometrically.

Results:
The frequency of 1.3% (2) HIVP24 Ag Ab, 4.6% (7) anti HCV, and 15.9% (24) HBeAg obtained in DM patients while a frequency 1% (1) HIVP24 Ag Ab. 6% (6) anti HCV, and 6% (6) HBeAg was obtained in non DM control subjects. There was an association between the expression of HIVP24 Ag Ab and DM considering the odds ratio (OR) of 1.329. There was no association between the expression of anti HCV and DM considering the OR of 0.7616 (OR 0.05). However, there was a significant association between the expression of HBeAg and DM considering the OR of 2.961 (OR >1.0; P< 0.05). Overall, 21.9% (33) of the DM expressed viral immune products; HBeAg was the most prevalent immune product in DM patients. There was a significantly higher plasma tumor necrosis factor alpha (TNFα) in DM patients with viral immune products than the results obtained in non DM without viral immune products(P < 0.05). There was a significantly higher difference in the value of TNFα in the degree of hyperglycemia of fasting blood glucose of 251–300 mg/dl compared with 201–250 mg/dl; 301–350 mg/dl compared with 201–250 mg/dl; 351–400 mg/dl compared with 201–250 mg/dl; 351–400 mg/dl compared with 251–300 mg/dl; 251–300 mg/dl compared with nondiabetic control; 301–350 mg/dl compared with nondiabetic control; and 351–400 mg/dl compared with nondiabetic control (P < 0.05). There was a significantly higher difference in the value of fasting blood glucose in the degree of hyperglycemia of fasting blood glucose of 301–350 mg/dl compared with 201–250 mg/dl; 351–400 mg/dl compared with 201–250 mg/dl; 201–250 mg/dl compared with nondiabetic control; 251–300 mg/dl compared with nondiabetic control; 301–350 mg/dl compared with nondiabetic control; and 351–400 mg/dl compared with nondiabetic control (P < 0.05).

Conclusions:
There was a significant increase in TNFα in diabetes patients, which increases as the degree of hyperglycemia increases and higher in diabetes patients who expressed viral immune product as there was a significant association between the expression of viral immune products, especially HBeAg and DM; hence, there was a significant relationship between inflammatory response, the degree of hyperglycemia, and the expression of viral immune products in DM patients.