Evaluating the association between inflammatory markers and glycemic control status in type 2 diabetes mellitus patients: a tertiary care centre experience
Abstract
Background: Type 2 diabetes mellitus is a chronic, multifactorial metabolic disease in which systemic inflammation plays a key role in the pathogenesis of insulin resistance. This study aimed to compare serum concentrations of ferritin, hs-CRP, IL-6, TNF-α, and IFN-γ between type 2 diabetes mellitus patients and matched healthy controls, and to determine their correlation with glycated haemoglobin (HbA1c) and fasting insulin levels. Methods: A case-control study was conducted comprising 50 patients with type 2 diabetes mellitus and 50 age- and sex-matched healthy controls under fasting conditions. Serum levels of HbA1c, fasting insulin, ferritin, hs-CRP, IL-6, TNF-α, and IFN-γ were measured. Intergroup comparisons were evaluated using the Mann–Whitney U test, and correlations with HbA1c and insulin were assessed using Spearman's rank correlation. Results: Serum levels of ferritin, hs-CRP, IL-6, and TNF-α were significantly higher in type 2 diabetic patients than in healthy controls (p<0.001), whereas IFN-γ levels showed no significant intergroup difference (p=0.515). Serum ferritin demonstrated a statistically significant positive correlation with both HbA1c (rho=0.38, p=0.007) and fasting insulin (rho=0.33, p=0.021). In contrast, serum hs-CRP (rho=0.13, p=0.368 with HbA1c; rho=0.19, p=0.193 with insulin), IL-6 (rho=-0.01, p=0.952 with HbA1c; rho=-0.11, p=0.462 with insulin), TNF-α (rho=0.11, p=0.448 with HbA1c; rho=0.13, p=0.364 with insulin), and IFN-γ (rho=0.20, p=0.154 with HbA1c; rho=0.09, p=0.538 with insulin) showed no significant correlation with either HbA1c or fasting insulin levels (p>0.05). Conclusions: Chronic systemic inflammation is pronounced in type 2 diabetes mellitus. Among the evaluated inflammatory biomarkers, serum ferritin uniquely correlates with both glycemic control and circulating insulin levels, highlighting its practical clinical utility in monitoring subclinical metabolic decompensation, while acute-phase cytokines reflect tonic inflammatory activation rather than direct glycemic fluctuations.