Increased Circulating Interleukin Concentrations in Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Abstract

This work aimed to quantitatively evaluate circulating interleukin concentration data available for patients with Type 2 diabetes. We performed a systematic review using PubMed, Web of Science, and the Cochrane Library. Original studies reporting data on circulating interleukin concentrations in at least one group of patients with Type 2 diabetes (obese Type 2 diabetes [OBD], overweight Type 2 diabetes [OWD], or lean Type 2 diabetes [LD]) and healthy weight controls (HWCs) were included. Data were extracted from 43 included studies uniquely encompassing 2646 patients with Type 2 diabetes and 6605 HWCs by independent investigators. We used a random-effects model to pool data in the Comprehensive Meta-Analysis Version 2 software. Effect sizes (ESs) were calculated as the standardized mean difference in interleukin concentrations between groups and then transformed into Hedge's g statistic. Our results revealed higher circulating concentrations in patients with Type 2 diabetes compared with HWCs, including IL-4, IL-6, IL-17, and IL-18. When stratified by BMI subgroups, all patients with Type 2 diabetes displayed elevated IL-6 concentrations compared with HWCs, with OBD patients having the highest ES, followed by OWD and LD. Similar to the overall results, higher interleukin concentrations in different BMI subgroups of patients with Type 2 diabetes were observed compared with HWCs in IL-4 (OWD), IL-17 (LD), and IL-18 (OBD, but not OWD). Meta-analysis outcomes demonstrated higher circulating concentrations of IL-4, IL-6, IL-17, and IL-18 in patients with Type 2 diabetes, strengthening the clinical evidence that Type 2 diabetes is accompanied by a systemic inflammatory response.