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Title: EFFECT OF OBESITY AND ASSOCIATED DISORDERS LIKE DIABETES, DYSLIPIDEMIA & HYPERTENSION ON LEVELS OF SERUM COMPLEMENT COMPONENT C3 IN INDIAN ETHNIC POPULATION

Authors: Ms. Bhavita Patel, Dr. Dilip Taviad, Mr . Brahmareddy Malapati , Dr. Rita Shah

Topic: Medicine

Abstract:

Background : Obesity is a well  recognised  as a state of chronic low grade inflammation and  the main source of complement factors is the adipose tissue which is associated with Insulin Resistance, altered glucose and lipid metabolism , all of which promote the development of metabolic & cardiovascular disorders. Objective: Till date no study has been conducted in Indian ethnic population exploring the relationship of serum complement C3 with obesity and disorders like diabetes, dylipidemia and hypertension so our objective was to study the effect obesity & associated disorders on serum C3 levels.  Material & Methods: The present study included 290 subjects (121 men & 169 women ) out of which 203 (70 %) were overweight 61 (21 %) were obese class I and 26 (9 %)  were Class II obese according to International Diabetes Federation (IDF) - Modified ATP III criteria. Biochemical parameters like Serum C3, Fasting sugar levels, serum Insulin levels and lipid profile were measured. Homeostasis model of assessment for insulin resistance (HOMA-IR) was calculated. Statistical analysis was done by Medcalc.v11.5.0.0.software. Results: Mean C3 levels in total no. patients were 148.61± 38.82 mg/dl. As BMI increased, there was significant increase in serum levels of C3. When the distribution of variables were studied in both sexes, no statistically significant differences were found for all variables except Age, BMI, blood pressure & C3 levels . Serum C3 also correlated significantly with BMI (r = 0.812, P< 0.0001), insulin resistance (r= 0.262, P <0.001), Triglyceride (r = 0.338, P < 0.001) & LDL (r= 0.431, P < 0.001). As associated disorders with obesity increased, there was significant increase in levels of C3 than only obese patients with no other associated disorders. (ANOVA, P< 0.001). Conclusion: In this study, association of serum C3 with increase in BMI was established & also relationship of C3 with Insulin levels, Insulin resistance and cardiovascular risk factors was found. Our study concluded that obesity associated with dyslipidemia, diabetes & hypertension have a significant effect in increasing the levels of serum C3 concentration.

Keywords: Inflammation, Obesity, Diabetes, Complement component 3, Insulin resistance

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    COMMENT - 1

  • Sunil Chowdary (Viewer) 17th Nov 2015 - 3:24 PM
    hi that wa very eloberative can u just enlighten do u have any status of the immune levels of these patients ? to the best of my knowledge c3 helps in ur innate immunity..does the bmi had any effect on the immune levels of these patients..with regards

  • COMMENT - 2

  • Bhavita Patel (Author) 17th Nov 2015 - 10:39 PM
    There has been a recent explosion of interest in the notion that chronic low-grade inflammation and activation of the innate immune system are closely involved in the pathogenesis of type 2 diabetes.
    Obesity results in inflammation and changes in immune system cells in adipose tissue. Adipocytes are an important source of C3 production in addition to that produced in the liver in response to interleukin-1 and in activated macrophages. It has been shown that adipose tissue produces all the factors of the alternative pathway for activation of the complement; recently, the gene expressions that code the proteins activating the complement system have been verified in human adipocytes.

    It has been suggested that the insulin resistance that occurs in the majority of obese subjects would give rise to hyperproduction of cytokines in adipose tissue, thus conditioning a low-degree chronic inflammatory response responsible for activation of the complement system. This situation would finally be responsible for the metabolic complications observed in obesity

    In the situation of insulin resistance presented in the majority of obese subjects, pro-inflammatory cytokines, especially interleukin 6 (IL6) and tumour necrosis factor alpha (TNFalpha), may play an important role in the insulin signal. These cytokines inhibit tyrosine phosphorylation of the insulin receptor substrate-1. It has been shown that the adipocytes express TNFalpha and may produce 30–40% of the circulating levels of IL6, the main regulator of C-reactive protein production in the liver. This hyperproduction of cytokines would condition a low-key chronic inflammatory response responsible for activation of the complement system, a situation that could contribute to the metabolic complications observed in obesity.

  • COMMENT - 3

  • Usha Nandini Marimuthu (Viewer) 18th Nov 2015 - 11:25 AM
    Obesity is a new world pandemic, researches on obesity and its effects are very important. The correlation found in your study is very new and informative and opens the path for new researches. Thank You

  • COMMENT - 4

  • Mr. Matin Ahmad Khan (Viewer) 18th Nov 2015 - 2:17 PM
    The relation between C3 and diabetes has been observed in men with BMI above and below the median (24.4 kg/m2),?

  • COMMENT - 5

  • Surya Narayanan Sethumadavan (Viewer) 19th Nov 2015 - 2:52 PM
    Interesting article. Thanks for posting. However, selecting 290 subjects and conducting a study, would it be representative of a population as diverse and as varied as Indian population of more than 1.3 billion people? How can you explain this? Even within India the racial and physical traits of people in northeast is very diverse from the western states or deep south. The sample size is too small and too wafer thin in my opinion.

  • COMMENT - 6

  • Bhavita Patel (Author) 19th Nov 2015 - 8:40 PM
    Hii....Usha Nandini M
    Thanks for liking my article......definately if some marker like C3 can predict diabetic complications , it will be useful to prevent early complications
    • Usha Nandini Marimuthu (Viewer) 27th Nov 2015 - 9:10 PM
      definitely.

  • COMMENT - 7

  • Bhavita Patel (Author) 19th Nov 2015 - 8:44 PM
    Hii... yes the relation between diabetes and c3 has been observed in men with BMI above and below median BMi 24.4 kg/m2 but as BMI increased correlation increased
    Thank You

  • COMMENT - 8

  • Bhavita Patel (Author) 19th Nov 2015 - 9:03 PM
    Hii... Dr. Surya Narayan..Thank You. definately this study is not representative of whole Indian ehthnic population, but this is like small pilot study,which is conducted in one part of India and small article is being published. But this study is still being continued ....and as many as diverse population is being taken from different parts of India . So as many as diverse population is being taken in this study.
    Regards
    Bhavita Patel.

  • COMMENT - 9

  • Marrie Louise Davis (Viewer) 20th Nov 2015 - 6:35 AM
    good day
    Is this study a true reflection of what is happening in India? Material & Methods sections: The present study included 290 subjects (121 men & 169 women ) out of which 203 (70 %) were overweight 61 (21 %) were obese class I and 26 (9 %) were Class II obese according to International Diabetes Federation (IDF). Looking at the amount of participants studied and the population. How effective is this research?

  • COMMENT - 10

  • Bhavita Patel (Author) 21st Nov 2015 - 9:11 PM
    Hii....This is just one part of study being analysed & published....This study is being continued yet & more than 1000 patients has being taken from diverse parts of India
    Thank You
    Regards
    Bhavita Patel

  • COMMENT - 11

  • Bhavita Patel (Author) 21st Nov 2015 - 9:11 PM
    Hii....This is just one part of study being analysed & published....This study is being continued yet & more than 1000 patients has being taken from diverse parts of India
    Thank You
    Regards
    Bhavita Patel