SCIENTIFIC-PRACTICAL JOURNAL

| укр | рус |

 

 
Home Editorial ethics For authors Current issue Archive Contacts

No5(5) 2022

Back to the issue


DOI 10.37219/2528-8253-2022-5-10
Filatova GA
Influence of glucose metabolism disorders and manifestations of dyslipidemia on the cytokine profile and peculiarities of correlation pleiades in patients with acute otitis media
Filatova Anna A.
Department of Otorhinolaryngology and Pediatric Otolaryngology
Kharkiv Academy of Postgraduate Education
Email : ane4kafilatova@ukr.net
ORCID ID: https://orcid.org/0000-0002-7480-754X

Abstract

The relevance of the study is due to the lack of data to determine the pathogenetic significance of cytokine profile specifics and correlation pleiades in patients with acute otitis media (AOM) on the background of disorders of glucose metabolism and dyslipidemia manifestations.
The aim of our research: to determine the peculiarities of cytokine profile of peripheral blood in the amount of IL-4, IL-6 and TNF-α and to investigate the correlation pleiades in patients with AOM on the basis of glucose metabolism disorders with regard to the processes of glucose formation, dyslipidemia, and bone tissue metabolism.
Materials and methods: We examined 73 patients with AOM aged 18 to 79 (29 males and 44 females), who were randomized into 4 groups.1 and 2 groups (comparison) (17 patients with acute AOM and 15 patients with AOM with paranasal sinus pathology in groups accordingly) and groups 3 and 4 (main groups) (20 patients with AOM with type 2 diabetes and 21 patients with AOM with glucose metabolism disorders accordingly). Apart from the clinical examination, all patients were tested for glucosylated hemoglobin (HbAlc), IL-4, IL-6, TNF-α and low-density lipoproteins (LDL). The pathogenetic significance of the observed changes was assessed by determining the correlations of the indices given, taking into account the previously established metabolism of bone tissue in the amount of parathormone, osteocalcin, and calcium.
Results of the study and discussion: In patients with acute otitis media with impaired glucose metabolism there was a significant (p˂0.001) increase in the pool of proinflammatory cytokines IL-6 (10.26±0.46 pkg/ml and 10.94±0.5 pkg/ml in groups 3 and 4 accordingly) and TNF-α (11.05±0.5 pkg/ml and 9.7±0.5 pkg/ml accordingly in groups 3 and 4).The increase in the level of TNF-α was 1.9 times greater in patients with type 2 diabetes and 1.7 times greater in patients with transient disorders of glucose metabolism, in relat ion to the increase in the amount of IL-6 (1.1 to 1.3 times in groups 3 and 4, respectively).The amount of antiinflammatory cytokine IL-4 was within the reference norms for the methodology used, but was consistent ly lower in patients with glucose metabolism disorders (7.27±0.2 pkg/ml and 7.79±0.2 pkg/ml in groups 3 and 4 respectively, p˂0,001).We also found a significant (p˂0,001) increase in low density lipoproteins as a manifestation of dyslipidemia in patients with AOM against the background of impaired glucose metabolism 1.8 times in group 3 patients (4,6±0,25 mmol/l) and 1.7 times in group 4 patients (4,27±0,2 mmol/l). Influence of carbohydrate metabolism disorders on formation of cytokine profile and significance of dyslipidemia in pathogenesis of AOM is confirmed by the determined authenticity of variations in glucose content, HbAlc and these indices in patients in the main groups (groups 3 and 4) and the comparison groups (groups 1 and 2) due to the absence of differences in the data between groups 1 and 2 and 3 and 4 (p˃0,05). The study of the correlat ion pleiades of the indices with the markers of bone tissue metabolism revealed the inimitability of their presence, number and strength in patients in groups 1-2 due to the lack of correlation with indicators of glucose and HbAlc, IL-6, LDL and parathormone, which may indicate that in these patients only the mucous membrane of the middle ear is involved in the process. In patients with AOM with type 2 diabetes mellitus, multiple interactions of moderate strength, both direct (glucose – TNF-α, IL-6; HbAlc – LDL, TNF-α, IL-6; parathormone – IL-6, LDL; LDL – TNF-α) and inverse (calcium – TNF-α, LDL; IL-6 – calcium, IL-4), with the effect on bone tissue metabolism
were found. In patients of group 4, the presence and strength of the interrelationships were similar to the above on the background of type 2 diabetes with a decrease in their number and a strong direct correlation of HbAlc – parathormone, IL-6; parathormone – IL-6, LDL; LDL – IL-6.
Conclusions: Blood cytokine profile in patients with acute otitis media with impaired glucose metabolism is characterized by a significant increase in the pool of proinflammatory cytokines ІL-6 and TNF-α, a decrease in the level of anti-inflammatory cytokine ІL-4 in dyslipidemia by indicators of a significant increase in LDL. Multiple interrelationships of the studied indicators in patients with AOM on the background of type 2 diabetes characterize the complex proinflammatory background with an impact on the indicators of bone tissue metabolism.
Similar interrelations on the background of transient disorders of glucose metabolism indicate their importance in the pathogenesis of a particular AOM, which is also confirmed by the validity of differences in the indicators and observed correlations in patients of groups 1-2 and 3-4. Taking into account the presence and peculiarities of the influence of any disorders of carbohydrate metabolism, including transient ones, is valuable for increasing the efficiency of diagnosis and treatment of AOM in adults.

Keywords

acute otitis media, disorders of carbohydrate metabolism, cytokines, IL-4, IL-6, TNF-α, low-density lipoproteins, dyslipidemia.


Reference

  1. American Academy of Family Physicians; American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otit is Media With Effusion. Otit is media with effusion. Pediatrics. 2004;113(5):1412-29. doi:10.1542/peds.113.5.1412.
  2. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev. 2020;16(5):442-9. doi: 10.2174/1573399815666191024085838.
  3. Bezeha MI. [Improving the efficiency of treatment of patients with acute otitis media complicated mastoiditis using modified conservative and surgical techniques] [dissertation]. Kyiv: State Inst itution «O.S. Kolomiychenko Institute of otolaryngology of National Academy of Medical Sciences of Ukraine»; 2018. 186 p. Available from: http://www.iol.com.ua/article/bezega_dis.pdf [In Ukrainian].
  4. Calle MC, Fernandez ML. Inflammation and type 2 diabetes. Diabetes Metab. 2012;38(3):183-91. doi:10.1016/j.diabet.2011.11.006.
  5. Chapman PR, Choudhary G, Singhal A. Skull Base Osteomyelitis: A Comprehensive Imaging Review. AJNR Am J Neuroradiol. 2021;42(3): 404-13. doi: 10.3174/ajnr.A7015.
  6. Chen JC, Yeh CF, Shiao AS, Tu TY. Temporal bone osteomyelitis: the relationship with malignant otitis externa, the diagnostic dilemma, and changing trends. ScientificWorldJournal. 2014;2014: 591714. doi: 10.1155/2014/591714.
  7. Cipriani C, Colangelo L, Santori R, Renella M, Mastrantonio M, Minisola S, Pepe J. The Interplay Between Bone and Glucose Metabolism. Front Endocrinol (Lausanne). 2020;11:122. doi: 10.3389 /fendo.2020.00122.
  8. Danishyar A, Ashurst JV. Acute Otitis Media. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2022 Jan 21.
  9. Federici M, Lauro R. Review article: diabetes and atherosclerosis – running on a common road. Aliment Pharmacol Ther. 2005;22 Suppl 2:11-5. doi: 10.1111/j.1365-2036.2005.02617.x.
  10. Germolec DR, Shipkowski KA, Frawley RP, Evans E. Markers of Inflammation. Methods Mol Biol. 2018;1803:57-79. doi:10.1007/978-1-4939-8549-4_5.
  11. Hadi HA, Suwaidi JA. Endothelial dysfunction in diabetes mellitus. Vasc Health Risk Manag. 2007; 3(6):853-76.
  12. He J, Dai P, Liu L, Yang Y, Liu X, Li Y, Liao Z. The effect of short-term intensive insulin therapy on inflammatory cytokines in patients with newly diagnosed type 2 diabetes. J Diabetes. 2022;14(3): 192-204. doi: 10.1111/1753-0407.13250.
  13. Hutz MJ, Moore DM, Hotaling AJ. Neurological Complications of Acute and Chronic Otitis Media. Curr Neurol Neurosci Rep.2018;18(3):11. doi: 10.1007/s11910-018-0817-7.
  14. Kalu SU, Ataya RS, McCormick DP, Patel JA, Revai K, Chonmaitree T. Clinical spectrum of acute otitis media complicating upper respiratory tract viral infection. Pediatr Infect Dis J. 2011; 30(2):95-9. doi: 10.1097/INF.0b013e3181f253d5.
  15. Kasperk C, Georgescu C, Nawroth P. Diabetes Mellitus and Bone Metabolism. Exp Clin Endocrinol Diabetes. 2017;125(4):213-7. doi: 10.1055/s-0042-123036.
  16. Kosakovsky AL, Yurochko FB. [Modern tactics in acute otitis media in children]. Ukraïnskyĭ medychnyĭ chasopys. 2013;5(97):61-4. [Article in Ukrainian].
  17. Krivopalov AA, Fanta IV. [Acute otitis media: epidemiology, classification, etiology and treatment]. Medical Council. 2016;(4):53-5. https://doi.org/10.21518/2079-701X-2016-4-53-55 [Article in Russian].
  18. Kuschen R, Fransis N.A. Antibiotic use and severe complications after acute otitis media and acute sinusitis: a retrospective cohort study. Br J Gen Pract. 2020;70(693):e255-e263. doi: 10.3399/bjgp20X708821.
  19. Laulajainen Hongisto A, Jero J, Markkola A, Saat R, Aarnisalo AA. Severe Acute Otitis Media and Acute Mastoiditis in Adults. J Int Adv Otol. 2016; 12(3):224-30. doi: 10.5152/iao.2016.2620.
  20. Leskinen K, Jero J. Acute complications of otit is media in adults. Clin Otolaryngol. 2005;30(6):511-6. doi:10.1111/j.1749-4486.2005.01085.x.
  21. Mills R, Hathorn I. Aetiology and pathology of otitis media with effusion in adult life. J Laryngol Otol. 2016;130(5):418-24. doi: 10.1017/S0022215116000943.
  22. Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, Grasso D, Barbiero C, Tamburlini G. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7(4):e36226. doi:10.1371/journal.pone.0036226.
  23. Peled C, Sadeh R, El-Saied S, Novack V, Kaplan DM. Diabetes and glycemic control in necrotizing otitis externa (NOE). Eur Arch Otorhinolaryngol. 2022;279(3):1269-75. doi: 10.1007/s00405-021-06772-y.
  24. Pichichero ME. Acute otitis media. Pediatr Clin North Am. 2013;60(2):391-407. doi: 10.1016/j.pcl.2012.12.007.
  25. Pochuieva TV, Filatova GA. [Peculiarities of bone tissue metabolism in patients with acute otitis media with impared carbonhydrate metabolism]. Otolaryngology. 2022;5(3-4):1-13. [Article in Ukrainian]
  26. Pochuieva TV, Filatova GA, Filatova IV, Iyevleva VI. [Pathogenetic significance of hyperglycemia in the format ion of the course peculiarities of acute otitis media and its complicat ions]. Meždunarodnyj medicinskij žurnal. 2022;4:71-9. [Article in Ukrainian].
  27. Pochuieva TV, Filatova IV, Miroshnichenko OS, Filatova GA. [Clinical portrait of a patient with type 2 diabetes mellitus as the basis for the specific course of acute otitis media]. Otolaryngology. 2021;4(6):14-25. [Article in Ukrainian].
  28. Pochuiеva T, Filatova A, Filatova I. Features of the clinical course of acute otitis media in patients with impaired carbohydrate metabolism. EUREKA: Health Sciences. 2022;(1):17-29. https://doi.org/10.21303/2504-5679.2022.002280.
  29. Poznyak A, Grechko AV, Poggio P, Myasoedova VA, Alfieri V, Orekhov AN. The Diabetes Melltus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int J Mol Sci. 2020;21(5):1835. doi:10.3390/ijms21051835.
  30. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media – prevention and treatment. Infect Drug Resist. 2014;7:15-24. doi: 10.2147/IDR.S39637.
  31. Ramakrishnan K, Sparks RA, Berryhill WE. Diagnosis and treatment of otitis media. Am Fam Physician. 2007;76(11):1650-8. Erratum in: Am Fam Physician. 2008;78(1):30.
  32. Rijk MH, Hullegie S, Schilder AGM, Kortekaas MF, Damoiseaux RAMJ, Verheij TJM, Venekamp RP. Incidence and management of acute otitis media in adults: a primary care-based cohort study. Fam Pract. 2021;38(4):448-53. doi:10.1093/ fampra/cmaa150.
  33. Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113(10): 1645-57. doi:10.1097/00005537-200310000-00004.
  34. Seppanen EJ, Thornton RB, Corscadden KJ, Granland CM, Hibbert J, Fuery A, Wiertsema SP, Vijayasekaran S, Coates HL, Jacoby P, Currie A, Richmond PC, Kirkham LS. High concentrations of middle ear antimicrobial peptides and proteins and proinflammatory cytokines are associated with detection of middle ear pathogens in children with recurrent acute otitis media. PLoS One. 2019;14(12):e0227080. doi: 10.1371/journal.pone. 0227080.
  35. Shanbhogue VV, Mitchell DM, Rosen CJ, Bouxsein ML. Type 2 diabetes and the skeleton: new insights into sweet bones. Lancet Diabetes Endocrinol. 2016;4(2):159-73. doi: 10.1016/S2213-8587(15)00283-1.
  36. Skotnicka B, Hassmann E. Proinflammatory and immunoregulatory cytokines in the middle ear effusions. Int J Pediatr Otorhinolaryngol. 2008;72(1): 13-7. doi: 10.1016/j.ijporl.2007.09.005.
  37. Smith A, Gutteridge I, Elliott D, Cronin M. Acute otitis media associated bilateral sudden hearing loss: case report and literature review. J Laryngol Otol. 2017;131(S2):S57-S61. doi: 10.1017/S0022215117000779.
  38. Sokołowski J, Lachowska M, Karchier E, Bartoszewicz R, Niemczyk K. Skull base osteomyelitis: factors implicating clinical outcome. Acta Neurol Belg. 2019;119(3):431-7. doi: 10.1007/s13760-019-01110-w.
  39. Tanninex E. [Peculiarities of the clinical course of acute mastoiditis]. Journal of Ear, Nose and Throat Diseases. 2003;(2):86-8. [Article in Ukrainian].
  40. Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev. 2015;2015(6):CD000219. doi: 10.1002/14651858.CD000219.pub4.
 

© 2019, Public Organization «Ukrainian Scientific Medical Society of Otorhinolaryngologists»