Monocyte chemoattractant protein-1 in patients with different types of diabetes mellitus: clinical and practical significance

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Abstract
Background. Monocyte chemoattractant protein-1 (MCP-1) plays a crucial role in inflammatory processes by recruiting monocytes and macrophages to sites of inflammation. Inflammation is closely linked to poor control of diabetes mellitus (DM), characterized by significant glycemic fluctuations and prolonged hyperglycemia, as well as subclinical, low-grade inflammation of adipose tissue in type 2 DM. Elevated levels of MCP-1 have been associated with both type 1 and type 2 DM; however, data on its role in the pathogenesis of latent autoimmune diabetes in adults (LADA) are extremely limited. Aim. To evaluate MCP-1 levels and their association with glycemic control parameters in patients with different types of DM (type 1 DM, type 2 DM, and LADA). Materials and methods. Between February and November 2023, 80 individuals participated in the study, divided into four groups: patients with type 1 DM (n = 22), type 2 DM (n = 22), LADA (n = 14), and healthy volunteers (n = 22). The median ages were 26 years [21; 32] for type 1 DM, 41 years [33; 51] for type 2 DM, 41 years [33; 46] for LADA, and 33 years [26; 40] for healthy controls. Inclusion criteria were age between 18 and 55 years, body mass index up to 35 kg/m², and a diagnosis of one of the specified forms of DM. Exclusion criteria included other systemic autoimmune diseases, pancreatic diseases, and the use of immunosuppressive therapy. Results. MCP-1 levels were significantly higher in patients with type 1 DM (213 [162; 263] pg/ml) and type 2 DM (228 [168; 294] pg/ml) compared to healthy volunteers (174 [151; 207] pg/ml; p 0.05). Patients with LADA showed a non-significant trend toward elevated MCP-1 levels (218.51 [160; 268] pg/ml; p 0.05). ROC analysis indicated that MCP-1 is not suitable as an additional marker for the differential diagnosis of LADA. Conclusion. Elevated MCP-1 levels in patients with type 1 and type 2 DM suggest its possible involvement in the pathogenesis of these diabetes types. The lack of significant MCP-1 elevation in patients with LADA limits its utility as a diagnostic marker for this condition.

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