Stress, inflammatory markers and factors associated in patients with type 2 diabetes mellitus

Stress is evaluated using tumour necrosis factor‐ α (TNF‐ α ), Heat Shock Protein 60 (Hsp60) and other markers in chronic diseases. We examined the association of Hsp60, cortisol, TNF‐ α and interleukin‐6 (IL‐6) serum levels with psychological and socio‐economic factors in patients with type 2 diabetes mellitus (DM‐2). We studied 151 DM‐2 patients in groups with < 1 year and > 5 years since diagnosis. Clinical data, family income and questionnaires of anxiety, depression, perceived stress, social support, glucose, glycated haemoglobin, lipids, Hsp60, cortisol, IL‐6 and TNF‐ α were collected. Patients with > 5 years since diagnosis of DM‐2 had lower body mass index (p < 0.016), higher glucose (p < 0.005) and HbA 1c (p < 0.005) levels. The group of recent diagnosis had higher Hsp60 (p < 0.00003). Hsp60 was associated negatively with years since diagnosis (p < 0.000012), and positively with glucose (p < 0.029). Cortisol was positively associated with glucose levels (p < 0.019) and family income (p < 0.037). TNF‐ α was associated with years since diagnosis (p < 0.004) and perceived stress (p < 0.018). At early stages of DM‐2, Hsp60 increases with glucose levels, cortisol is associated with glucose levels. At later stages TNF‐ α increases, associated with perceived stress. Copyright © 2007 John Wiley & Sons, Ltd.