Inflammatory, oxidative stress and anti-oxidative markers in patients with endometrial carcinoma and diabetes

Background. The role of chronic inflammation and oxidative stress in the development of diabetes and cancer has been established. In this study, we aimed to investigate inflammatory and oxidative stress markers in patients with diabetes (DM) and endometrial carcinoma (EC) separately and in combination. Methods: In a case-control study design, a total of 88 participants were enrolled including: 37 patients with EC (19 with DM and 18 without DM), 29 with type2 diabetes and 22 healthy controls. Cancer patients were sampled before treatment. Serum oxidative stress markers including: oxidized low density lipoprotein (ox-LDL,) nitric oxide (NO), advanced glycation end-products (AGEs) and advanced oxidation protein products (AOPP), malondialdehyde (MDA); ferric reducing ability of plasma (FRAP), as an antioxidant marker, and inflammatory markers including: Interleukin 6 (IL6), C reactive protein (CRP) and tumor necrosis factor alpha (TNF alpha) were measured. Results: Ox-LDL, NO, MDA, AOPP and AGE were increased in all patients either with endometrial carcinoma and/or diabetes compared to healthy controls (p < 0.05). Patients with both EC and DM had higher oxidative markers including: OX-LDL (17.47 +/- 0.84 vs. 12.36 +/- 0.91), NO (82.27 +/- 5.75 vs. 76.34 +/- 5.36), MDA (3.3 +/- 0.1 vs. 2.75 +/- 0.48) and AGE (73.89 +/- 5.71 vs. 69.02 +/- 3.14) compared to those with EC alone (rho < 0.05). Levels of FRAP was lower in patients with both diabetes and cancer, cancer alone and diabetes alone compared to healthy controls (p < 0.05). Inflammatory markers, TNF alpha, IL6 and hs-CRP, were also significantly increased in patients with EC with and without DM compared to controls (rho < 0.05). However, there were no significant differences between two groups of EC regarding to inflammatory markers (rho > 0.05). Patients with DM had significantly higher levels of inflammatory markers compared to control group (all rho < 0.05). In addition, significant subadditive interaction effect between EC and DM regarding levels of oxLDL, NO, AGE, AOPP and FRAP) was observed (p < 0.05). Conclusion: Increased levels of chronic inflammatory and oxidative stress markers were observed in both endometrial carcinoma and diabetes. Additional effect of diabetes in patients with cancer was mediated more significantly via increase in oxidative stress rather than inflammatory markers.