• Farhat Ijaz Department of Physiology, CMH Lahore Medical College
  • Rana Khurram Aftab , Assistant Professor, Department of Physiology, King Edward Medical University, Lahore
  • Syed M. Zubair Department of Physiology, King Edward Medical University, Lahore
  • Rana Rakhshan Aftab Rashid Latif Medical College, Lahore, Pakistan
Keywords: Insulin Resistance, Obesity, Type 2 Diabetes Mellitus, Tumour Necrosis Factor Alpha


Background: Obesity is a major cause of many metabolic disorders characterized by chronic inflammation that is linked with T2DM and insulin resistance. Tumour Necrosis Factor Alpha (TNF-α) is remarkably higher in obese people. The aim of this study was to determine the levels of TNF-α and its correlation with insulin resistance and body mass index in type 2 diabetic patients. Methods: This study was conducted at Diabetic Clinic of Mayo Hospital, Lahore. TNF-α levels were determined and correlated with insulin resistance and body mass index in 90 obese type 2 diabetics. TNF-α and serum insulin were determined using ELISA. Insulin resistance was calculated by HOMA-IR. Pearson correlation test was used to correlate TNF-α with Insulin Resistance and body mass index, and p≤0.05 was considered statistically significant. Results: There was a strong positive correlation of fasting insulin and HOMA-IR with TNF-α (r=0.986, p<0.001). There was also strong positive correlation of TNF-α with BMI. Conclusion: Increased inflammation in obese diabetics explains the role of TNF-α in insulin resistance caused by obesity. Weight reduction in obese individuals will help in reducing TNF-α levels and to improve insulin sensitivity in T2DM.

Pak J Physiol 2018;14(2):18–20


1. World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization Technical Report Series 894. WHO 2000. Available at: WHO_TRS_894/en/
2. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009;9:88.
3. Afzal S, Qaiser F, Saeed I, Malik K. Metabolic syndrome according to ATP3 guidelines in public sector diabetic clinic in Pakistan. Healthmed 2014;8:1207¬–13.
4. Hamada D, Maynard R, Schott E, Drinkwater CJ, Ketz JP, Kates SL, et al. Suppressive effects of insulin on tumor necrosis factor-dependent early osteoarthritic changes associated with obesity and type 2 diabetes mellitus. Arthritis Rheumatol 2016;68:1392–402.
5. Rajarajeswari D, Ramalingam K, Krishnamma M, Krishna TS. Association of TNF-α with obesity in type 2 diabetes mellitus. Int J Pharm Biol Sci 2011;2(2):352–5.
6. Popa C, Netea MG, van Riel PL, van der Meer JW, Stalenhoef AF. The role of TNF-α in chronic inflammatory conditions, intermediary metabolism and cardiovascular risk. J Lipid Res 2007;48(4):751–62.
7. Hotamisligil GS, Budavari A, Murray D, Spiegelman BM. Reduced tyrosine kinase activity of the insulin receptor in obesity-diabetes. Central role of tumor necrosis factor alpha. J Clin Invest 1994;94:1543–9.
8. Bertin E, Nguyen P, Guenounocu M, Durlach V, Potron G, Leutenegger M. Plasma levels of tumor necrosis factor-alpha (TNF-alpha) are essentially dependent on visceral fat amount in type 2 diabetic patients. Diabetes Metab 2000;26(3):178–82.
9. Bhatty SA, Aziz S, Shaikh NA, Hussain T. Insulin resistance and inflammatory markers in obesity. Pak J Med Sci 2012;28(1):101–4.
10. Kern P, Saghizadeh M, Ong J, Bosch RJ, Deem R, Simsolo RB. The expression of tumor necrosis factor in human adipose tissue. Regulation by obesity, weight loss, and relationship to lipoprotein lipase. J Clin Invest 1995;95:2111–9.
11. Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Speigelman BM. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin Invest 1995;95:2409–15.
12. Qi L, van Dam RM, Meigs JB, Manson JE, Hunter D, Hu FB. Genetic variations in IL-6 gene and type 2 diabetes: tagging-SNP haplotype analysis in large-scale case-control study and meta-analysis. Hum Mol Gene 2006;15:1914–20.
13. Dandona P, Aljada A, Bandyopadhyay A. Inflammation: The link between insulin resistance, obesity and diabetes. Trends Immunol 2004;25(1):4–7.
14. Gallagher D, Kelley DE, Yim JE, Spence N, Albu J, Boxt L, et al. Adipose tissue distribution is different in type 2 diabetes. Am J Clin Nutr 2009;89(3):807–14.
15. White MF. IRS proteins and the common path to diabetes. Am J Physiol Endocrinol Metab 2002;283(3):E413–422.
16. Katsuki A, Sumida Y, Murashima S, Murata K, Takarada Y, Ito K, et al. Serum levels of tumor necrosis factor-alpha are increased in obese patients with noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1998;83:859–62.
17. Miyazaki Y, Pipek R, Mandarino LJ, DeFronzo RA. Tumor necrosis factor-α and insulin resistance in obese type 2 diabetic patients. Int J Obes Relat Metab Disord 2003;27(1):88–94
18. Cersosimo E, Triplitt C, Mandarino LJ, DeFronzo RA. Pathogenesis of Type 2 Diabetes Mellitus. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, et al, (Eds). Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000. Available from:
19. Saghizadeh M, Ong JM, Garvey WT, Henry RR, Kern PA. The expression of TNF alpha by human muscle. Relationship to insulin resistance. J Clin Invest 1996;97:1111–6.
20. Mishima Y, Kuyama A, Tada A,Takahaslin K, Ishioka T, Kibata M. Relationship between TNF alpha and Insulin Resistance in obese men with Type 2 Diabetes Mellitus. Diabetes Res Clin Pract 2001;52(2):119–23.


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Ijaz F, Aftab R, Zubair S, Aftab R. CORRELATION OF TUMOUR NECROSIS FACTOR-α WITH OBESITY INDUCED INSULIN RESISTANCE IN TYPE 2 DIABETES MELLITUS. PJP [Internet]. 30Jun.2018 [cited 26Oct.2020];14(2):18-0. Available from:

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