Could glycated hemoglobin be considered a marker of inflammation in patients with diabetes mellitus?
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Abstract
La fisiopatología de la diabetes incluye la persistencia de un estado inflamatorio de bajo grado caracterizado por el incremento de citocinas proinflamatorias, proteínas de fase aguda y alteraciones en la respuesta inmunitaria que conllevan al desarrollo de complicaciones macrovasculares y microvasculares. Los mecanismos involucrados en la activación del estado inflamatorio no están totalmente esclarecidos, pero se sabe que la hiperglucemia juega un rol determinante. La hemoglobina glicada es en la actualidad el marcador biológico por excelencia utilizado para evaluar la evolución de los niveles de glucemia en los pacientes diabéticos debido a su formación irreversible y acumulativa, proporcionando información retrospectiva sobre el equilibrio glucémico durante dos a tres meses anteriores a su medición. Sin embargo, poco se conoce sobre su asociación con la respuesta inflamatoria en estos pacientes. El objetivo de esta investigación es recopilar evidencias que permitan establecer una asociación entre los niveles de HbA1c y el estado inflamatorio en pacientes con diabetes mellitus, lo que permitiría considerar a la HbA1c no sólo como una medida fiable para evaluar el control glucémico retrospectivo. Sino además, como un biomarcador asociado al estado inflamatorio y por consiguiente al riesgo de desarrollar complicaciones propias de esta enfermedad.
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