Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 246-252
DOI: https://doi.org/10.52403/ijshr.20260328
Serum TNF-α and Its Association with Glycaemic Control in Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Study
Mukul Vyas1, Bhavana Tiwari2, Rohit Manyal3, Rajeev Lohokare4
1PG Resident, Department of Biochemistry, M.G.M. Medical College, Indore, Madhya Pradesh, India.
2Assistant Professor, Department of Biochemistry, M.G.M. Medical College, Indore, Madhya Pradesh, India.
3Assistant Professor, Department of Biochemistry, M.G.M. Medical College, Indore, Madhya Pradesh, India.
4Associate Professor and Head, Department of Biochemistry, M.G.M. Medical College, Indore,
Madhya Pradesh, India.
Corresponding Author: Dr. Rajeev Lohokare
ABSTRACT
Background: Chronic low-grade inflammation is increasingly recognized as an important component of the pathophysiology of type 2 diabetes mellitus (T2DM). Tumor necrosis factor-alpha (TNF-α), a pro-inflammatory cytokine implicated in insulin resistance, may be associated with worsening glycaemic control. This study compared serum TNF-α concentrations between individuals with T2DM and healthy controls and evaluated the association between TNF-α and glycated haemoglobin (HbA1c).
Methods: This comparative case-control study included 120 participants, comprising 60 individuals with T2DM and 60 age- and sex-matched healthy controls. Clinical and biochemical parameters were recorded. HbA1c was measured by ion-exchange high-performance liquid chromatography, while serum TNF-α concentrations were determined using an enzyme-linked immunosorbent assay. TNF-α concentrations were compared between study groups and across HbA1c categories among participants with T2DM. Pearson correlation analysis was used to assess the relationship between TNF-α and HbA1c. Binary logistic regression was performed to identify variables associated with T2DM status. Receiver operating characteristic (ROC) analysis was used to evaluate the discriminatory performance of TNF-α, HbA1c, and their combined model.
Results: Serum TNF-α concentrations were significantly higher in participants with T2DM than in controls (34.8 ± 9.6 vs. 13.7 ± 4.3 pg/mL; p<0.001). Among participants with T2DM, mean TNF-α concentrations increased progressively across HbA1c categories, from 21.4 ± 4.2 pg/mL in those with HbA1c of 6.5–7.5% to 45.6 ± 8.5 pg/mL in those with HbA1c >9.5% (p<0.001). TNF-α showed a strong positive correlation with HbA1c (r=0.712; p<0.001). In logistic regression, TNF-α, HbA1c, and BMI were independently associated with T2DM status. ROC analysis demonstrated AUCs of 0.903 for TNF-α, 0.958 for HbA1c, and 0.972 for the combined model.
Conclusion: Serum TNF-α concentrations were elevated in T2DM and were positively associated with HbA1c and worsening glycaemic control. TNF-α may provide complementary information regarding inflammatory activity in T2DM; however, larger prospective and multicentre studies with independent validation are required before its clinical utility can be established.
Keywords: Type 2 diabetes mellitus; tumour necrosis factor-alpha; HbA1c; glycaemic control; inflammation; insulin resistance.