Vol.:(0123456789) 1 3
Clinical and Experimental Medicine
https://doi.org/10.1007/s10238-018-0495-4
ORIGINAL ARTICLE
Reduced mitochondrial DNA content in lymphocytes is associated
with insulin resistance and infammation in patients with impaired
fasting glucose
Mohamad Hafzi Abu Bakar
1
· Nany Hairunisa
2
· Hasniza Zaman Huri
2,3
Received: 27 April 2017 / Accepted: 9 March 2018
© Springer International Publishing AG, part of Springer Nature 2018
Abstract
Altered mitochondrial DNA (mtDNA) is the most common denominator to numerous metabolic diseases. The present study
sought to investigate the correlation between mtDNA content in lymphocytes and associated clinical risk factors for impaired
fasting glucose (IFG). We included 23 healthy control and 42 IFG participants in this cross-sectional study. The measure-
ments of mtDNA content in lymphocytes and pro-infammatory markers derived from both normal and diseased individuals
were quantifed. Spearman partial correlation and multivariate statistical analyses were employed to evaluate the association
between mtDNA content and other metabolic covariates in IFG. Reduced mtDNA content was observed in the IFG group with
microvascular complications than those without complications. The IFG patients with lowest median of mtDNA content had
considerably elevated hyperglycemia, insulin resistance and infammation. The adjusted partial correlation analysis showed
that mtDNA content was positively correlated with HDL-cholesterol and IL-10 (P < 0.005 for all). Further, multiple linear
regression analyses verifed that reduced mtDNA content in lymphocytes was independently associated with HOMA-IR
(β = 0.027, P = 0.003), HbA1c (β = 0.652, P = 0.002), HDL-cholesterol (β = − 1.056, P = 0.021), IL-6 (β = 0.423, P = 0.002),
IL-10 (β = − 1.234, P = 0.043) and TNF-α (β = 0.542, P < 0.001) after adjustment for confounding factors. Our data show that
reduced mtDNA content in lymphocytes was associated with insulin resistance and infammation in individuals with IFG.
Keywords mtDNA · Lymphocytes · Impaired fasting glucose · Insulin resistance · Infammation
Introduction
Diabetes is a global healthcare problem afecting human
population worldwide. According to International Diabetes
Federation (IDF), 415 million people have been diagnosed
with diabetes in 2015 and the number is projected to reach
642 million in 2040. Of this global burden, it is estimated
that about 90% of diabetes patients are sufered from type 2
diabetes (T2D) with a greater degree of insulin resistance.
Current classifcations of individuals at risk of developing
T2D are mainly based on the established factors such as
blood fasting glucose, HbA1c, body mass index (BMI) and
age [1]. Notably, recent estimation showed that up to 70% of
individuals with prediabetes state progressively develop dia-
betes in years [2]. On account of health risks, the transitions
from the early symptoms of insulin resistance including
impaired fasting glucose (IFG) and impaired glucose toler-
ance (IGT) that precedes T2D may take several years. How-
ever, the identifcation and diagnosis of prediabetes indi-
viduals is not commonly employed in the clinical practice.
The proposed mechanisms underpinning the develop-
ment of these metabolic dysregulations are embedded in
the complex networks of genetics and environmental fac-
tors. A number of considerable reports have revealed that
impaired mitochondrial homeostasis contributes to a broad
range of T2D progressions [3]. Several defects in mitochon-
drial integrity have been found in ofspring of type 2 diabetic
patients, proving the degree of heritability [4]. Depletion of
mitochondrial (mtDNA) content in pancreatic islet [5] and
* Mohamad Hafzi Abu Bakar
mhafzi88@usm.my
1
Bioprocess Technology Division, School of Industrial
Technology, Universiti Sains Malaysia, 11800 Gelugor,
Penang, Malaysia
2
Clinical Investigation Centre, University Malaya Medical
Centre, 59100 Lembah Pantai, Kuala Lumpur, Malaysia
3
Department of Pharmacy, Faculty of Medicine, University
of Malaya, 50603 Kuala Lumpur, Malaysia