RT Journal
A1 Dovio A, Angeli A
T1 CYtokines and type 2 diabetes mellitus
JF JAMA
JO JAMA
YR 2001
FD November 14
VO 286
IS 18
SP 2233
OP 2233
DO 10.1001/jama.286.18.2233
UL http://dx.doi.org/10.1001/jama.286.18.2233
AB 
To the Editor: Dr Pradhan and colleagues1 found that elevated levels of interleukin 6 (IL-6)
					were associated with the risk of developing type 2 diabetes mellitus in a
					large cohort of apparently healthy middle-aged women. Their data are consistent
					with the results of others.2- 3
					According to Pradhan et al, type 2 diabetes mellitus may be a manifestation
					of a long lasting and ongoing cytokine-mediated acute phase response involving
					IL-6. However, the mechanisms of the diabetogenic action of IL-6 are far from
					clear. Modulation of insulin secretion by IL-6 does not seem to be a major
					factor; on the other hand, there is recent evidence that IL-6 may produce
					insulin resistance.2- 3 Cytokines
					can exert their effects either directly or indirectly, although a direct effect
					of IL-6 on the insulin–receptor transduction pathway has not been demonstrated.
					Indirect effects on insulin resistance have been attributed to the stimulatory
					action of IL-6 on the hypothalamic-pituitary-adrenal axis, hence to induction
					of a hypercortisolemic state.3 In fact,
					hypercortisolism leads to insulin resistance in a number of conditions.