Research Article
Volume 5 Issue 4 - 2021
Relationship of Serum Interleukin-6, Malondialdehyde and Cholesteryl Ester Transfer Protein in Patients with Metabolic Syndrome
Kyi Soe Tun1, Khin Win Sein2* and Thet Thet Swe3
1Assistant lecturer, Department of Biochemistry, University of Pharmacy, Mandalay, Myanmar
2Former Professor and Head of Department of Biochemistry, University of Medicine, Mandalay, Rector, University of Nursing, Mandalay, Myanmar
3Associate Professor, Department of Biochemistry, University of Medicine, Mandalay, Myanmar
*Corresponding Author: Khin Win Sein, Former Professor and Head of Department of Biochemistry, University of Medicine, Mandalay, Rector, University of Nursing, Mandalay, Myanmar.
Received: March 29, 2021; Published: March 31, 2021


Metabolic Syndrome (MetS) is a major health burden throughout the world because of its high prevalence and risk of atherosclerosis and cardiovascular disease (CVD). The present study was aimed to find out the relationship of serum Cholesteryl Ester Transfer Protein (CETP), with interleukin-6 (IL-6) and malondialdehyde (MDA) as the contributory factors to dyslipidemia in patients with Metabolic Syndrome (MetS). The cross-sectional comparative study was conducted at the Outpatient Department (OPD) of medical units in Mandalay General Hospital. The clinically diagnosed cases of metabolic syndrome (n = 40) who attended to OPD of medical unit in Mandalay General Hospital were categorized as patients with metabolic syndrome according to National Cholesterol Education Program (Adult Treatment Panel [ATP] III) (2001). An apparently healthy volunteers (n = 40) who were staffs of University of Medicine Mandalay participated as controls in this study. Serum IL-6 and serum CETP levels were determined by sandwich enzyme linked immunosorbent assay (ELISA). Serum MDA level was determined by colorimetric method based on a thiobarbituric acid reacting substances (TBARS) assay.

The mean level of serum IL-6 (30.25 21.58 pg/mL) and MDA levels (10.999.54 mmol/L) were significantly higher in MetS patients than that of controls, p < 0.0001. The serum IL-6 level was positively associated with MDA level in MetS patients (r = 0.86), p < 0.0001 and in controls (r = 0.44) p < 0.0001, respectively.

The mean serum CETP level was significantly higher in MetS patients (4.860.83 mg/mL) compared to controls (1.471.13 mg/mL), p < 0.0001. There was a strong positive correlation between IL-6 and CETP level in both controls (r = 0.73) p < 0.0001 and MetS patients (r = 0.62) (p < 0.0001).

The present study indicated that serum IL-6, MDA and CETP levels were found to be higher in patients with MetS than in controls. The inflammatory cytokine especially IL-6 and oxidative stress marker, MDA was positively associated with serum CETP considered as a marker for dyslipidemia in MetS as the high CETP level may reflect reduced HDL-C and reduced LDL particle.

In conclusion, present data indicated that the release of inflammatory cytokine especially IL-6 and oxidative stress marker, MDA were found to be associated with serum CETP contributing to dyslipidemia as one of the components of MetS. However, these markers could not be considered as contributory factor to metabolic syndrome (MetS).

Keywords: Cardiovascular Disease (CVD); Cholesteryl Ester Transfer Protein (CETP); Interleukin-6 (IL-6); Malondialdehyde (MDA); Outpatient Department (OPD); Adult Treatment Panel (ATP); Enzyme Linked Immunosorbent Assay (ELISA); Thiobarbituric Acid Reacting Substances (TBARS); Metabolic Syndrome (MetS)


  1. Ford ES. “Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S”. Diabetes Care11 (2005): 2745-2749.
  2. Tint Swe Latt., et al. “Prevalence of the metabolic syndrome among adults in four townships of Yangon Division”. Myanmar Health Research Congress, Ministry of Health, Union of Myanmar (2004).
  3. Alberti KG., et al. “Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity”. Circulation16 (2009): 1640-1645.
  4. Lakka HM., et al. “The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men”. The Journal of the American Medical Association21 (2002): 2709-2716.
  5. Furukawa S., et al. “Increased oxidative stress in obesity and its impact on metabolic syndrome”. Journal of Clinical Investigation12 (2004): 1752-1761.
  6. Sarbijani HM., et al. “The association between Metabolic Syndrome and serum levels of lipid peroxidation and interleukin-6 in Gorgan”. Diabetes and Metabolic Syndrome1 (2016): S86-S89.
  7. Kolovou GD., et al. “Pathophysiology of dyslipidaemia in the metabolic syndrome”. Postgraduate Medical Journal956 (2005): 358-366.
  8. Tilg H and Moschen AR. “Inflammatory Mechanisms in the Regulation of Insulin Resistance”. Molecular Medicine 14 (2008): 222-231.
  9. Grundy SM. “Metabolic syndrome pandemic”. Arteriosclerosis, Thrombosis, and Vascular Biology4 (2008): 629-636.
  10. Bao P., et al. “Association between IL-6 and related risk factors of metabolic syndrome and cardiovascular disease in young rats”. International Journal of Clinical and Experimental Medicine8 (2015): 13491-13499.
  11. Laishram V., et al. “Interleukin-6 in obese type II diabetes with hypertension”. International Journal of Research in Medical Sciences 4 (2016): 896-901.
  12. Sandhofer A., et al. “Cholesteryl Ester Transfer Protein in Metabolic Syndrome”. Obesity 14 (2006): 812-818.
  13. Goldberg AS and Hegele RA. “Cholesteryl ester transfer protein inhibitors for dyslipidemia: focus on dalcetrapib”. Drug Design, Development and Therapy 6 (2012): 251-259.
  14. Muñoz Contreras AM., et al. “An approach to the etiology of metabolic syndrome”. Colombia Médica1 (2013): 57-63.
  15. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. “Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)”. The Journal of the American Medical Association19 (2001): 2486-2497.
  16. Alberti KG., et al. “IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition”. Lancet9491 (2005): 1059-1062.
  17. Mancia G., et al. “2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)”. Journal of Hypertension7 (2013): 1281-1357.
  18. Esterbauer H and Cheeseman KH. “Determination of aldehydic lipid peroxidation products: Malonaldehyde and 4-hydroxynonenal, Methods in Enzymology, Academic Press 186 (1990): 407-421.
  19. Mohammadi M., et al. “Clinical Significance of Serum IL-6 and TNF-α Levels in Patients with Metabolic Syndrome”. Reports of Biochemistry and Molecular Biology1 (2017): 74-79.
  20. Korita I., et al. “Inflammation Markers in Patients with Cardiovascular Disease and Metabolic Syndrome”. Journal of Medical Biochemistry3 (2013): 214-219.
  21. Hu FB., et al. “Inflammatory markers and risk of developing type 2 diabetes in women”. Diabetes3 (2004): 693-700.
  22. Kitsios K., et al. “Interleukin-6, Tumour Necrosis Factor alpha and Metabolic Disorders in Youth”. Journal of Endocrinology and Metabolism, North America3 (2012): 120-127.
  23. Myo Thet Oo. “Effect of meditation on serum lipid profile and malondialdehyde level in apparently healthy individuals. 2007; M.Med.Sc (Biochemistry) Thesis, University of Medicine, Mandalay (2007).
  24. Khin Moe Moe Nwe’ Oxidative Stress Marker and Antioxidant Vitamins in Patients with Chronic Renal Failure and in Normal Individuals”. M.Med.Sc (Biochemistry) Thesis, University of Medicine, Mandalay (2009).
  25. May Pyone Kyaw. “Effects of Antioxidant Vitamins on Age Related Changes in Markers of Oxidative Stress in Apparently Healthy Elderly Individuals”. PhD (Biochemistry) Thesis, University of Medicine (2), Yangon (2005).
  26. Saw Malar Win. “Oxidative stress Marker and Antioxidant Vitamins in Patients with Falciparum Malaria”. M.Med.Sc (Biochemistry) Thesis, University of Medicine, Mandalay (2008).
  27. Gopal N., et al. “Serum Gamma Glutamyl Transferase Levels in Obese South India adults with reference to atherogenic lipid risk factors and lipid peroxides”. International Journal of Medical and Health Sciences 1 (2012): 2277-4505.
  28. Yesilbursa D., et al. “Lipid peroxides in obese patients and effects of weight loss with orlistat on lipid peroxides levels”. International Journal of Obesity 29 (2004): 142-145.
  29. Kiran B Sai Ravi., et al. “Total Antioxidant Status and Oxidative Stress in Diabetes Mellitus and Metabolic Syndrome”. International Journal of Pharmaceutical Sciences Review and Research 40 (2016): 271-277.
  30. Bitla AR., et al. “Antioxidant status in patients with metabolic syndrome as measured by ferric reducing ability of plasma (FRAP) assay”. The Journal of Clinical and Scientific Research 3 (2012): 114-120.
  31. Hamma SA., et al. “Oxidative Stress in Algerian Adults Obesity”. Journal of Metabolic Syndrome 4 (2015): 188.
  32. Win Kyaw Thu. “Cholesterol Ester Transfer Protein Level in Normolipidemic and Hyperlipidemic Subjects”. M.Med.Sc (Biochemistry) Thesis, University of Medicine, Mandalay (2015).
  33. Ebenbichler CF., et al. “Relationship between cholesteryl ester transfer protein and atherogenic lipoprotein profile in morbidly obese women”. Arteriosclerosis, Thrombosis, and Vascular Biology 9 (2002): 1465-1469.
  34. Arai T., et al. “Increased plasma cholesteryl ester transfer protein in obese subjects. A possible mechanism for the reduction of serum HDL cholesterol levels in obesity”. Arteriosclerosis, Thrombosis7 (1994): 1129-1136.
  35. Austin MA., et al. “Low-density lipoprotein subclass patterns and risk of myocardial infarction”. The Journal of the American Medical Association13 (1988): 1917-1921.
  36. Le Goff W., et al. “Pharmacological modulation of cholesteryl ester transfer protein, a new therapeutic target in atherogenic dyslipidemia”. Pharmacology and Therapeutics1 (2004): 17-38.
  37. Chen SJ., et al. “Relationships between inflammation, adiponectin, and oxidative stress in metabolic syndrome”. PLoS One9 (2012): e45693.
  38. Guedes Juliano Magalhães., et al. “Association of inflammation, dyslipidemia, obesity and physical activity status in children”. Motriz: Revista de Educação Física2 (2016): 18-26.
Citation: Khin Win Sein., et al. “Relationship of Serum Interleukin-6, Malondialdehyde and Cholesteryl Ester Transfer Protein in Patients with Metabolic Syndrome”. EC Diabetes and Metabolic Research 5.4 (2021): 71-81.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 21, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.