Epidemiologic studies conducted in areas with a high prevalence of DM (e.g., West Virginia, USA) (21) have shown that serum TNF-α, IL-6, and isoprostanes (IsoPs) levels are significantly elevated in patients with early-stage DCM, whereas bilirubin (Bil) concentrations are decreased. This evidence concerns the gene IL6 and familial dilated cardiomyopathy.