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Some Parameters of Inflammation & Oxidative Stress in Relation to the Risk of Type 2 Diabetes Mellitus

Author: Abdul Kareem H. Issa
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2010 Volume: 9 Issue: 1 Pages: 25-30
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background Many clinical trials have indicated that lifestyle modification can delay or prevent the progression to type 2 diabetes in people with impaired glucose tolerance test (IGT). Detection of IGT requires a test which is inconvenient to screen for this condition in clinical practice or in the general population. Therefore, there is a need to search for additional significant risk factors for type 2 diabetes. Patients &methods Seventy two adults ≥ 40 years old (36 males and 36 females) were evaluated in this study. They were subjects who performed a brief 75-grams oral glucose tolerance test and were classified as having normal glucose tolerance (NGT group; 24 subjects), impaired glucose tolerance (IGT group; 24 subjects), or diabetes mellitus (DM group; 24 patients).In addition to hematocrit (PCV) and erythrocyte sedimentation rate (ESR), serum level of highly sensitive C-reactive protein (hsCRP) was measured. Also the serum levels of thiobarbituric acid-reactive substances (TBARS), iron, copper and ferric reducing ability of plasma (FRAP) were estimated in addition to erythrocyte glutathione (Ery-GSH) level. Results Both IGT group and DM group have a significantly high hsCRP mean level (2.59 ± 1.03 and 2.89 ± 0.90 respectively vs. 1.57 ± 1.40 mg /L in NGT group, P< 0.001), and a significantly decreased FRAP level (939.2 ± 157.4 and 961.5 ± 125.1 respectively vs. 1063 ± 104.5 µmole/L in NGT group, p< 0.01 ) as well as a significantly high TBARS and a significantly low Ery-GSH level in comparison with NGT group. The positive correlation between hsCRP and TBARS, although was statistically not significant, showed a step-wise increment from NGT, to IGT and to DM group (r = 0.01, 0.14 and 0.23 respectively). Conclusions IGT is associated with a state of low-grade inflammation and oxidative stress. Serum levels of hsCRP as a marker of inflammation and TBARS as a marker of oxidative stress may serve for identifying people at high risk for developing type 2 diabetes. Such people will be important targets for programs that are designed to prevent diabetes.


Article
Relationship between microalbuminuria and glycosylated hemoglobin, and some biomarkers of oxidative stress in type 2 diabetes mellitus

Authors: Hawazin Yousuf Khalaf --- Abdulkareem H. Issa --- Abbas M. Rahmah
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2015 Volume: 28 Issue: 2 Pages: 85-93
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Diabetic nephropathy is a common chronic complication in type 2 diabetes mellitus (T2DM) at the time of diagnosis or later on and to progress with longer duration of the disease. Microalbuminuria (MIC) heralds diabetic nephropathy and precedes proteinuria and is an important risk factor for cardiovascular disease (CVD).Once proteinuria develops after microalbuminuria, progression to end-stage kidney disease occurs rapidly over ~5 years.Objective: To identify the relative importance of glycemic control status and some oxidative stress markers in the discrimination between patients with and without MIC so that the more important ones may be a priority targets in the prevention or treatment of diabetic nephropathy.Subjects and methods: One hundred female T2DM patients and 50 apparently healthy aged-matched women as a control group were enrolled in the study. Diabetic patients comprised two groups; group A: DM patients without MIC; group B: DM with MIC. For each study subject, clinical characteristics were recorded and the following parameters were measured: Urinary Albumin: Creatinine ratio (A:C ratio), and serum levels of fasting glucose , HbA1C, uric acid, thiobarbituric acid-reactive substances (TBARS), and α-tocopherol.Results: Group B patients were found to have a significantly higher mean value of BMI, blood pressure, and longer duration of disease. The mean ratio of HbA1C of group B was significantly higher than in group A (8.7 ± 1.4% vs. 7.1 ± 1%, P < 0.001). On comparison of oxidative stress markers then group B had higher serum TBARS (8±1 vs. 5.9±1 µmol/L, P<0.001), and uric acid (5.8±1vs. 4.9±1.1 mg/dl, P<0.001) than in group A but the two groups showed no significant difference in α-tocopherol. The results revealed that there is a high significant positive correlation between serum TBARS levels and uric acid levels in group B (r = 0.565, p <0.001), while it showed a statistically significant negative correlation between TBARS levels and α-tocopherol levels (r = - 0.837, p<0.001).Receiver operator characteristic (ROC) curve was used to discriminate between group B and A. The area under the curve was highest for serum TBARS (ROC area =0.909) followed by HbA1C (0.814) and their diagnostic accuracy were 85% and 77% respectively.Conclusion: Poor glycemic control and oxidative stress are interrelated states that characterize T2DM patients. Among study analytes, serum levels of TBARS and HbA1c have the highest relative importance in discrimination between patients with and without MIC so that may be, in sequence, a priority targets in the prevention and treatment of diabetic nephropathy.

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