scholarly journals Expression Profiling of Genes Related to Endothelial Cells Biology in Patients with Type 2 Diabetes and Patients with Prediabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Sara Moradipoor ◽  
Patimah Ismail ◽  
Ali Etemad ◽  
Wan Aliaa Wan Sulaiman ◽  
Salma Ahmadloo

Endothelial dysfunction appears to be an early sign indicating vascular damage and predicts the progression of atherosclerosis and cardiovascular disorders. Extensive clinical and experimental evidence suggests that endothelial dysfunction occurs in Type 2 Diabetes Mellitus (T2DM) and prediabetes patients. This study was carried out with an aim to appraise the expression levels in the peripheral blood of 84 genes related to endothelial cells biology in patients with diagnosed T2DM or prediabetes, trying to identify new genes whose expression might be changed under these pathological conditions. The study covered a total of 45 participants. The participants were divided into three groups: group 1, patients with T2DM; group 2, patients with prediabetes; group 3, control group. The gene expression analysis was performed using the Endothelial Cell Biology RT2Profiler PCR Array. In the case of T2DM, 59 genes were found to be upregulated, and four genes were observed to be downregulated. In prediabetes patients, increased expression was observed for 49 genes, with two downregulated genes observed. Our results indicate that diabetic and prediabetic conditions change the expression levels of genes related to endothelial cells biology and, consequently, may increase the risk for occurrence of endothelial dysfunction.

Author(s):  
SAHAR K HEGAZY ◽  
TAMER A ELBEDEWY ◽  
HAIDY M SAMI

Objective: Endothelial dysfunction is afflicted to the maturation of arteriosclerosis and type 2 diabetes mellitus (T2DM) vascular complications. This study designed to evaluate the impact of fenofibrate adjuvant therapy on endothelial dysfunction and cardiovascular risk in patients with T2DM. Methods: Seventy-five subjects were recruited from the Internal Medicine Department of Tanta University Hospital. The participants were classified into three groups: Group 1 (control group), 25 healthy subjects; Group 2, 25 T2DM patients received glimepiride/metformin (2:500 mg/day); and Group 3, 25 T2DM patients received glimepiride/metformin (2:500 mg/day)+fenofibrate (300 mg/day). Patients were assessed before and 3 months after intervention for the determination of body mass index (BMI), blood pressure, glycemic picture (hemoglobin A1C % and homeostatic model assessment of insulin resistant), lipid panel, Castelli’s risk index (CRI-I and CRI-II), albumin-to-creatinine ratio (ACR), and endothelial dysfunction biomarkers (asymmetric dimethylarginine [ADMA] and Syndecan-1 (SDC-1)]. Data were statistically analyzed by one-way analysis of variance; p<0.05 was considered statistically significant. Results: The addition of fenofibrate to oral hypoglycemic drugs (Group 3) provoked a significant decrease in all measured parameters when compared with Group 2. As compared to the control group, Group 3 showed no significant difference in most measured parameters after 3 months of therapy. For T2DM patients of Group 3, both ADMA and SDC-1 showed a significant positive correlation with all measured parameters except for high-density lipoprotein cholesterol which exhibited significant negative correlation after 3 months of therapy (p<0.05). Conclusion: The addition of fenofibrate adjuvant therapy to oral hypoglycemic drugs improved the vascular endothelial dysfunction, CRI-I, CRI-II, glycemic picture, lipid panel, ACR, and blood pressure and reduced the BMI in patients with T2DM.


2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     


Author(s):  
М.А. Быковская ◽  
А.А. Раскуражев ◽  
А.А. Шабалина ◽  
К.В. Антонова ◽  
М.М. Танашян

Введение. Сосудистые осложнения сахарного диабета (СД) являются одной из ведущих причин повышения смертности пациентов трудоспособного возраста. Предполагается, что индуцированный гипергликемией окислительный стресс и нарушение антиоксидантной защиты играют роль в патологическом механизме повреждения сосудов, частично за счет влияния оксида азота (NО). Цель исследования: уточнение взаимосвязей в системах асимметричного диметиларгинина (АДМА) и NO у пациентов с цереброваскулярными заболеваниями (ЦВЗ) на фоне СД 2-го типа (СД-2). Материалы и методы. Обследованы 72 пациента с ЦВЗ со стенозирующим поражением внутренней сонной артерии вне острого периода: группу 1 составили 39 пациентов (18 мужчин и 21 женщина) с СД-2 в возрасте 65 [58; 72] лет; в группу 2 вошли 33 больных (15 мужчин и 18 женщин) без СД-2 в возрасте 66 [56; 74] лет. Контрольную группу составили 30 добровольцев (16 мужчин и 14 женщин) без проявлений церебральной ишемии и нарушений углеводного обмена, с нормальными значениями индекса массы тела, некурящие, в возрасте 62 [50; 66] лет. Проводилось клиническое обследование, нейро- и ангиовизуализационное исследование, спектр биохимических исследований крови, в том числе определение содержания АДМА и показателей системы NO. Результаты. В группе 1 содержание нитрата, нитрита и NO составило 62,1 [56; 68] мкмоль/л, 48,5 [26; 52] мкмоль/л и 13,6 [9; 23] мкмоль/л соответственно, что достоверно отличалось от значений этих показателей в группе 2 — 58,3 [45; 64] мкмоль/л, 39,6 [26,0; 42,3] мкмоль/л и 18,7 [16,1; 24,7] мкмоль/л соответственно. Отмечен также более высокий уровень AДМА в крови у пациентов с ЦВЗ в сочетании с СД-2 — 0,42 [0,21; 0,53] ммоль/л. Заключение. Обнаружена взаимосвязь между уровнями AДМА и NO при ЦВЗ на фоне СД-2. Это требует продолжения исследований биомаркеров повреждения сосудистой стенки для определения их места в патогенезе ишемических церебральных осложнений СД-2. Background. Vascular complications of diabetes mellitus (DM) are one of the leading causes of increased mortality in patients of employable age. Hyperglycemia-induced oxidative stress and impaired antioxidant protection have been suggested to play a role in the pathological mechanism of vascular damage, in part due to the effects of nitric oxide (NO). Objectives: clarification of relationships in the systems of asymmetric dimethylarginine (ADMA) and NO in patients with cerebrovascular diseases (CVD) and type 2 diabetes (DM-2). Patients/Methods. We examined 72 CVD patients with stenosing lesions of the internal carotid artery outside the acute period: group 1 consisted of 39 patients (18 men and 21 women; 65 [58; 72] years old) with DM-2; group 2 consisted of 33 patients (15 men and 18 women; 66 [56; 74] years old) without DM-2. The control group consisted of 30 volunteers (16 men and 14 women; 62 [50; 66] years old) without manifestations of cerebral ischemia and carbohydrate metabolism disorders, with normal body mass index, non-smokers. A clinical examination, neuro- and angio-imaging study, a spectrum of biochemical blood tests, including the concentration of asymmetric dimethylarginine (ADMA) and indicators of NO system were carried out. Results. In group 1, the content of nitrate, nitrite and NO was 62.1 [56; 68] μmol/l, 48.5 [26; 52] μmol/l and 13.6 [9; 23] μmol/l, respectively, that significantly differed from the content of these parameters in group 2 — 58.3 [45; 64] μmol/l, 39.6 [26.0; 42.3] μmol/l and 18.7 [16.1; 24.7] μmol/l, respectively. Noted also a higher blood level of ADMA in patients with CVD combined with DM-2 — 0.42 [0.21; 0.53] mmol/l. Conclusions. A relationship was found between ADMA and NO levels in CVD patients with DM-2. This requires further studies of biomarkers of vascular wall damage to determine their place in the pathogenesis of ischemic cerebral complications of DM-2.


2020 ◽  
Vol 20 (2) ◽  
pp. 833-840
Author(s):  
Erhan Onalan ◽  
Yusuf Doğan ◽  
Ebru Onalan ◽  
Nevzat Gozel ◽  
Ilay Buran ◽  
...  

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.


2021 ◽  
pp. 43-47
Author(s):  
Liliia Mogylnytska

Cardiovascular disease is the leading cause of death in diabetes mellitus. Endothelial dysfunction is the first step in the development of atherosclerotic vascular lesions, which underlies cardiovascular pathology, and adhesion molecules secreted by the endothelium during inflammatory changes are involved in the progression of this lesion. The objective: the serum level of adhesive molecules (ІCAM-1, VCAM-1, Е-selectin) in hypertensive and non-hypertensive type 2 diabetes patients as a marker of endothelial dysfunction and its relationship with other risk factors for cardiovascular disease was studied. Materials and methods. We examined 64 patients with type 2 diabetes, which were divided into two subgroups: the first subgroup – 41 hypertensive type 2 diabetes patients (age – 53,56±7,14 years, BMI – 32,2±87,4; HbA1c – 9,97±2,02%), the second subgroup – 23 nonhypertensive type 2 diabetes patients (age – 50,5±4,92 years, BMI – 25,4±5,22; HbA1c – 9,09±1,95%). The control group included 18 people without diabetes with normal blood pressure (age – 50,72±6,98 years, BMI – 24,71±4,88; HbA1c – 5,26±0,42%). The serum level was determined by immunoenzyme assay. The significance of the difference between the mean values was determined by the t-Student test. Multifactor regression analysis was used to assess the relationships between the studied factors. Results. We revealed an increase of serum levels of ІCAM-1, VCAM-1, Е-selectin in hypertensive (+71,62%, +68,42%, +66,95%, respectively) and non-hypertensive type 2 diabetes patients (+46,17%, +62,79%, +42,85%, respectively) compared with the control group (p<0,01). The serum concentration of ІCAM-1, Е-selectin was higher in hypertensive type 2 diabetes patients compared to non-hypertensive type 2 diabetes patients (+17,27%, +16,86%, respectively, p<0,01). There was a significant effect of Hb1Ac, lipids, insulin resistance on the serum level of ІCAM-1, VCAM-1, Е-selectin (p<0,01). The corresponding regression equations are derived. Conclusion. There is an increase of serum level of ІCAM-1, VCAM-1, Е-selectin in hypertensive and non-hypertensive type 2 diabetes patients, which indicates the development of endothelial dysfunction. Hypertension, hyperglycemia, dyslipidemia and insulin resistance contribute to the development of these changes.


2021 ◽  
Vol 15 (2) ◽  
pp. 121-132
Author(s):  
Thallapaneni Sasikala ◽  
Suchitra M Manohar ◽  
Aparna RR Bitla ◽  
S Sarala ◽  
Suresh Vaikkakara

Aim: We aimed to investigate biomarkers of inflammation, oxidative stress as surrogate markers of subclinical atherosclerosis in patients with Type 2 diabetes mellitus (T2DM). Materials & methods: Subjects were grouped based on carotid intima media thickness (CIMT). Group 1: healthy controls (CIMT <0.57 mm); Group 2: T2DM without subclinical atherosclerosis (CIMT <0.57 mm); Group 3: T2DM with subclinical atherosclerosis (CIMT ≥0.57 mm). Results: Significantly higher MDA, Hs-CRP, Ox-LDL, PTX-3, IL-6, ICAM-1 and lower FRAP, IL-10 levels in T2DM groups compared with controls (p = 0.001). Changes were more significant in Group 3 compared with Group 2. ICAM-1 had the highest sensitivity and specificity at a cut-off value of >40.34 ng/ml compared with Ox-LDL and PTX-3 (p < 0.001). Conclusion: ICAM can be considered as an alternate surrogate biomarker of CIMT.


2003 ◽  
Vol 77 (20) ◽  
pp. 11232-11243 ◽  
Author(s):  
M. Fenaux ◽  
T. Opriessnig ◽  
P. G. Halbur ◽  
X. J. Meng

ABSTRACT Porcine circovirus type 2 (PCV2) is the primary causative agent of postweaning multisystemic wasting syndrome (PMWS), whereas the ubiquitous porcine circovirus type 1 (PCV1) is nonpathogenic for pigs. We report here the construction and characterization of two chimeric infectious DNA clones of PCV1 and PCV2. The chimeric PCV1-2 clone contains the PCV2 capsid gene cloned in the backbone of the nonpathogenic PCV1 genome. A reciprocal chimeric PCV2-1 DNA clone was also constructed by replacing the PCV2 capsid gene with that of PCV1 in the backbone of the PCV2 genome. The PCV1, PCV2, and chimeric PCV1-2 and PCV2-1 DNA clones were all shown to be infectious in PK-15 cells, and their growth characteristics in vitro were determined and compared. To evaluate the immunogenicity and pathogenicity of the chimeric infectious DNA clones, 40 specific-pathogen-free (SPF) pigs were randomly assigned into five groups of eight pigs each. Group 1 pigs received phosphate-buffered saline as the negative control. Group 2 pigs were each injected in the superficial inguinal lymph nodes with 200 μg of the PCV1 infectious DNA clone. Group 3 pigs were each similarly injected with 200 μg of the PCV2 infectious DNA clone, group 4 pigs were each injected with 200 μg of the chimeric PCV1-2 infectious DNA clone, and group 5 pigs were each injected with 200 μg of the reciprocal chimeric PCV2-1 infectious DNA clone. As expected, seroconversion to antibodies to the PCV2 capsid antigen was detected in group 3 and group 4 pigs. Group 2 and 5 pigs all seroconverted to PCV1 antibody. Gross and microscopic lesions in various tissues of animals inoculated with the PCV2 infectious DNA clone were significantly more severe than those found in pigs inoculated with PCV1, chimeric PCV1-2, and reciprocal chimeric PCV2-1 infectious DNA clones. These data indicated that the chimeric PCV1-2 virus with the immunogenic ORF2 capsid gene of pathogenic PCV2 cloned into the nonpathogenic PCV1 genomic backbone induces a specific antibody response to the pathogenic PCV2 capsid antigen but is attenuated in pigs. Future studies are warranted to evaluate the usefulness of the chimeric PCV1-2 infectious DNA clone as a genetically engineered live-attenuated vaccine against PCV2 infection and PMWS.


2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Radhika R. ◽  
Navaneetha M. ◽  
Ravichandran K. ◽  
Hemavathi P.

<p><strong>Background: </strong>The primary aim of managing diabetes is to maintain blood glucose level to prevent diabetes induced complications. Studies showed that ladies finger and fenugreek seeds are blood sugar stabilizer. The objective of this randomized active controlled trial was to assess the effect of ladies finger water versus fenugreek seeds water on the blood glucose level among subject with type 2 diabetes.</p><p><strong>Methods: </strong>Total of 180 study participants were selected and equally assigned to three groups by computer generated randomization. Group 1-received ladies finger water and oral antidiabetic drug (OAD); group 2-received fenugreek seeds water and OAD; group 3-received only OAD for 15 days. Pre and post intervention fasting blood sugar (FBS) was assessed by accu-chek Performa glucometer. Wilcoxon signed rank test; one-way analysis of covariance followed by post hoc test with Bon-ferroni correction was done.</p><p><strong>Results: </strong>Analysis was done based on 168 subjects. There was a significant reduction in FBS level with the mean difference of group 1-21.0 mg/dl (p&lt;0.001), group 2-20.3 mg/dl (p&lt;0.001) and group 3-4.7 mg/dl (p=0.068). No significant difference found between group 1 and group 2 (p=1.00), but significant difference found between group 1 and group 3 (p=0.032); group 2 and group 3 (p=0.012). Both ladies finger water and fenugreek seeds water were superior in reduction of FBS than OAD.</p><p><strong>Conclusions: </strong>Ladies finger water or fenugreek seeds water can be used as adjunct along with OAD to control type 2 diabetes mellitus.</p><p><strong> </strong></p>


2015 ◽  
Vol 22 (01) ◽  
pp. 143-148
Author(s):  
Rehan Khawaja ◽  
Tahir Munir ◽  
Uzma Hassan ◽  
Syed Shoaib Shah

Objectives: To access the Antioxidant Status in Patient with Variation in Durationof Type 2 Diabetes Mellitus. Data source: 90 selected patients suffering from Type 2 DiabetesMellitus (DM) and 30 subjects as control group. Design of study: Case Control Study. Setting:Rawal Institute of Health Sciences, Islamabad. Period: July 2013 – March 2014. Materials& methods: Out of 120 selected subjects, 90 were of DM type 2and 30 were assigned ascontrol group (group 1). Based on duration, patients of DM type 2 were divided into; group2, 3 and 4; group 2 – patients with DM (type 2) duration less than 5 years, group 3 - with DMduration between 5-10 years and group 4 - with duration of DM more than 10 years. Smokers,renal failure, coronary artery disease, thyroid disease and previous antioxidant treatmentpatients were excluded from the study. Diabetes mellitus type 2 was diagnosed according tothe standards set by American Diabetes Association. The fasting plasma glucose levels weremeasured by glucose oxidase method; HbA1c by automated kit on Cobas Integra of Roche.The TAC was measured by calorimetric TAC Assay Kit (BioVision) while Vitamin C and E weremeasured by using ELISA Kit (HUMAN). Cut off values for HbA1c was taken as ≤6%; FBS≤110 mg/dl; TAC ≥1.16 mmol/L; Vitamin C ≥2 mg/dl; Vitamin E ≥ 9.5nmol/ml. Results: Asthe duration of type 2 diabetes increases, it was seen that vitamin C levels and TAC levels inall groups except between groups 1 & 2 decreased significantly; however, anti-oxidant vitaminE, was found to be significantly decreased in all the groups as the duration increases. Asignificantly increased level of HbA1c were noticed in groups 2, 3 and 4 as compared to group1 as the duration of diabetes increases; however, the levels were found to be non-significantwhen group 4 was compared with that of group 2 and group 3. When fasting blood sugarwas compared between the diabetic groups a significant increased levels were noticed in allthe groups with the exception between group 3 and 4. A significant differences between eachgroup and within the groups was observed when Hb1Ac, vitamin E, vitamin C, &TAC werecompared using ANOVA. A statistical significant correlation was observed when HbA1c wascorrelated with FBS; however, it shows an inverse relationship with TAC, vitamin C and vitaminE. A significant inverse correlation of FBS was noticed with TAC, vitamin C, and vitamin E. Asignificant positive correlation was seen when TAC was correlated with vitamin C and vitamin E.A similar trend of significant positive correlation was seen when vitamin C was correlated withvitamin E. Conclusions: The levels of total anti-oxidant capacity, vitamin C, and vitamin Egradually decrease with duration of diabetes and are associated with oxidative stress. Theseantioxidant vitamins (vitamin C and vitamin E) should be supplemented in diabetics to increasetheir quality of life. TAC status may be taken as early marker to detect complications in diabetictype 2 patients especially of longer duration.


2021 ◽  
Vol 9 (1) ◽  
pp. 21-27
Author(s):  
S.O. Rykov ◽  
K.V. Korobov ◽  
S.Yu. Mogilevskyy

Background. One of the early microvascular complications of type 2 diabetes mellitus (T2DM) is diabetic retino­pathy (DR). Its main cause is prolonged hyperglycemia, which triggers the development of microangiopathy. In this regard, the issue of damage to paired eyes and the spread of DR in the initial stages has not been fully clarified. The purpose: to study the peculiarities of lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 dia­betes mellitus. Materials and methods. We examined 91 patients with T2DM (182 eyes), who did not have retinopathy according to the International Diabetic Retinopathy Severity Scale of the American Academy of Ophthalmology (2002). Paired eyes were divided into three groups: group 1 included 132 paired eyes (66 patients) with 10 points according to the Early Treatment Diabetic Retinopathy Group Study (ETDRS); group 2 consisted of 25 eyes with 10 points on ETDRS, and group 3 — 25 paired eyes with retinal vascular anomalies (14–15 points on ETDRS). The patients were examined again after 1 year. According to the ETDRS, Airlie House classification, microaneurysms, microhemorrhages, intraretinal microvascular abnormalities, retinal vascular abnormalities, and retinal nonperfusion were detec­ted. Results. The majority (58.3 %) of paired eyes without initial changes (group 1) had no progression of DR within 1 year, 12.9 % had vascular anomalies (14–15 points on ETDRS), 13.6 % deve­loped mild, and 15.2 % — moderate non-proliferative DR. The highest progression of DR (88.0 % of eyes) was observed in eyes without diabetic vascular changes, which were paired to eyes with such changes (group 2) that was 2.1 times (p < 0.001) higher than the indicator of paired eyes without diabetic changes (group 1; 41.7 %). Most eyes that had mild vascular changes (group 3) progressed to moderate non-proliferative DR after 1 year, which was four times more often than in eyes that had no initial changes (60.0 versus 15.2 %; p < 0.001). DR in the eyes of group 3 with progression accounted for 43–47 points on EDTRS; the visual acuity of these eyes, both before and after 1 year, was significantly lower than in other groups, and the level of glycated hemoglobin in the blood of patients with such eyes was significantly higher. Conclusions. This study established the features of the progression of early stages of DR in patients with T2DM, and the significance of primary retinal vascular anomalies in the presence of which the progression of DR was faster.


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