Effects and association of pro-oxidants with magnesium in patients with diabetic nephropathy

Diabetic nephropathy (DN) is the most common microvascular complication observed in patients with type-2 diabetes mellitus. Furthermore, magnesium (Mg) deficiency is a common problem in diabetic patients. In this study, we estimated the levels of Mg, which is an important trace element and pro-oxidant marker, and then evaluated the association between serum Mg and pro-oxidants in patients with DN. In the present study, 200 patients were enrolled and were divided into two groups. The control and DN groups consisted of 100 healthy individuals and 100 patients with DN, respectively. Serum Mg, total anti-oxidant capacity (TAC), and superoxide dismutase (SOD) levels were estimated using the Calmagite, Koracevic, and Marklund and Marklund methods, respectively. Glutathione (GSH) and malondialdehyde (MDA) levels were estimated using the Tietze F and Jean CD method, respectively. Mg levels were found to be significantly decreased in the DN group in comparison to the control group. Anti-oxidant markers were statistically significantly reduced (P <0.001), whereas MDA levels were statistically significantly elevated (P <0.001) in the DN group compared to the control group. There was a significant positive association of Mg with TAC, SOD, and GSH. A statistically significant negative association of Mg with MDA (r = -0.302, P <0.001, n = 100) was also observed. An apparent relationship was observed between hypomagnesemia and oxidative stress in patients with DN. Lower levels of Mg and oxidative stress were also strongly linked.

Improved serotonergic neurotransmission by genistein pretreatment regulates symptoms of obsessive-compulsive disorder in streptozotocin-induced diabetic mice

Background Initial evidences have shown that diabetes mellitus occurs concomitantly with obsessive-compulsive disorder (OCD) symptomatology. Serotonergic psychiatric therapy posits that serotonin is a central character in the management of OCD. Hence, it is worth investigating novel chemical entities affecting the serotonergic system for targeting OCD. An isoflavonoid phytoestrogen, genistein, has been recognized as of great pharmacological value especially for protecting neurodegeneration, depression (serotonin regulation), and diabetes. The effectiveness of genistein pretreatment on the symptoms of OCD in streptozotocin-induced diabetic mice is investigated in this study. We also evaluate the probable involvement of the serotonergic system. Methods Groups of diabetic mice were treated with genistein at the dose of 5.0 and 10.0 mg/kg (intraperitoneal, twice daily, 14 days), and symptoms of OCD were assessed by the marble-burying behavior, in comparison with the standard drug fluoxetine. Neurochemical assessment of the serotonergic ratio 5-hydroxyindole-3-methoxyphenylacetic acid/5-hydroxytryptamine (5-HIAA/5-HT) in the cortical region of the brain was performed using HPLC (high-pressure liquid chromatography). Results Chronic treatment with genistein significantly recovered [F(6, 35)=53.00, p<0.0001, R2=0.9008] the symptoms of OCD as assessed by marble burying behavior in normal and diabetic mice. Locomotor performance was not influenced by the diabetic condition or any associated treatment. The turnover of serotonin neurotransmission (5-HIAA/5-HT) was significantly boosted in the diabetic condition; genistein treatment dragged it [F(6, 35)=35.75, p<0.0001, R2=0.8597] toward the respective control. Conclusions Genistein supplementation might be a potential therapeutic line for the management and/or prevention of diabetes-associated OCD symptomatology.

Association of Dyslipidemia, Increased Insulin Resistance, and Serum CA 15-3 with Increased Risk of Breast Cancer in Urban Areas of North and Central India

Objective:

This study aims to determine the association of dyslipidemia and increased insulin resistance (IR) with increased breast cancer (BC) risk.

Materials and Methods:

The study group comprised 110 premenopausal and 143 postmenopausal, untreated female BC patients in the age range of 29–72 years. Control group consisted of 117 premenopausal and 141 postmenopausal healthy females in the age range of 23–75. Approximately 8-ml blood samples were drawn to measure various biochemical parameters. Serum glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein-cholesterol were measured. Very low-density lipoprotein-cholesterol (VLDL-C) and LDL-C were calculated using Friedewald's formula. Serum insulin and serum CA 15-3 were estimated by immune enzymatic assay. IR was assessed using homeostasis model assessment IR index (HOMA-IR).

Results:

Clinical variables in the case and control groups were compared using the unpaired Student's t-test. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary logistic regression analysis. Pearson's correlation analysis was used to determine the association between CA 15-3 and variables of interest. Total cholesterol, TG, LDL, VLDL, serum glucose, serum insulin, HOMA-IR, and serum CA 15-3 were significantly higher (P < 0.001) in BC patients compared to those in controls. Significant adjusted ORs with 95% CI were found to be fasting glucose, total cholesterol, and TGs. We also found a significant positive correlation between total cholesterol, TG, LDL, serum glucose, serum insulin, HOMA-IR, and serum CA 15-3.

Conclusion:

This study confirms the association between dyslipidemia, IR, and increased BC risk.

Role of adiponectin in mediating the association of osteocalcin with insulin resistance and type 2 diabetes: a cross sectional study in pre- and post-menopausal women

OBJECTIVE

To analyse the association of osteocalcin with insulin resistance and type 2 diabetes and assess the role of adiponectin in these relationships.

METHODS

This study comprised 98 newly diagnosed type 2 diabetic women (51 pre-menopausal and 47 post-menopausal) and 102 age and BMI matched controls (53 pre-menopausal and 49 post-menopausal). Insulin resistance was calculated by homeostasis model assessment-insulin resistance (HOMA-IR).

RESULTS

Osteocalcin was significantly positively correlated with adiponectin in both pre-menopausal (p = 0.0026) and post-menopausal diabetic women (p = 0.0357). Significant negative association between osteocalcin and HOMA-IR was observed only in pre-menopausal diabetic women (p = 0.0019), but the association was partially reduced (p = 0.0219) after additional adjustment for adiponectin. Adiponectin slightly attenuated the inverse association between osteocalcin and presence of type 2 diabetes in both pre- and post-menopausal women.

CONCLUSION

The protective action of osteocalcin against the development of insulin resistance and type 2 diabetes in women may be partially mediated through up-regulation of adiponectin secretion.

Significance of urine albumin / creatinine ratio (UACR) and uric acid in women with preeclampsia and its comparison with healthy normotensive pregnant women in their third trimester

Objective. To determine the significance of urine albumin / creatinine ratio (UACR) as to predict proteinuria in new-onset hypertension and uric acid in women with preeclampsia and its comparison with healthy normotensive pregnant women. Methods. Healthy normotensive pregnant women (n = 45), women with preeclampsia (n = 36) were included in the study. The preeclamptic group was further divided into two subgroups: mild (n  =  25) and severe preeclampsia (n = 11). Results. Higher mean values of urine albumin / creatinine ratio (UACR) and uric acid were found in preeclamptic pregnant women (319.05 ± 247.56 mg/g, 5.98  ±  2.1  mg/dl) as compared to healthy normotensive pregnant women (22.15  ±  8.1  mg/g, 4.07  ±  0.91  mg/dl) in the third trimester with highly significant difference (p 

Relationships between serum osteocalcin levels versus blood glucose, insulin resistance and markers of systemic inflammation in central Indian type 2 diabetic patients

BACKGROUND

Recent studies have demonstrated an endocrine role of osteoblast derived protein osteocalcin in the regulation of blood glucose homeostasis. In addition emerging evidence suggests that subclinical inflammation is associated with altered bone metabolism. However, the relationship between osteocalcin and inflammatory markers is still unclear.

AIM

This study was aimed to investigate the association of serum osteocalcin with fasting plasma glucose, insulin resistance and markers of systemic inflammation - interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in central Indian type 2 diabetic patients.

PATIENTS AND METHODS

This study included 108 individuals with newly diagnosed type 2 diabetes mellitus (DM) and 50 age and body mass index (BMI) matched healthy subjects as controls. Blood samples were analyzed for fasting plasma glucose, fasting insulin, interleukin-6, hs-CRP and serum osteocalcin. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR).

RESULTS

In the present study we observed significantly lower level of osteocalcin in type 2 diabetic group compared to non diabetic control (p < 0.0001). In linear regression analysis adjusted for age, gender, BMI, waist circumference and waist to hip ratio, serum level of osteocalcin was inversely associated with fasting plasma glucose (beta = -0.015; p = 0.0004), fasting insulin (beta = -0.059; p = 0.0242), HOMA-IR (beta = -0.149; p = 0.0011), interleukin-6 (beta = -0.071; p = 0.0036) and hs-CRP levels (beta = -0.506; p = 0.0085) in the diabetic subjects.

CONCLUSIONS

Our findings suggest that osteoblast derived protein osteocalcin may have a wide ranging role in the pathophysiology of type 2 diabetes by being associated with both blood glucose homeostasis and systemic inflammation.

Attenuation of serum ferritin and iron burden by intake of antioxidants in beta thalassemia major

It has been anticipated that iron and ferritin burden in patients with beta thalassemia major is associated with enhanced free radical formation and blemished antioxidant defense system. The goal of study was to scrutinize impact of serum iron, total iron binding capacity (TIBC), ferritin and erythrocyte catalase in patients with beta thalassemia major. 140 beta thalassemia major patients were studied before and after supplementation of antioxidants for one month, and status was compared with 140 age and sex matched healthy controls. A significant elevation was found in the levels of serum iron and ferritin (P < 0.001) with concomitant decrease in erythrocyte catalase (P < 0.001) in patients when compared with controls. After one month supplementation of antioxidants, catalase was elevated significantly (P < 0.001) and marginal rise in serum TIBC concentration increased marginally while iron and ferritin were decreased marginally (P > 0.05) when compared with controls and baselines values. Beta thalassemia major children receive multiple blood transfusions, and are at risk of secondary iron overload induced oxidative stress. These effects may be help to minimize with supplementation of antioxidants.

Relationship of serum osteocalcin levels with blood glucose, insulin resistance and lipid profile in central Indian men with type 2 diabetes

OBJECTIVE

To assess the relationship of serum osteocalcin levels with blood glucose, insulin resistance and lipid profile in central Indian men with type 2 diabetes.

METHODS

Anthropometric and biochemical parameters were measured in 56 newly diagnosed type 2 diabetic men and in 56 age and body mass index (BMI) matched controls. Insulin resistance was calculated by homeostasis model assessment of insulin resistance (HOMA-IR).

RESULTS

After adjustment for age and BMI, osteocalcin levels were negatively correlated with fasting plasma glucose (p = 0.0004), fasting insulin (p = 0.0311), HOMA-IR (p = 0.0023), and triglycerides (p = 0.0095), and positively correlated with high density lipoprotein (HDL)-cholesterol (p = 0.0042) in type 2 diabetic patients. In multivariate logistic regression analyses that adjusted for age, BMI, waist circumference and waist-to-hip ratio, osteocalcin was inversely associated with the presence of type 2 diabetes (p < 0.0001).

CONCLUSION

Osteocalcin may play a protective role in the pathogenesis of type 2 diabetes, not only through direct involvement in glucose homeostasis, but also through improving lipid profile.

Comparative analysis of lycopene in oxidative stress

OBJECTIVE

Lycopene is a phytochemical, found in tomatoes having singlet oxygen quenching ability higher than other antioxidants, participates in most of chemical reactions to protect critical cellular biomolecules. Present study is to analyze effect of tomato's lycopene, synthetic lycopene, its placebo form in patients of OS.

METHODS

Study includes 45 patients having oxidative stress, age 40-60 years and 30 age and sex matched healthy control. Blood samples were collected at the enrollment, end of 2 weeks of lycopene restricted diet and after 10 weeks of lycopene supplementation. Oxidative stress biomarkers MDA, SOD, GPX, GR, GSH, Catalase, vitamin C and E were measured.

RESULTS

Results of study revealed decreased lipid peroxidation and OS after various forms of lycopene supplementation but comparative analysis showed significant increase in OS biomarkers except MDA in patients receiving synthetic lycopene as compare to natural and placebo form.

CONCLUSION

Dietary intake of tomato lycopene is beneficial to fight against OS but in the synthetic form it is more bioavailable and more effective against OS.

Comparative study of nitro blue tetrazolium (NBT) reduction method for estimation of glycated haemoglobin with glycated HbA1c estimated on DCA2000+analyzer (immunoagglutination inhibition)

Glycated haemoglobin is a diagnostic tool, used for the monitoring of the glycemic status among diabetic patients. The present study is designed to compare and correlate modified NBT reduction method for the estimation of Glycated protein (Glycated Haemoglobin) with HbA1C estimated on DCA+2000Analyzer. Glycated protein reduces Nitro Blue Tetrazolium (NBT) reagent in alkaline medium to tetrazinolyl radical NBT+ which is disproportional to yield a highly colored formazan dye (MF+) (monoformazen), absorbance of colored compound was measured which gives the concentration of glycated proteins present in the sample. Heme free globin (glycated hemoglobin) was extracted out and dissolved immediately in 1 ml normal saline. Dissolved globin was treated with modified NBT reagent, absorbance of color developed was recorded in milli delta A/min. The results of modified NBT were then compared with HbA1c estimated by immunoagglutination inhibition method. Correlation coefficient between Glycated hemoglobin and HbAlc was found to be r=0.926 using Schimadzu CL-750 spectrophotometer and r=0.902 using colorimeter. Results of this study were found to be statistically significant p < 0.001. Thus the present study concludes that Glycated hemoglobin testing by modified NBT reduction method is as sensitive as HbAlc estimated by DCA2000+Analyzer (immunoagglutination inhibition). Hence it could be used for routine monitoring of blood glucose control level in diabetic subjects.

Oxidized LDL and paraoxanase status in ischemic stroke patients

Stroke is the leading cause of mortality and long term disability among adults in industrialized countries. Oxidative stress is an independent risk actor by inducing production of oxygen free radicals in ischemic stroke. Because a relationship may be associated between ox-ldl and paraoxanase, the aim of this study was to investigate the association between ox-ldl and paraoxanase in ischemic stroke patients by determining whether ox-ldl is a useful marker for monitoring oxidative stress in ischemic stroke patients. Our study included 100 patients of ischemic stroke and 100 controls. Compared with controls ox-ldl was significantly raised in stroke patients and Paraoxanase activity was low. Our findings suggest that there is a significant association between raised plasma ox-ldl and decrease activity of Paraoxanase with age indicating that plasma ox-ldl may reflect oxidative stress in ischemic stroke patients.

Comparative study of NBT reduction method for estimation of glycated protein (serum fructoseamine) with glycated HbA1c estimated on DCA 2000+Analyzer (immunoagglutination inhibition)

Glycated protein estimation is a diagnostic tool, used for the long term and short term monitoring of the glycemic status of diabetic patients. The present study is designed to compare and correlate modified NBT reduction method for the estimation of Glycated protein (serum fructosamine) with HbAlc estimated on DCA+2000 Analyzer. Glycated protein (serum fructosamine) reduces Nitro Blue Tetrazolium (NBT) reagent in alkaline medium to tetrazinolyl radical NBT+ which forms a highly colored monoformazen compound, absorbance of which is directly proportional to the concentration of glycated protein (serum fructosamine) present in the sample and is recorded as delta A/min. The results of modified NBT were then compared with HbA1c estimated by immunoagglutination inhibition method. Correlation coefficient between HbAlc with serum fructosamine was found to be r = 0.739 using Schimadzu CL-750 spectrophotometer and r = 0.731 using colorimeter. Results of this study were found to be statistically significant P < 0.001. Hence this method could be used for routine monitoring of blood glucose control in diabetics as HbA1c estimation.

Study of oxidative stress and trace element levels in patients with alcoholic and non-alcoholic coronary artery disease

Alcohol consumption induces oxidative stress, and leads to lipid peroxidation. These effects have been linked to alcohol-related toxicity and diseases are considered relevant to alcohol-atherosclerosis interrelationship. Deficiency of many antioxidants and trace elements may impair the antioxidant defense leading to ethanol induced oxidative stress. In the present study, our aim was to investigate the lipid peroxidation, lipid profile, antioxidant enzymes and trace elements in patients with and without alcoholic coronary artery disease (CAD). Our study included 61 patients suffering from CAD, 124 patients suffering from alcoholic CAD with high to moderate alcohol intake, 75 controls were randomly selected for our study. Increased serum lipid peroxidation, total cholesterol, triglycerides, LDL cholesterol and copper levels were high while levels of HDL cholesterol, glutathione peroxdiase, superoxide dismutase, trace elements like Selenium and Zinc were low in high alcoholic CAD patients compared with moderate and non alcoholic CAD patients. The results obtained from present study indicate that high alcohol intake predicts low antioxidant enzyme and that trace element may contribute to the increased susceptibility for the development of CAD.

Association between paraoxonase activity and lipid levels in patients with premature coronary artery disease

BACKGROUND

South Asians, especially Indians show increased risk for atherosclerosis and have the higher mortality rates due to coronary artery disease. The increasing incidence of coronary artery disease in young patients is possibly due to industrialization, stress of life, less exercise and increasing incidence of smoking and other factors. We attempted to determine an independent association of paraoxonase with coronary artery disease in young patients.

METHOD

The lipid profile and serum paraoxonase were investigated in 120 angiographically-proven premature coronary artery disease patients (99 males and 21 females, all <45 years) with diabetes mellitus, smoking, hyperlipidemia, obesity, hypertension along with 50 (41 male and 9 female) normal subjects and compared.

RESULTS

A significant increase was observed in the concentrations of total cholesterol, triglycerides and LDL cholesterol in premature coronary artery disease patients. The activities of paraoxonase and HDL cholesterol concentrations decreased in coronary artery disease patients compared to control subjects.

CONCLUSION

A paraoxonase was an independent (p<0.001, OR 14.9 and 95% CI 5.6-35.9) risk factor for premature coronary artery disease patients along with lipid profiles. Paraoxonase activity should be evaluated in all coronary artery disease patients in the absence of traditional risk factors.

Cystatin C-A novel marker of glomerular filtration rate: A review

Glomerular filtration rate is routinely assessed by measuring the serum markers such as urea nitrogen and serum creatinine. Although these markers are widely used to assess renal function but they do not perform optimally in certain clinical settings. There is thus a practical need for an easily automated alternative to plasma creatine, which would be more specific, sensitive and reliable from the analytical and clinical view point. Compared with the above endogenous markers, and time consuming laborious tests, Cystatin C facilitates the recognition of abnormal renal function in children, as its reference range is constant beyond the 1(st) year of life. This review mainly focuses on the diagnostic performance of Cystatin C against other renal markers in the pediatric population and in specific subpopulations of patients.

Lycopene - tomato's secret weapon against oxidative stress

Back ground: Lycopene, 40 carbon acyclic carotenoid containing 11 conjugated double bonds, is a phytochemical found in tomatoes and other red fruits. Oxygen derived free radicals are the most reactive species and as an antioxidant lycopene has a singlet oxygen quenching ability twice as high as that of ?-carotene and 10 times higher that of ?-tocoferol, lycopene participate in a host of chemical reactions to protect critical cellular biomolecules including lipid, proteins and DNA. Materials and Methods: The present study include 30 subjects having oxidative stress, age between 40-60 years, nonsmoker, with no history of chronic systemic illness and no medication were taken as patients.30 patients matched healthy subjects were taken as control. All subjects were selected from outpatient department of NSCB Medical College Jabalpur M.P. After estimation of base line antioxidant enzyme and vitamins, we supplement 180 gm of tomato (products like soup, paste. ketchup) contain 12 mg of lycopene to the patient group. After 60 days of lycopene supplementation oxidative stress biomarkers like SOD, GPX, GR, GSH, lipid peroxidation product MDA and other antioxidant vitamins A, vitamin C, vitamin E were estimated in patient's blood sample. Results: The main result of the study revealed that lipid per oxidation product MDA was found to be decreased significantly but after lycopene supplementation levels were improved. The results of SOD , GPX, GR, GSH,Vitamin A ,Vitamin E and Vitamin C were significantly increased after lycopene supplementation, it indicates the improved antioxidant profile after the supplementation of lycopene. Conclusion: There was a significant decrease in oxidative stress after the supplementation of lycopene therefore the study suggest that body's internal production of antioxidant is not enough to neutralize all free radicals, so increased dietary intake of antioxidant lycopene in the form of tomato products is beneficial, which is easily available in developing country like India. Key Words: Oxidative stress; Lycopene; MDA; GSH; SOD; Vitamin C; Vitamin E DOI: http://dx.doi.org/10.3329/bjms.v10i4.9500 BJMS 2011; 10 (4): 275-279