Xanthine oxidase and lens oxidative stress markers in diabetic and senile cataract patients

Protein kinase A activation alleviates cataract formation via increased gap junction intercellular communication

Cataract is the leading cause of blindness worldwide. Here, we reported a potential, effective therapeutic mean for cataract prevention and treatment. Gap junction communication, an important mechanism in maintaining lens transparency, is increased by protein kinase A (PKA). We found that PKA activation reduced cataracts induced by oxidative stress, increased gap junctions/hemichannels in connexin (Cx) 50, Cx46 or Cx50 and Cx46 co-expressing cells, and decreased reactive oxygen species (ROS) levels. However, ROS reduction was shown in wild-type, Cx46 and Cx50 knockout, but not in Cx46/Cx50 double KO lens. In addition, PKA activation protects lens fiber cell death induced by oxidative stress via hemichannel-mediated glutathione transport. Connexin deletion increased lens opacity induced by oxidative stress associated with reduction of anti-oxidative stress gene expression. Together, our results suggest that PKA activation through increased connexin channels in lens fiber cell decreases ROS levels and cell death, leading to alleviated cataracts.

The role of oxidative damage in cataract etiopathogenesis

Background

Cataract usually occurs due to age and diabetes, but the mechanisms of cataract formation have not yet been fully elucidated. In this study, the relationship between cataract and oxidative stress was evaluated by examining the aqueous humor reflecting lens metabolism.

Objective

In this study, the effect of oxidative stress on the etiopathogenesis of cataract was investigated through the total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and arylesterase (ARE) levels in aqueous humor samples of patients with cataract.

Design

A prospective cohort study.

Methods

This study was conducted on patients who were scheduled for cataract surgery between June 2020 and March 2021. The patients were divided into four groups according to their cataract density as grades 1, 2, 3, and 4. TOS, TAS, and ARE levels of aqueous humor samples were measured spectrophotometrically, and comparisons were made between groups.

Results

A total of 100 eyes of 100 patients were included in this study. TAS levels were found significantly higher in the grade 2 group compared with the grade 4 group (p = 0.006). In addition, a significant negative correlation was present between cataract grade and TAS level (r = -0.237; p = 0.018). There was no significant difference between diabetic and nondiabetic patients in terms of TAS, TOS, OSI, and ARE levels.

Conclusion

The aqueous humor of patients with a high degree of cataract is characterized by low antioxidant capacity. Decreased antioxidant capacity has a role in cataract formation and progression.

Evaluation of antioxidative enzymes levels and lipid peroxidation products levels in diabetic and non diabetic senile cataract patients

Background

The current study aimed to investigate the Superoxide dismutase, Glutathione Peroxidase activity, Advanced oxidation Protein products levels, Malondialdehyde levels, Baseline Conjugated Diene concentration, and 8-Isoprostaglandin F2α (8-IPG-F2α) quantification in diabetic and non-diabetic senile cataract patients to find out the pathomechanism of early onset of cataract in diabetic patients.

Methods

This case-control study was performed on 184 subjects undergoing cataract surgery. For 8-IPG-F2α quantification, 35 diabetics and non-diabetic lenses and the entire study included 22 patients with diabetic senile cataracts and non-diabetic senile cataracts of aqueous humor age ≥ 40 years. Ninety-two patients with diabetic senile cataract and non-diabetic senile cataract lenses aged ≥ 40 years were incorporated for all other studies. The student's t-test was used for statistical analysis.

Results

From the study population, the mean age was 63.82 ± 0.6, and 75% of them were female. Higher female prevalence in both groups was observed. The results revealed that the superoxide dismutase and glutathione peroxidase activity were significantly reduced in diabetic patients compared to non-diabetic patients (p < 0.001) in both lenses and aqueous humor. Malondialdehyde, conjugated diene, and 8-IPG-F2α levels significantly increased in diabetic patients when compared to non-diabetic (p < 0.01), and advanced oxidation protein products levels also significantly increased in diabetic patients when compared to non-diabetics in both lenses and aqueous humor (p < 0.001).

Conclusion

The current study revealed that oxidative stress and Lipid per-oxidation have an imperative role in the diabetic-related complication, specifically in the lens, may have a responsibility in the pathomechanism of early onset of cataracts coupled with diabetes mellitus.

Clinical Association of Biochemical Variations Among Multilocus Genotypes of Antioxidant Enzymes with Susceptibility of Cataract in Hyperglycemia

Hyperglycemia plays a pronounced role in accelerating the process of aging due to high oxidative stress which triggers dyslipidemia and subsequently led to the progression of cataract. The aim of this study was to investigate lipid profile and its relationship with genotypes of SOD1, GPX1, and CAT variants in cataract patients. Total n = 680 samples were screened in four groups: senile cataract (SC), diabetic cataract (DC), type 2 diabetes mellitus (DM), and controls (CL). Lipid profile was estimated and compared between groups, and its correlation was tested with glycemic markers. Association of SOD1 50 bp Indel, GPX1 (rs1800668), and CAT (rs1001179) genotypes with all clinical variables was investigated in cataract groups by regression statistics in SPSS® 16.0. Comparative analysis revealed that amount of total cholesterol and low-density lipoprotein parameters were significantly higher in both groups of cataracts when compared with controls (p < 0.01). Statistically higher levels of triglycerides were also evident in DM patients as compared with other three groups (p < 0.01). Significant weak positive correlation of glycated hemoglobin, fasting (FBG), and random blood glucose (RBG) levels was observed with triglycerides in DM (r = 0.16), SC (r = 0.15), and DC (r = 0.18) groups. Mutant genotype of SOD1 and CAT variants indicated significant association with TC, whereas GPX1 variant with FBG levels in accelerating predisposition of cataract in patients with diabetes (OR > 1.0). Outcomes suggested that TG may serve as a potential biomarker of lipid profile with manifestation of cataract in type 2 DM. Furthermore, hypercholesterolemia and hypertriglyceridemia demonstrated an inducing role in the pathogenesis of cataract with aging in hyperglycemia.

Hallmarks of lens aging and cataractogenesis

Lens homeostasis and transparency are dependent on the function and intercellular communication of its epithelia. While the lens epithelium is uniquely equipped with functional repair systems to withstand reactive oxygen species (ROS)-mediated oxidative insult, ROS are not necessarily detrimental to lens cells. Lens aging, and the onset of pathogenesis leading to cataract share an underlying theme; a progressive breakdown of oxidative stress repair systems driving a pro-oxidant shift in the intracellular environment, with cumulative ROS-induced damage to lens cell biomolecules leading to cellular dysfunction and pathology. Here we provide an overview of our current understanding of the sources and essential functions of lens ROS, antioxidative defenses, and changes in the major regulatory systems that serve to maintain the finely tuned balance of oxidative signaling vs. oxidative stress in lens cells. Age-related breakdown of these redox homeostasis systems in the lens leads to the onset of cataractogenesis. We propose eight candidate hallmarks that represent common denominators of aging and cataractogenesis in the mammalian lens: oxidative stress, altered cell signaling, loss of proteostasis, mitochondrial dysfunction, dysregulated ion homeostasis, cell senescence, genomic instability and intrinsic apoptotic cell death.

Pro-Aging Effects of Xanthine Oxidoreductase Products

The senescence process is the result of a series of factors that start from the genetic constitution interacting with epigenetic modifications induced by endogenous and environmental causes and that lead to a progressive deterioration at the cellular and functional levels. One of the main causes of aging is oxidative stress deriving from the imbalance between the production of reactive oxygen (ROS) and nitrogen (RNS) species and their scavenging through antioxidants. Xanthine oxidoreductase (XOR) activities produce uric acid, as well as reactive oxygen and nitrogen species, which all may be relevant to such equilibrium. This review analyzes XOR activity through in vitro experiments, animal studies and clinical reports, which highlight the pro-aging effects of XOR products. However, XOR activity contributes to a regular level of ROS and RNS, which appears essential for the proper functioning of many physiological pathways. This discourages the use of therapies with XOR inhibitors, unless symptomatic hyperuricemia is present.

Phototoxicity of environmental radiations in human lens: revisiting the pathogenesis of UV-induced cataract

The magnitude of cataract pathology is indeed significant as it is the principal cause of blindness worldwide. Also, the prominence of this concept escalates with the current aging population. The burden of the disease is more tangible in developing countries than developed ones. Regarding this concern, there is a gap in classifying the pathogenesis of the ultraviolet (UV) radiation-induced cataracts and explaining the possible cellular and subcellular pathways. In this review, we aim to revisit the effect of UV radiation on cataracts categorizing the cellular pathways involved. This may help for better pharmaceutical treatment alternatives and their wide-reaching availability. Also, in the last section, we provide an overview of the protecting agents utilized as UV shields. Further studies are required to enlighten new treatment modalities for UV radiation-induced pathologies in human lens.

Xanthine oxidase activity in type 2 diabetic Nigerians

AIM

This study evaluated the activity of xanthine oxidase in Nigerians with type 2 diabetic mellitus as well as its relationship with lipid peroxidation, inflammatory bio markers and glycemic control indices.

METHODS

Two hundred and thirty seven (237) subjects, comprising of one hundred and fifty seven (157) DM subjects and eighty (80) aged matched controls participated in this study. Blood samples were collected from the participants for the estimations of xanthine oxidase activity, uric acid, malon diadehyde (MDA), erythrocyte sedimentation rate (ESR), high sensitive c - reactive protein (hs CRP), glucose, fructosamine and glycosylated hemoglobin by standard methods.

RESULTS

The results of this study showed a significantly increased activity of xanthine oxidase in DM (0.044 ± 0.05μ/mg) compared with apparently healthy controls (0.028 ± 0.00 μ/mg). The mean plasma levels of MDA (42.40 ± 2.50μmol/l) and uric acid (7.22 ± 0.20 mg/dl) in DM were significantly higher (p ≤ 0.05) than healthy non DM group. The mean levels of hs CRP in DM (4.09 ± 0.91μg/ml) was significantly higher than controls (1.30 ± 0.50μg/ml, p = 0.009). While no association of xanthine oxidase was observed with glycemic control indices and hs CRP, a negative association of xanthine oxidase was observed with MDA (r = -0.514, p = 0.000).

CONCLUSION

Increased activity of xanthine oxidase in DM was associated with increased lipid peroxidation and could be a salient entity towards the onset on complications.

Evaluation of the etiology of persistent iritis after cataract surgery

Background

The purpose of this study was to evaluate patients with persistent iritis after cataract surgery to determine its incidence and risk factors. Adjusting the management of patients at risk could allow for a more predictable post-operative course and outcome. A retrospective chart review was performed of patients who had post-operative iritis longer than 1 month after cataract surgery during a 2-year period at Storm Eye Institute at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. Patient demographics and various pre-operative, intra-operative, and post-operative factors were analyzed for trends.

Results

Thirty-nine patients (49 eyes) met the inclusion criteria, and this group was compared to a control cohort of 40 patients (66 eyes) who did not have persistent iritis after cataract surgery. The overall incidence of post-operative iritis was 1.75%. In all patients with post-operative iritis lasting greater than 1 month, African American race and pupil expansion device use were statistically significant factors. After excluding patients with a history of ocular inflammation or known inflammatory or autoimmune diagnosis (1.20% incidence), there were still a significantly higher proportion of African Americans compared to the control group. When patients with post-operative iritis of less than 6 months in duration were additionally excluded, the incidence was 0.32%, and history of diabetes was statistically significant in addition to race.

Conclusions

Risk factors for persistent iritis after cataract surgery include being diabetic, of African American racial background, and pupil expansion device use. These patients can be better informed of the higher risk of prolonged inflammation in their post-operative course, and peri-operative management can be tailored accordingly.

Association between cataract progression and ischemia-modified albumin in relation to oxidant-antioxidant profiles in the serum, aqueous humor, and lens

PURPOSE

To evaluate the levels of ischemia-modified albumin (IMA) in relation to oxidant-antioxidant profiles in the serum, aqueous, and lens in cataract patients.

SETTING

Department of Ophthalmology, Menoufia University, Shebin El Kom, Menoufia, Egypt.

DESIGN

Prospective case series.

METHODS

Patients were divided into 2 groups. The cataract (study) group comprised patients with senile cataract and the control group, age- and sex-matched healthy persons. Patients with systemic disease or cataract formation secondary to identifiable causes were excluded. In all cases, a complete history was taken and a clinical examination was performed. In the cataract group, the lens was examined, and the cataract type and severity were graded. Blood levels of catalase, malondialdehyde (MDA), superoxide dismutase (SOD), and IMA were measured in all participants and in the aqueous and lens lysate of cataract patients.

RESULTS

Each group comprised 30 participants. Cataract patients had significant higher levels of serum MDA and IMA than the control group but had lower levels of serum catalase and SOD. Patients with cortical cataracts had higher level of serum IMA, aqueous catalase, and SOD levels patients with nuclear cataracts but had a lower level of lens SOD. There was a significant positive correlation between serum MDA and the patient's age and serum catalase levels.

CONCLUSION

Patients with cortical cataract had increased local oxidative stress and diminished antioxidant activity compared with systemic oxidative activity, which was not the same in patients with nuclear cataract.

Xanthine oxidase activity in patients with age-related cataract associated with hypertension

Reactive oxygen species and lipid peroxidation are important factors that contribute to the development of age-related cataract. The study included 130 patients with age-related cataract, 69 of whom were diagnosed with hypertension (HT), 20 with hypertension and type 2 diabetes mellitus (DM), and 41 had no accompanying condition. The following parameters were measured in the serum of the examinees: products of lipid peroxidation malondialdehyde (MDA) and lipofuscin-like fluorophores (LLF), activity of prooxidative enzymes xanthine oxidase (XO) and myeloperoxidase (MPO), antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), the concentration of thiol groups, and the ferric reducing activity of plasma. The activity of prooxidative enzymes XO and MPO was higher in the plasma of patients with HT (XO=9.0±1.2 U/L; MPO=77.3±8.4 U/L) and with HT and DM (XO=11.9±0.9 U/L; MPO=89.5±5.0 U/L) compared to patients with age-related cataract (XO=6.2±0.9 U/L; MPO=52.4±6.3 U/L; P<0.01). Our research has shown that patients with age-related cataract and hypertension were exposed to increased oxidative damage of biomolecules, based on the increased plasma LLF and MDA content and decreased levels of thiol groups. Oxidative changes of biomolecules in these patients were associated with increased activity of the XO, MPO, and GPx enzymes and a lower extracellular SOD activity and total ferric reductive ability of plasma.

Serum adenosine deaminase and xanthine oxidase activities in silver catfish naturally infected with Ichthyophthirius multifiliis: The influence of these enzymes on inflammatory and oxidative status

Adenosine deaminase (ADA) activity, through adenosine (Ado) levels, as well as xanthine oxidase (XO) activity through uric acid levels exerts an essential role on immune and inflammatory responses during infectious diseases. Thus, the aim of this study was to evaluate the involvement of seric ADA and XO activities in the inflammatory and oxidative status of silver catfish naturally infected with Ichthyophthirius multifiliis. Seric ADA activity decreased, while Ado levels increased in infected animals compared to uninfected animals. Moreover, the seric XO activity increased in infected animals compared to uninfected animals, alongside the seric levels of uric acid, metabolites of nitric oxide (NOx) and reactive oxygen species (ROS). Based on this evidence, the downregulation of seric ADA activity exerts an anti-inflammatory profile, contributing to restricting the inflammatory process. The most important finding is that upregulation of seric XO activity leads to an excessive formation of uric acid, which contributes to oxidative and inflammatory processes. Moreover, uric acid induces the release of pro-inflammatory and pro-oxidative mediators, such NOx and ROS, which contribute directly to disease pathogenesis. In summary, the upregulation of XO activity may be considered a pathway involved in NOx and ROS production in silver catfish infected with I. multifiliis.

An exploratory LC-MS-based metabolomics study reveals differences in aqueous humor composition between diabetic and non-diabetic patients with cataract

Cataract is the leading cause of blindness worldwide. Epidemiological studies revealed up to a fivefold increased prevalence of cataracts in diabetic subjects. Metabolomics is nowadays frequently implemented to understand pathophysiological processes responsible for disease occurrence and progression. It has also been used recently to study the metabolic composition of aqueous humor (AH). AH is a transparent fluid which fills the anterior and posterior chambers of the eye. It supplies nutrients and removes metabolic waste from avascular tissues in the eye. The aim of this study was to use metabolomics to compare the AH of diabetic and non-diabetic patients undergoing cataract surgery. Several antioxidants (methyltetrahydrofolic acid, taurine, niacinamide, xanthine, and uric acid) were found decreased (-22 to -61%, p-value 0.05-0.003) in AH of diabetics. Also amino acids (AA) and derivatives were found decreased (-21 to -36%, p-value 0.05-0.01) while glycosylated AA increased (+75-98%, p-value 0.03-0.009) in this group of patients. Metformin was detected in AH of people taking this drug. To our knowledge, this is the first metabolomics study aiming to assess differences in AH composition between diabetic and non-diabetic patients with cataract. An increased oxidative stress and perturbations in amino acid metabolism in AH may be responsible for earlier cataract onset in diabetic patients.

The Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Anterior Segment

Purpose. To evaluate the safety of high-intensity focused ultrasound keratoplasty as a treatment for presbyopia by examining its effect on the rabbit anterior segment. Methods. The right corneas of 36 New Zealand rabbits were treated with HIFU keratoplasty. The animals were sacrificed at 1, 7, 15, 30, 60, and 90 days after operation. Collagen type I, MMP-2, and MMP-9 were evaluated using immunohistochemistry. For the detection of apoptosis, the TUNEL method was applied. The SOD and MDA levels were analyzed with assay kits. Results. Collagen type I, MMP-2, and MMP-9 levels were altered after the operation but returned to normal within 90 days. The apoptotic index (AI) of the corneal cells decreased from 1 to 30 days gradually. No apoptosis was observed in the epithelial cells of the lens, and the SOD and MDA levels were normal at any time point. Conclusion. After HIFU keratoplasty, the histomorphology of the cornea changed, the corneal collagen type I levels decreased, the corneal MMP-2 and MMP-9 levels increased, and the corneal cells underwent apoptosis for a period of time. Ninety days after the operation, the levels returned to normal, and the lenses were not affected. Thus, HIFU presents good biological safety for eyes.

Potential of CeCl3@mSiO2 nanoparticles in alleviating diabetic cataract development and progression

Cataract is a major cause of visual impairment for diabetic patients. It is imperative to develop efficient therapeutic agents against diabetic cataract (DC) because diabetes confers higher risk for complications after cataract surgery. We have previously reported the role of CeCl₃ loaded mesoporous silica (CeCl₃@mSiO₂) nanoparticles in reducing the oxidative stress of lens epithelial cells. However, the potential of CeCl₃@mSiO₂ in preventing diabetic cataract development remains unclear. In this study, we applied CeCl₃@mSiO₂ nanoparticles with a size of 87.6±8.9nm to streptozotocin-induced diabetic cataract rat model by intraperitoneal injection. Our results showed that CeCl₃@mSiO₂ efficiently ameliorated the progression of DC. Consistent with antioxidant effect of CeCl₃@mSiO₂in vitro, administration of CeCl₃@mSiO₂ significantly abrogated hyperglycemia-mediated upregulation of advanced glycation end products, lipid peroxidation and protein carbonylation in animal lens. Taken together, our study provides a potential nanodrug to manage the development of DC.

Cataract induction by administration of nitroglycerin in cardiac patients through imbalance in redox status

Purpose

The objective of this study was to evaluate the role of nitroglycerin in the pathogenesis of cataract.

Design

Prospective study.

Patient and methods

This study was performed in adults from tertiary Saudi Arabian hospitals (34 males and 26 females in each group, aged from 40 to 60 years), who were divided into four groups with an equal number of subjects (control group, cardiac group, idiopathic cataract group, and a group of cardiac patients using nitroglycerin and with cataracts). Fasting glucose concentrations, blood glycated hemoglobin levels, lipid profiles, and levels of nitrite, conjugated dienes (CD), thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), and reduced glutathione (GSH) were determined.

Results

Treatment of cardiac patients with nitroglycerin produced an imbalance in their systemic redox status, leading to the development of cataracts, which was reflected by a significant increase in the levels of nitrite, CD, and TBARS and a significant decrease in SOD activity and GSH, compared with idiopathic cataract patients. The results of correlation studies and multiple regression analysis revealed a significant positive correlation between different biochemical parameters (GSH, SOD, TBARS, CD, and nitrite) in the blood and lens in both idiopathic cataract patients and cardiac patients treated with nitroglycerin.

Conclusion

The study points to the relative and predictive effects of nitric oxide derived from nitroglycerin in the development of cataract in the presence of the oxidative stress induced by nitroglycerin treatment.

Is Xanthine oxidase activity in polycystic ovary syndrome associated with inflammatory and cardiovascular risk factors?

The aim of this study is to examine women with polycystic ovary syndrome (PCOS) to determine the relationship between xanthine oxidase (XO) and oxidative stress, inflammatory status, and various clinical and biochemical parameters. In this cross-sectional study a total of 83 women including 45 PCOS patients and 38 healthy women were enrolled. We collected blood samples for XO and superoxide dismutase (SOD) activity, hormone levels, cholesterol values, and inflammatory markers. Body mass index (BMI) , waist-to-hip ratio (WHR), and blood pressure were assessed. Blood samples were taken for hormonal levels, cholesterol levels, fasting plasma glucose (FPG), fasting plasma insulin (FPI), homeostatic model assessment-insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI), C-reactive protein (CRP), white blood cell and neutrophil counts, XO and SOD activities. The basal hormone levels, triglyceride (TG) levels, TG/HDL-C (high density lipoprotein-cholesterol) ratios FPG, FPI and HOMA-IR levels were higher in PCOS patients compared to controls (p<0.05). Platelet and plateletcrit (PCT) values, CRP, and XO activity were significantly increased, however SOD activity was decreased in PCOS patients (p<0.001). XO activity was positively correlated with LH/FSH and TG/HDL ratios, CRP, PCT, FPG, FPI, and HOMA-IR, and negatively correlated with QUICKI levels. In conclusion, XO is a useful marker to assess oxidative stress in PCOS patients. Positive correlations between XO and inflammatory markers and cardiovascular disease risk factors suggest that XO plays an important role in the pathogenesis of PCOS and its metabolic complications.

New 1,4-Dihydropyridines Down-regulate Nitric Oxide in Animals with Streptozotocin-induced Diabetes Mellitus and Protect Deoxyribonucleic Acid against Peroxynitrite Action

Diabetes mellitus (DM) and its complications cause numerous health and social problems throughout the world. Pathogenic actions of nitric oxide (NO) are responsible to a large extent for development of complications of DM. Search for compounds regulating NO production in patients with DM is thus important for the development of pharmacological drugs. Dihydropyridines (1,4-DHPs) are prospective compounds from this point of view. The goals of this study were to study the in vivo effects of new DHPs on NO and reactive nitrogen and oxygen species production in a streptozotocin (STZ)-induced model of DM in rats and to study their ability to protect DNA against nocive action of peroxynitrite. STZ-induced diabetes caused an increase in NO production in the liver, kidneys, blood and muscles, but a decrease in NO in adipose tissue of STZ-treated animals. Cerebrocrast treatment was followed by normalization of NO production in the liver, kidneys and blood. Two other DHPs, etaftorone and fenoftorone, were effective in decreasing NO production in kidneys, blood and muscles of diabetic animals. Furthermore, inhibitors of nitric oxide synthase (NOS) and an inhibitor of xanthine oxidoreductase (XOR) decreased NO production in kidneys of diabetic animals. Treatment with etaftorone decreased expression of inducible NOS and XOR in kidneys, whereas it increased the expression of endothelial NOS. In vitro, the studied DHPs did not significantly inhibit the activities of NOS and XOR but affected the reactivity of peroxynitrite with DNA. These new DHPs thus appear of strong interest for treatment of DM complications.

Anthraquinones and flavonoids of Cassia tora leaves ameliorate sodium selenite induced cataractogenesis in neonatal rats

The present study was undertaken to evaluate the efficacy ofCassia toraleaves, an edible plant traditionally used for eye ailments, in preventing experimental cataractogenesis.

Xanthine Oxidase Activity in Type 2 Diabetes Mellitus Patients with and without Diabetic Peripheral Neuropathy

This study investigated the relationship between serum xanthine oxidase (XOD) activity and the occurrence of diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients. Serum XOD activity, ischemia-modified albumin (IMA), uric acid (UA), albumin, glycated hemoglobin (HbA1c), advanced glycation end products (AGE), total free thiols, atherogenic index of plasma (AIP), and body mass index (BMI) were measured in 80 T2DM patients (29 with and 51 without DPN), and 30 nondiabetic control subjects. Duration of diabetes, hypertension, medication, and microalbuminuria was recorded. Serum XOD activities in controls, non-DPN, and DPN were 5.7 ± 2.4 U/L, 20.3 ± 8.6 U/L, and 27.5 ± 10.6 U/L (p < 0.01), respectively. XOD activity was directly correlated to IMA, UA, BMI, HbA1c, and AGE, while inversely correlated to serum total free thiols. A multivariable logistic regression model, which included duration of diabetes, hypertension, AIP, HbA1c, UA, and XOD activity, revealed HbA1c [OR = 1.03 (1.00-1.05); p = 0.034] and XOD activity [OR = 1.07 (1.00-1.14); p = 0.036] as independent predictors of DPN. Serum XOD activity was well correlated to several other risk factors. These results indicate the role of XOD in the development of DPN among T2DM patients.

Plasma metabolomic profiling of patients with diabetes-associated cognitive decline

Diabetes related cognitive dysfunction (DACD), one of the chronic complications of diabetes, seriously affect the quality of life in patients and increase family burden. Although the initial stage of DACD can lead to metabolic alterations or potential pathological changes, DACD is difficult to diagnose accurately. Moreover, the details of the molecular mechanism of DACD remain somewhat elusive. To understand the pathophysiological changes that underpin the development and progression of DACD, we carried out a global analysis of metabolic alterations in response to DACD. The metabolic alterations associated with DACD were first investigated in humans, using plasma metabonomics based on high-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry and multivariate statistical analysis. The related pathway of each metabolite of interest was searched in database online. The network diagrams were established KEGGSOAP software package. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic accuracy of metabolites. This is the first report of reliable biomarkers of DACD, which were identified using an integrated strategy. The identified biomarkers give new insights into the pathophysiological changes and molecular mechanisms of DACD. The disorders of sphingolipids metabolism, bile acids metabolism, and uric acid metabolism pathway were found in T2DM and DACD. On the other hand, differentially expressed plasma metabolites offer unique metabolic signatures for T2DM and DACD patients. These are potential biomarkers for disease monitoring and personalized medication complementary to the existing clinical modalities.