The urinary concentration of sialic acid is increased in non-insulin-dependent diabetic patients with microangiopathy: a possible useful marker for diabetic microangiopathy

Sialic acid: a novel marker of cardiovascular disease?

The global burden posed by cardiovascular disease (CVD), due to a rising incidence of known risk factors, underlines an urgent need to identify other potential risk factors. Sialic acid (SA), an abundant terminal monosaccharide of glycoconjugates, is a possible risk factor for CVD. Although large-scale epidemiological surveys have shown that serum total sialic acid (TSA) is positively associated with mortality from coronary artery disease (CAD) and stroke, studies investigating the correlation between serum TSA and the severity of atherosclerosis are conflicting. Clinical and epidemiological studies indicate that serum TSA is a marker of a sustained inflammatory response in CVD, rather than causal in nature. Data also indicates ethnic variation in baseline TSA. This article reviews current methods for determining serum TSA and evidence supporting serum TSA as a risk factor for CVD. Potential mechanisms for this role are examined. The use of serum TSA as a marker of atherosclerotic disease is evaluated.

Osteoclastic function is accelerated in male patients with type 2 diabetes mellitus: the preventive role of osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG) on the decrease of bone mineral density

To clarify the pathogenesis of altered bone metabolism in diabetic state and its underlying mechanisms, the bone mineral content and fasting levels of serum intact parathyroid hormone (i-PTH), intact osteocalcin (i-OC), tartrate-resistant acid phosphatase (TRAP) and osteoclastgenesis inhibitory factor/osteoprotegerin (OCIF/OPG) were measured in male type 2 diabetic patients and their age-matched controls. In addition, urine levels of osteoclastic markers, C-telopeptide of type I collagen (CTx), deoxypyridinoline (DPD), and N-telopeptide of type I collagen (NTx) were simultaneously determined. Serum levels of i-PTH and i-OC in diabetic patients were significantly lower than those in the controls. Conversely, serum concentrations of TRAP were significantly elevated in diabetic patients. However, no clear correlation was observed between serum i-OC and TRAP. It was also observed that urinary excretion of CTx, DPD, and NTx was significantly increased in the diabetics as compared with the controls. Unexpectedly, serum levels of OCIF/OPG tended to be higher in the diabetic group, and these values exhibited a significantly positive correlation with those of serum TRAP. There was found a significantly negative correlation between serum TRAP and bone mineral density (BMD) and also between serum OCIF/OPG and bone mineral density. It seems probable that OCIF/OPG has a suppressive role on the increased bone resorption to prevent further loss of the skeletal bone mass in type 2 diabetic patients.

Type 2 diabetes mellitus: a disease of the innate immune system? An update

A few years ago a hypothesis was proposed suggesting that elements of the innate immune system, such as acute phase reactants, contribute to the development of Type 2 diabetes mellitus. Acute phase reactants such as C-reactive protein and sialic acid may thus predict risk of developing Type 2 diabetes mellitus, as well as being markers of diabetes microvascular and macrovascular complications. This article discusses these issues.

Level of sialic acid residues in platelet proteins in diabetes, aging, and Hodgkin's lymphoma: a potential role of free radicals in desialylation

The present study evaluated the levels of sialic acid and carbonylation in platelet proteins from diabetes, old age, and Hodgkin's lymphoma cases and explored the role of free radicals in desialylation. Sialic acid and carbonylation were estimated in platelet suspension obtained from 10 healthy adult control subjects, 20 elderly healthy persons, 20 cases with diabetes, and 10 with Hodgkin's lymphoma. The level of sialic acid residues in platelets was found to be significantly lower and the carbonylation of proteins was higher in old age, diabetes, and lymphoma cases in comparison to controls. The level of carbonylation correlated with desialylation in these cases. In vitro treatment of platelets with free radicals was found to cause desialylation and to increase the carbonyl content. Addition of 2-mercaptoethanol, an antioxidant, significantly attenuated the above effects. The study indicates the possible role of free radicals in desialylation of platelet proteins in the above clinical conditions.

Correlations between bone mineral density and circulating bone metabolic markers in diabetic patients

Diabetic osteopenia, a known chronic complication of diabetes, has been demonstrated with alterations in the calcium-vitamin D endocrine system. In order to investigate the relationship between the decrease of bone density and the altered mineral metabolism in non-insulin-dependent diabetes mellitus (NIDDM), 104 male clinical-proven NIDDM patients were studied. All patients were examined on metacarpal bone mineral density (m-BMD) by means of computed X-ray densitometry (CXD) methods. The values of the Z-score of m-BMD were significantly lower than those of age-matched controls (P<0.01). There was a positive correlation between m-BMD and serum calcium levels (P<0.01), but a negative correlation was conversely observed between m-BMD and serum intact parathyroid hormone (PTH) (P<0.01), indicating that the negative calcium balance under diabetic conditions could cause the decrease of m-BMD in NIDDM. Interestingly, since a significantly positive correlation was found between circulating levels of calcium and parathyroid hormone-related peptide (PTHrP) (P<0.05) but not PTH, it seems likely that PTHrP plays a more compensatory role on the maintenance of calcium homeostasis than PTH under diabetic conditions. Based on these observations, the CXD method would be useful in measuring the mineral density of cortical bone, and would also be beneficial to investigate underlying pathogenetic mechanism of diabetic osteopenia.