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Xiong W, Liu H, Xiang B, Shang G. Liraglutide combined with routine therapy improves renal function, renal fibrosis, immune status, and prognosis of type 2 diabetes patients. Am J Transl Res 2024; 16:3405-3412. [PMID: 39114730 PMCID: PMC11301491 DOI: 10.62347/vysw5854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/22/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To investigate the effect of Liraglutide in conjunction with routine therapy on renal function, renal fibrosis, immune status, and prognosis in patients with diabetes mellitus. METHODS The clinical data of patients with Type 2 diabetes mellitus (T2DM) treated at the First Affiliated Hospital of Jishou University from March 2021 to March 2022 were retrospectively analyzed. Patients were assigned into a control group (n=42) and a study group (n=42) according to their treatment regimen. The control group received routine treatment, and the study group received Liraglutide in addition to routine treatment. The therapeutic effects, blood glucose levels, renal function, renal fibrosis, and Immunoglobulin (Ig) levels as well as the incidence of adverse reactions, were compared between the two groups. RESULTS The effective rate was higher in study group (97.62%) than that of the control group (78.57%) (P<0.05). After treatment, the fasting blood-glucose (FBG), 2-hour postprandial plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c) levels were decreased; and the study group displayed a significantly lower blood glucose level than the control group (all P<0.05). Also, the serum creatinine (Scr), blood urea nitrogen (BUN), and 24-hour urinary protein quantification (24h-UPor) were decreased after treatment; and the study group showed more pronounced improvement in renal function index than did the control group (all P<0.05). The levels of IgA, IgM, and IgG were increased after treatment compared to pre-treatment; and the study group exhibited significantly better improvement than the control group (all P<0.05). However, the study group reported a notably higher incidence of adverse reactions than the control group (19.05% vs 2.38%; P<0.05). CONCLUSION Liraglutide combined with routine therapy is effective in treating patients with diabetes, which can effectively reduce the levels of blood glucose andurinary protein, and the degree of renal fibrosis, while improving renal and immune functions and the clinical prognosis of diabetic patients.
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Affiliation(s)
- Wen Xiong
- Department of Nephrology, First Affiliated Hospital of Jishou University Jishou 416000, Hunan, China
| | - Hongxia Liu
- Department of Nephrology, First Affiliated Hospital of Jishou University Jishou 416000, Hunan, China
| | - Bo Xiang
- Department of Nephrology, First Affiliated Hospital of Jishou University Jishou 416000, Hunan, China
| | - Guangyu Shang
- Department of Nephrology, First Affiliated Hospital of Jishou University Jishou 416000, Hunan, China
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Liu Z, Ma Z, Jin L, Nizhamuding X, Zeng J, Zhang T, Zhang J, Wang J, Zhao H, Zhou W, Zhang C. Altered neopterin and IDO in kynurenine metabolism based on LC-MS/MS metabolomics study: Novel therapeutic checkpoints for type 2 diabetes mellitus. Clin Chim Acta 2024; 557:117859. [PMID: 38518968 DOI: 10.1016/j.cca.2024.117859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/26/2024] [Accepted: 03/03/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND This study assessed the alternations of kynurenine pathway (KP) and neopterin in type 2 diabetes mellitus (T2DM) and explored possible differential metabolites. METHODS A fresh residual sera panel was collected from 80 healthy control (HC) individuals and 72 T2DM patients. Metabolites/ratios of interest including tryptophan (TRP), kynurenine (KYN), 5-hydroxytryptamine (5HT), kynurenic acid (KA), xanthurenic acid (XA), neopterin (NEO), KA/KYN ratio and KYN/TRP ratio were determined using a targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) metabolomics approach, and the difference between groups was assessed. Supervised orthogonal partial least squares-discriminant analysis and differential metabolite screening with fold change (FC) were performed to identify distinct biomarkers. The diagnostic performance of KP metabolites in T2DM was evaluated. RESULTS Significant decreases of TRP, 5HT, KA, XA, and KA/KYN and increases of KYN/TRP and NEO in T2DM compared to HC group were observed (P < 0.05). The KP metabolites panel significantly changed between T2DM and HC groups (Q2: 0.925, P < 0.005). 5HT (FC: 0.63, P < 0.01) and NEO (FC: 3.27, P < 0.01) were proven to be distinct differential metabolites. A combined testing of fasting plasma glucose and KYN/TRP showed good value in the prediction of T2DM (AUC: 0.904, 95% CI 0.843-0.947). CONCLUSIONS The targeted LC-MS/MS metabolomics study is a powerful tool for evaluating the status of T2DM. This study facilitated the application of KP metabolomics into future clinical practice. 5HT and NEO are promising biomarkers in T2DM. KYN/TRP was highly associated with the development of T2DM and may serve as a potential treatment target.
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Affiliation(s)
- Zhenni Liu
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Zijia Ma
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Lizi Jin
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Xiaerbanu Nizhamuding
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Jie Zeng
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China
| | - Jing Wang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China
| | - Haijian Zhao
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China.
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
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Melekoğlu R, Ünüvar S, Türkmen NB, Çetin A, Zeyveli Çelik N, Yüce H, Yaşar Ş. Evaluation of serum neopterin, periostin, Tenascin‐C, tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-2 levels in obese pregnant women. Turk J Obstet Gynecol 2022; 19:257-267. [DOI: 10.4274/tjod.galenos.2022.70593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Saghazadeh A, Rezaei N. Elevated neopterin in tuberculosis and co-infection with HIV and the effect of treatment: A systematic review, meta-analysis, and meta-regression. Int Immunopharmacol 2022; 111:109147. [PMID: 35973370 DOI: 10.1016/j.intimp.2022.109147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/21/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neopterin (NEO) is a marker of immune stimulation. Increased NEO levels have been associated with autoimmune diseases, infections, and malignancies. Studies of NEO alterations in tuberculosis (TB) with or without HIV co-infection show inconsistent results. Moreover, challenges exist regarding TB diagnosis in people with HIV. METHODS We did a systematic review and meta-analysis of studies comparing urinary, pleural, and blood NEO levels between patients with TB or HIV-TB co-infection as the case group and subjects without TB and HIV or subjects with HIV without TB as the control group, respectively. RESULTS Blood NEO levels in patients with active TB were higher than healthy controls, with a large effect size of 1.99. Patients with TB had higher blood NEO levels before anti-tuberculosis therapy (ATT) than after ATT for months or when treatment ended with moderate effect sizes (1.13-1.46). meta-analysis of studies of patients with HIV-TB co-infection yielded similar results, with higher blood NEO levels in patients than controls that remained significant in subgroups of studies on pulmonary TB (PTB) patients and serum NEO and higher blood NEO levels in patients before than after ATT. CONCLUSION Meta-analyses reveal alteration in NEO levels in different specimens, e.g., blood, urine, and pleural fluid, in patients with TB with or HIV-TB co-infection compared to the control groups. Future studies need to investigate the utility of NEO as a diagnostic/prognostic biomarker for TB. Also, cellular and molecular mechanisms linking NEO and TB remain to be addressed.
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Affiliation(s)
- Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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Tanrıverdi Z, Meteroglu F, Yüce H, Şenyiğit A, Işcan M, Unüvar S. The usefulness of biomarkers in diagnosis of asbestos-induced malignant pleural mesothelioma. Hum Exp Toxicol 2021; 40:1817-1824. [PMID: 33998299 DOI: 10.1177/09603271211017324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Malignant pleural mesothelioma (MPM) is a malignant tumor that is associated mostly with asbestos exposure. The present study was to evaluates the diagnostic value of neopterin, periostin, YKL-40, Tenascin-C (TNC), and Indolamine 2,3-dioxygenase (IDO) as noninvasive markers of malign pleural mesothelioma. METHODS Included in the study were 30 patients diagnosed with malign pleural mesothelioma, and 25 people as a control group. Biomarker levels were determined using an enzyme immunoassay . A Mann-Whitney U test and Spearman correlation methods were used for the statistical analysis. RESULTS All evaluated biomarkers were found to be significantly higher in the MPM group than in the control group (p < 0.05). There was no effect of such variables as gender, age or MPMsubtype on the parameters (p > 0.05) in the patient group. All biomarkers were positively correlated with each other (p < 0.001). CONCLUSIONS The current non-invasive biomarkers that can be used in the diagnosis of MPM yielded significant results and can make important contributions to the early diagnosis of MPM.
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Affiliation(s)
- Zübeyde Tanrıverdi
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
| | - Fatih Meteroglu
- Department of Thoracic Surgery, Faculty of Medicine, 37507Dicle University, Diyarbakır, Turkey
| | - Hande Yüce
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
| | - Abdurrahman Şenyiğit
- Department of Chest Diseases, Faculty of Medicine, 37507Dicle University, Diyarbakır, Turkey
| | - Mümtaz Işcan
- Faculty of Pharmacy, 64188Cyprus International University, Nicosia, Cyprus
| | - Songül Unüvar
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
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Nedeva I, Gateva A, Assyov Y, Karamfilova V, Velikova T, Kamenov Z. Neopterin in the Evolution from Obesity to Prediabetes and Newly Diagnosed Type 2 Diabetes. Metab Syndr Relat Disord 2021; 19:249-255. [PMID: 33599536 DOI: 10.1089/met.2020.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Neopterin, marker of cellular immunity and oxidative stress, is mainly produced by activated macrophages. It could play a crucial role in the development of insulin resistance (IR) and type 2 diabetes (T2D). The aim of this study was to investigate the circulating levels of neopterin in different stages of glucose dysregulation from obesity through prediabetes to newly diagnosed diabetes. Methods: Neopterin levels were determined using a commercially available human enzyme-linked immunosorbent assay kit. The homeostasis model assessment of IR was used as an index to assess IR. Results: The sample consisted of 163 subjects with mean age 52.5 ± 11.3 years, divided in three age- and body mass index (BMI)-matched groups-obesity, prediabetes, and diabetes. The control group consisted of 42 healthy individuals. Neopterin levels were significantly higher in patients with obesity and/or prediabetes and newly diagnosed diabetes than those in the control group, respectively (4.14 ± 2.51; 4.04 ± 2.80 and 2.17 ± 1.93 vs. 0.87 ± 0.84; P < 0.05). Correlation analysis showed that the level of neopterin positively correlated with BMI, waist, waist-to-stature ratio, waist-to-hip ratio, fasting glucose, and triglycerides. Receiver operating characteristic analysis established neopterin suitable for distinguishing subjects with obesity [area under the curve (AUC) = 0.83; P < 0.001] and carbohydrate disturbances (AUC = 0.59; P < 0.05) from those without these conditions. Neopterin ≥0.47 ng/mL have an odds ratio (OR) of 2.71 for development of dysglycemia, whereas threshold value of neopterin ≥0.56 ng/mL shows an OR of 5.94 for development of obesity. Conclusion: The levels of neopterin were increased in patients with obesity and carbohydrate disturbances. Further studies will elucidate the role of the biomarker in development of T2D and its complications.
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Affiliation(s)
- Iveta Nedeva
- Clinic of Endocrinology, Department of Internal Medicine, Medical University of Sofia, University Hospital "Alexandrovska," Sofia, Bulgaria
| | - Antoaneta Gateva
- Clinic of Endocrinology, Department of Internal Medicine, Medical University of Sofia, University Hospital "Alexandrovska," Sofia, Bulgaria
| | - Yavor Assyov
- Clinic of Endocrinology, Department of Internal Medicine, Medical University of Sofia, University Hospital "Alexandrovska," Sofia, Bulgaria
| | - Vera Karamfilova
- Clinic of Endocrinology, Department of Internal Medicine, Medical University of Sofia, University Hospital "Alexandrovska," Sofia, Bulgaria
| | - Tsvetelina Velikova
- Laboratory of Clinical Immunology, Department of Clinical Laboratory and Clinical Immunology, Medical University of Sofia, University Hospital "Lozenetz," Sofia, Bulgaria
| | - Zdravko Kamenov
- Clinic of Endocrinology, Department of Internal Medicine, Medical University of Sofia, University Hospital "Alexandrovska," Sofia, Bulgaria
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Relationship between guanosine triphosphate pathway and tetrahydrobiopterin in gestational diabetes mellitus. J Diabetes Metab Disord 2021; 19:1391-1396. [PMID: 33520842 DOI: 10.1007/s40200-020-00659-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/31/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022]
Abstract
Purpose The present study assesses the change in tetrahydrobiopterin (BH4), one of the most important products in the guanosine triphosphate (GTP) pathway and in other parameters that might affect nitric oxide (NO) production, in gestational diabetes mellitus (GDM). Methods The study included 100 healthy pregnant women and 100 women diagnosed with GDM. Serum levels of neopterin, BH4 and NO were measured. The levels of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS) and guanosine triphosphate cyclohydrolase I (GCHI/GTPCH) gene expression were determined. Results It was found that diabetes led to an increase in neopterin and NO levels, and a decrease in BH4 levels. A stimulation was observed in eNOS gene expression in the GDM group when compared to the control group, while GCHI levels were found to decrease when compared to the control group. iNOS gene expression was detected in neither the healthy controls nor the patient group. Conclusions Decreased NO bioavailability plays an important role in the progression of such macrovascular diseases as diabetes. BH4 levels decrease in diabetes patients, while the increased gene expression of GCHI reverses the diabetes-related BH4 deficiency and allows the endothelial cells to regain their ability to produce NO. Since GCHI is the rate-limiting enzyme in the biosynthesis of BH4, changes in GCHI levels directly affect the BH4 levels and the NO metabolism, leading to an increased risk of macrovascular complications. The significant increase in neopterin levels suggest that this is a potential biomarker for the early diagnosis of GDM.
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Wan RH, Yuan Y, Hao W, Zheng LY, Lu J. Relationship Between Serum Neopterin Level and Peripheral Arterial Plaque in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2021; 14:2871-2878. [PMID: 34234484 PMCID: PMC8254027 DOI: 10.2147/dmso.s315986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/14/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Neopterin is an inflammatory factor synthesized by monocyte macrophages in response to γ-interferon. It plays an important role in regulating a variety of physiological and pathological processes, including obesity, diabetes, and cardiovascular disease. This study aims to clarify the relationship between peripheral arterial plaque and serum neopterin in type 2 diabetes. METHODS We consecutively selected 121 inpatients with type 2 diabetes. After collecting relevant clinical indicators, we collected serum from all patients and measured neopterin levels through enzyme linked immune sorbent assay. Peripheral arterial plaques (the carotid and femoral arteries) were detected by B-mode ultrasound. Multivariate logistic regression was used to determine the independent influencing factors. The correlation between neopterin levels and other variables was analyzed by Spearman correlation analysis. P <0.05 was considered to be statistically significant. RESULTS There was no difference in serum neopterin levels between arterial plaques group and no plaques group. Serum neopterin levels in patients with carotid plaque were elevated compared to patients without carotid plaque. Logistic regression analysis showed that a higher serum neopterin level was an independent risk factor for the presence of carotid plaques. Serum neopterin levels were positively correlated with BMI, HOMA-IR, and serum creatinine and negatively correlated with eGFR. CONCLUSION Serum neopterin levels were positively and independently associated with carotid plaque in patients with type 2 diabetes.
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Affiliation(s)
- Ren-Hui Wan
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Yang Yuan
- Laboratory of Cardiothoracic Surgery Department, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Wei Hao
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Long-Yi Zheng
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
| | - Jin Lu
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China
- Correspondence: Jin Lu Department of Endocrinology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, People’s Republic of ChinaTel/FAX +86 21 31161391 Email
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Gürcü S, Girgin G, Yorulmaz G, Kılıçarslan B, Efe B, Baydar T. Neopterin and biopterin levels and tryptophan degradation in patients with diabetes. Sci Rep 2020; 10:17025. [PMID: 33046801 PMCID: PMC7552423 DOI: 10.1038/s41598-020-74183-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to evaluate the possible changes of neopterin, biopterin levels and tryptophan degradation in diabetes and to compare the results within diabetes groups and with healthy subjects. Diabetes mellitus patients and healthy controls were recruited the study. Patients were further subgrouped according to their drug therapy. Serum neopterin concentrations were detected by ELISA. Urinary neopterin, biopterin, serum tryptophan (Trp) and kynurenine (Kyn) levels were detected by HPLC. There was no difference between controls and diabetes patients in serum neopterin, urinary neopterin and biopterin levels (p > 0.05, all). Serum Trp and Kyn levels were significantly different in type 1 diabetes (T1DM) patients compared to controls (p < 0.05, both). Serum neopterin levels were significantly higher in type 2 diabetes patients (T2DM) compared to T1DM (p < 0.05). Urinary biopterin levels of T2DM patients using both metformin and vildagliptin were significantly higher than T1DM patients (p < 0.05). The correlations between serum neopterin and urinary neopterin, Kyn and Kyn/Trp were statistically significant in control and patient groups (p < 0.05, all). The study showed that Kyn/Trp was altered in diabetes patients due to immune modulation. On the other hand, although xenobiotic exposure may change pteridine levels, metformin and/or vildagliptin use in T2DM patients did not have any effect on the measured parameters.
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Affiliation(s)
- Sinem Gürcü
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
- Eskisehir City Hospital, Hospital Pharmacy, Eskişehir, Turkey
| | - Gözde Girgin
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
| | - Göknur Yorulmaz
- Faculty of Medicine, Department of Endocrinology, Osmangazi University, Eskişehir, Turkey
| | - Bilge Kılıçarslan
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
| | - Belgin Efe
- Faculty of Medicine, Department of Endocrinology, Osmangazi University, Eskişehir, Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey.
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Al-Nimer M, Ratha R, Mahwi T. Utility of Tetrahydrobiopterin Pathway in the Assessment of Diabetic Foot Ulcer: Significant and Complex Interrelations. J Diabetes Res 2019; 2019:3426878. [PMID: 31828160 PMCID: PMC6881761 DOI: 10.1155/2019/3426878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 09/26/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Tetrahydrobiopterin (BH4) pathway that included generation of neopterin (Neop), biopterin (Biop), and nitric oxide (NO) is altered in type 2 diabetes (T2D). The aim of this study was to assess the biomarkers of BH4 pathway in noninfected DFUs and to relate these levels to the variables of diabetes as well as to the hematological indices. METHODS We performed a cross-sectional investigating study in a Kurdish people including 30 healthy subjects (group I), 66 T2D patients (group II), and 57 DFUs patients (group III). Hematological indices including red cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) were determined by Coulter hematological analysis. Serum BH4 markers including NO, Neop, and Biop were determined by using an enzyme-linked immunosorbent assay (ELISA) technology. The relationship between BH4 markers with glycemic and hematological indices was assessed by Spearman's correlation and multivariable regression analysis. RESULTS Neop was significantly increased while PDW was significantly decreased in group III compared with group II patients. Nitric oxide was found to be inversely correlated with age (r = -0.382), duration of diabetes (r = -0.264), mean arterial blood pressure (r = -0.532), body mass index (r = -0.321), RDW (r = -0.322), and PDW (r = -0.284) in group III patients. Circulating Neop and Biop significantly correlated with RDW and erythrocyte sedimentation rate. Multivariable regression analysis revealed that serum Neop predicted the DFUs in 92.5% of group III patients. CONCLUSION Tetrahydrobiopterin biomarkers are predictors of DFUs and the significant correlation of neopterin with red distribution width and erythrocyte sedimentation rate indicating the role of neopterin in the vascular and inflammation concerns of noninfected DFUs.
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Affiliation(s)
- Marwan Al-Nimer
- Department of Pharmacology and Toxicology, Hawler Medical University, Erbil, Iraq
- Department of Clinical Pharmacy, University of Sulaimani, Sulaimani, Iraq
| | - Rawa Ratha
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Sulaimani, Iraq
| | - Taha Mahwi
- Department of Medicine, College of Medicine, University of Sulaimani, Sulaimani, Iraq
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Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria. J Med Biochem 2019; 39:83-90. [PMID: 32549781 DOI: 10.2478/jomb-2019-0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/29/2019] [Indexed: 11/20/2022] Open
Abstract
Background Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Progressive damage and decline in the number of podocytes often occur in the early stages of DN. Thus, nephrin as a podocyte-specific protein may be regarded as a potential biomarker of early detection of DN. The aim of this study is to determine whether urinary nephrin is an earlier marker in DN than microalbuminuria and to test the significance of urinary nephrin as a marker for early detection of DN. Methods Our cross-sectional study included 90 patients with type 2 diabetes mellitus (T2DM), 30 patients with diagnosed DN and 60 patients without diagnosed DN. As a control group, we used 30 healthy subjects. All patients with T2DM were classified into three subgroups according to urinary microalbumin/creatinine ratio (UMCR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Nephrin in urine was measured by immunoenzyme assay, microalbumin with turbidimetric and creatinine with the photometric method. In blood sera, we measured a few standard biochemical parameters. Results Nephrinuria was found to be present in 100% of patients with T2DM and macroalbuminuria, in 88% with microalbuminuria, as well as 82% of patients with T2DM and normoalbuminuria. A concentration of urinary nephrin was significantly increased in all groups of subjects with T2DM compared to the control group (p<0.05). Nephrinuria correlated statistically negative with eGFR (r=-0.54). ROC analysis showed that nephrin has a total predicted probability of 96% in patients with DN. Conclusions Urinary nephrin is earlier, more specific and sensitive marker than microalbumin in early detection of DN.
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Association of Serum Paraoxonase 1 Activities, Polymorphisms and Oxidative Stress in Breast Cancer Patients with Type 2 Diabetes Mellitus. J Med Biochem 2019; 38:368-375. [PMID: 31156348 PMCID: PMC6534952 DOI: 10.2478/jomb-2018-0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023] Open
Abstract
Background The aim of the study was to investigate the association of paraoxonase 1 (PON1) polymorphism, PON1/arylesterase (ARE) activity and oxidative stress index (OSI) in breast cancer (BC) patients with type 2 diabetes (DM). Methods Our study group consisted of 30 healthy women (HV group) and 66 female BC patients. The BC patients were divided into two groups: those with (n=37) and without DM (n=29) (BDM and NBDM group). Genotyping of PON1 Q192R and L55M polymorphisms were done by polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) method. Serum PON1/ARE enzyme activities, total oxidant status (TOS) and total antioxidant status (TAS) were analysed by spectrophotometric method. The ratio of TOS to TAS was accepted as the oxidative stress index (OSI). Results PON1 Q192R genotype frequency distribution was significantly different in the BDM group compared to the NBDM group (p=0.021). When alleles distribution was examined, R and L alleles were significantly lower, Q and M alleles were significantly higher in the BDM group than in the NBDM group (p<0.001). TOS and OSI were statistically higher in BC patients than HV group (p<0.001). Conclusions Our results suggest that PON1 gene Q and M alleles may be the risk factors predisposing formation of BC due to increased oxidant damage seen in DM. However, these statements require further confirmation with screening PON1 polymorphism in a greater number of patients with DM, and also wide range follow-up studies are necessary for the same purpose.
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Evaluation of Paraoxonase, Arylesterase, and Homocysteine Thiolactonase Activities in Patients with Diabetes and Incipient Diabetes Nephropathy. J Med Biochem 2019; 38:481-488. [PMID: 31496913 PMCID: PMC6708292 DOI: 10.2478/jomb-2019-0014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 01/29/2019] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this study is to examine the relationship among the changes in activities of paraoxonase (PON), arylesterase (ARE) and homocysteine thiolactonase (HTLase) enzyme having antioxidant properties and the development of diabetic nephropathy (DN), one of the most common complications of diabetes. Methods Normoalbuminuric type-2 diabetic patients (Group II, n=100), microalbuminuric type 2 diabetic patients (Group III, n=100) and the control group (Group I, n=100) were included in the study. The age and gender of the patient groups matched with the age and gender of the control group. HTLase, PON and ARE enzyme activities were measured by the spectrophotometric method using a g-thiobutyrinolactone, paraoxon, and phenylacetate substrates respectively. In this study, an autoanalyzer application was developed in order to measure HTLase enzyme activity for the first time. Results Serum HTLase, ARE and PON activities of Group III and Group II were significantly low compared to HTLase, ARE and PON results of Group I (p<0.05). Conclusions Based on our results, PON, ARE and HTLase enzyme activities were found to be decreased due to the increase in the degree of DN.
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