Association between Glycated Hemoglobin with the Levels of Serum Proinflammatory Cytokines and Antioxidants in Patients with Type 2 Diabetes Mellitus in Universitas Sumatera Utara Hospital

Glutathione Peroxidase-1 Pro198Leu Variant in Tuberculosis-infected Type2 Diabetes Mellitus Patients at Pulmonary Polyclinic Medan

BACKGROUND: Glutathione peroxidase-1 (GPx-1) is an antioxidant that plays an important to the body protection system against oxidative stress. The GPx-1 polymorphism that has been identified in individual with several diseases. AIM: This study aimed to observe the distribution of GPx-1 Pro198Leu variant in tuberculosis (TB)-infected Type 2 diabetes mellitus (T2DM) patients at pulmonary polyclinic Medan. GPx-1 Pro198Leu polymorphism was genotyped in 40 T2DM patients that also infected by TB. MATERIALS AND METHODS: Analysis of GPx-1 Pro198Leu polymorphism was done using polymerase chain reaction (PCR) and restriction fragment length polymorphism. The PCR products were digested 4 h at 37°C with Apa1 restriction enzyme. The result of Apa1 enzyme digestion was visualized with 4% agarose. RESULTS: From 40 TB-infected T2DM patients, the frequency of genotypes CC,CT, and TT were, respectively, 82.5%, 17.5%, and 0%. The frequency of C allele was higher than T allele, i.e. 91.3% and 8.7%. CONCLUSION: It was concluded that in TB-infected T2DM patients at pulmonary polyclinic Medan, the GPx-1 Pro198Leu polymorphism has CC variant higher than CT, whereas the TT genotype was not found. The frequency of the C allele is higher than the T allele.

Comparative evaluation of inflammatory parameters and substitute insulin resistance indices in elderly women with and without type 2 diabetes mellitus

PURPOSE

To analyze the influence of inflammatory parameters and substitute insulin resistance indices on the risk of type 2 diabetes mellitus (DM) development in elderly women, as well as to compare anthropometric measures and metabolic parameters according to the presence of type 2 DM and HbA1c levels.

PATIENTS AND METHODS

One hundred and twenty elderly women (67.9 ± 6.0 years) were submitted to anthropometric analysis, determination of inflammatory and metabolic parameters. They also underwent indices of lipid accumulation product (LAP), high density triglyceride/lipoprotein ratio (TG/HDL), triglyceride glucose index (TyG), as well as TyG by body mass index (BMI) ratio (TyG-BMI) assessment.

RESULTS

Body mass index, tumor necrosis factor alpha, interleukin-2, blood glucose, TG, LAP, TG/HDL, TyG and TyG-BMI were significantly higher in elderly women with DM compared to non-diabetic women. LAP ≥ 55.4 (OR = 2.29; P = .027); TyG ≥ 8.8 (OR = 3.52; P < .001) and TyG-BMI ≥ 264.8 (OR = 3.54; P = .001) were identified as risk factors for DM.

CONCLUSION

High pro-inflammatory parameters, low levels of anti-inflammatory markers and higher levels of substitute insulin resistance indices are risk predictors for DM development in elderly women in primary health care.

Joint Measurements of Leukocyte Elastase and Myeloperoxidase Promote Identification of the State of Neutrophils in Diabetic Patients

The clinic of diabetes mellitus (DM) offers a number of hypotheses about the leading role of polymorphonuclear neutrophils (PMNs) in both oxidative stress and diabetic complications. However, the results of numerous studies are extremely controversial. Why is it so? We appreciated the clinical significance of simultaneous measurement data of several PMN parameters, which must complement each other. For this purpose, myeloperoxidase (MPO) and elastase (EL) were jointly analyzed in the blood plasma from 160 type 2 diabetes mellitus patients with high levels of HbA_1c. A weakly positive correlation (r ∼ 0.56) was observed between MPO and EL analytical data, and any correlation between the concentrations of MPO/EL and HbA_1c was absent. Medians of 160 measurements of MPO/EL concentrations were ∼103/190 ng/mL, and 95% of all results were in the range below 320/1016 ng/mL, respectively. The share of DM patients whose concentrations of MPO, EL, or either of two parameters exceeded the corresponding reference values was 65%, 80%, and 82.5%, respectively. These findings—a high intensity of neutrophil degranulation process—indicated that some diabetic conditions promote the transfer of PMNs to an “arousal” or “subactivation” state, which is identical or similar to their activation, providing in vivo an almost inexhaustible source of extremely “aggressive” MPO and EL. Thus, the conjoint MPO/EL measurements confirm the leading role of PMNs in the development of various complications of diabetes. The paradox is that the diagnostic significance of MPO/EL as independent parameters in diabetic patients is unambiguous for a number of reasons.

The Gene Polymorphisms (-308G/A) and the Tumor Necrosis Factor-alpha Levels in Type 2 Diabetic Patients with and Without Tuberculosis Infection

BACKGROUND

The gene polymorphism (-308G/A) and tumor necrosis factor-alpha (TNF-α) levels influence development of disease in type 2 diabetic patients and tuberculosis patients.

AIM

In this study, we analyze the association between the TNF-α polymorphisms (-308G/A) and the levels of TNF-α in type 2 diabetic patients with and without tuberculosis infection.

METHODS

This study was an analytic observational with cross sectional approach consisting 40 type 2 diabetic patients with tuberculosis infection, 40 type 2 diabetic patients without tuberculosis infection and 40 healthy control (HC) subjects. The TNF-α gene polymorphism (-308G/A) was analyzed with polymerase chain reaction-restriction fragment lengths polymorphisms (PCR-RFLP) method. The TNF-α levels were measured using an enzyme-linked immunosorbent assay. The association between gene polymorphism (-308G/A) in study groups was analyzed by Fisher's exact test, tumor necrosis factor-alpha (TNF-α) levels in study groups was carried out using the Kruskal-Wallis test. Hardy-Weinberg Equilibrium also determined genotype deviation and allele frequencies.

RESULTS

The GG and GA+AA genotypes frequency in both of patient groups and HC subjects were not differ significantly (95% and 5% vs 95% and 5% vs 92.5% and 7.5%; p > 0.05). The TNF-α levels (pg/ml) of type 2 diabetic without tuberculosis infection were higher than those of type 2 diabetic with tuberculosis infection and HC subjects (7.42 ± 0.78 vs 2.23 ± 0.51 vs 2.57 ± 0.63; p < 0.01). The TNF-α levels in the GA+AA genotypes were higher than the GG wild-type genotype (p > 0.05). There was no significant deviation of genotype frequency and allele from Hardy-Weinberg Equilibrium.

CONCLUSION

The gene polymorphism (-308G/A) had no association with type 2 diabetic patients with and without tuberculosis infection and the gene polymorphism (-308G/A) was not influence the TNF-α levels but there was a significant differentiation of TNF-α levels between the groups.