[ effect of zinc supplemention on glycosylated hemoglobin in type II diabetic patients]

Diabetes mellitus is one of the most common metabolic disorders due to partial or complete deficiency of insulin or insulin resistance. The most common problems is uncontrolled diabetes are chronic complication including renal and cardiovascular failure. Zinc as an essential trace element, can affect some aspects of insulin synthesis, secretion and function. The aim of this study was to evaluate the effect of zinc supplementation in diabetes control status in a group of type-II diabetic patients. In this clinical trial, 60 fdiabetic patients [type-II] were divided in 2 groups, randomly. One of them consumed 25 mg/day zinc and the other had 50 mg daily for 2 months. Fasting blood glucose [FBS], 2 hour post prandial blood glucose [2hpp], glycosylated hemoglobin [HbA1c], and serum levels of zinc were evaluated in patients before and after zinc supplementation. Wilcoxon and Man-Whitney tests were used for statistical analysis. 22 patients in each group with the mean age of 48 years completed the study. Serum levels of zinc in the group with 25 mg/day supplementation didn't show significant change, but in the second group increased significantly after supplementation [160 +/- 30 micro g/dl vs 140 +/- 30, p=0.002]. HbA1c significantly reduced after supplementation [9.7 +/- 1.86 vs 8.9 +/- 1.5, p=0.02]. There were not significant changes in FBS and 2hpp before and after zinc supplementation. Our results indicate that elevation of zinc level in diabetic patients has favorable effect on HbA1c and diabetes control status. It is assumed that some of the diabetic patients suffer from a latent zinc deficiency and this may by unfavorably diabetes control status

[Six-month intra-individual variations of plasma lipoprotein [a] in College students]

Lipoprotein [a] [Lp[a]] is a cholesterol-rich particle with atherothrombogenic properties. Plasma level of Lp[a] is mainly determined genetically, but other factors may also affect it. There is little available data on normal range and biological variations of Lp[a] among Iranian population. To evaluate the biological variations of Lp[a] and other serum lipids in 30 college students during a six-month period. This was a descriptive analytical study in which the fasting serum levels of Lp[a], lipids, and lipoproteins of 30 college students [20 females, 10 males, age ranged between 22 to 26 years, who were clinically health, and coming from various regions of Iran] were measured once a month over a 6-month period. Intra-individual standard deviations, variances and coefficients of variations [CV] were determined for Lp[a], total cholesterol [TC], triglycerides [TG], high-density lipoprotein-cholesterol [HDL-C], and low-density lipoprotein-cholesterol [LDL-C]. Plasma Lp[a] with a mean of 14.7 +/- 12.7 mg/dl showed an intra-individual CV ranged from 5.4 to 53.4% with a mean of 11%. The Lp[a] variations were negatively correlated with Lp[a] concentration and changes in TC, and LDL-C levels. Total intra-individual CV for other lipids ranged from 11% for TC to 24.5% for TG. Plasma Lp[a] showed intermediate mean concentration and relatively high intra-individual variations in our study population. This variation was similar to that of total cholesterol, but hardly lower than triglycerides. Plasma Lp[a] variations was negatively related to cholesterol variations and Lp[a] concentration

[Effect of sour tea [Hibiscus sabdariffa] on blood glucose, lipid profile and lipoproteins in diabetics]

Hibiscus Sabdariffa is widely cultivated in tropical areas and its red persistent calyx is the major component possessing a sour taste that is used in beverages and food colorants. As a traditional medicine, it is claimed to be effective against kidney stones and urinary bladder stones, and is also used for its antibacterial, antifungal, hypocholesterolemic, antispasmodic and antihypertensive actions. We conducted this study to evaluate the effects of sour tea on blood sugar, lipids and lipoproteins. This sequential double-blind randomized controlled clinical trial was conducted on 60 diabetic patients in the Yazd Diabetic Research Center. Patients were assigned randomly into two groups, the sour tea [ST] and the ordinary tea [OT] group. Sachets containing one spoonful of sour or ordinary tea were given to the patients, based on random numbers. They were instructed to consume one glass of boiled water, boiled for 20-30 min, 2 times daily between their meals in the morning and afternoon, for 30 days. Fasting blood samples were taken at the beginning and at the end of the study for measuring blood glucose, hemoglobin A1C, total cholesterol, HDL-C, LDL-C, triglycerides, Apo AI, Apo B100 and Lp[a]. Data were analyzed using the SPSS statistical package. A total 60 patients were recruited, 53 of whom completed the study [27 in ST and 26 in OT]. Except for Lp[a] and Apo AI, means of all lipids and lipoproteins at the beginning, were significantly decreased or increased [HDL-C] compared with the related means at of the end of the study in the sourtea [ST] group however, only the mean for HDL-C was significantly increased [approximately 16.7%] at the end of intervention in in the ordinary tea [OT] group. The mean for fasting blood glucose at the end of study did not differ significantly with the initial mean in both groups. In contrast, the mean of hemoglobin A1C was significantly decreased in the ST group. The results showed that sour tea has significant effects on blood lipid profiles in diabetic patients however, it did not have significant effects on blood glucose or hemoglobin A1C. Drinking sour tea can be recommended for diabetic patients

[Evaluation of chemical urine dipstick for detection of albuminuria]

Microalbuminuria is a marker for nephropathy in diabetic patients and recognition of albuminuria is an important step for early detection and evaluation of diabetes complications. To assess the reliability of urine dipstick tests for detection of albuminuria. The first morning urine samples from candidates for urinanalysis were collected and the results of dipstick tests for protein on 200 selected samples recorded. Urine albumin concentration was determined by electroimmunoassay and the level of urine creatinine determined by Jaffe method. The albumin/creatinine ratio was further calculated as an index of urine albumin excretion rate. Comparing with reference method, the sensitivity, specificity, positive predictive value [PV+], and negative predictive value [PV-] of dipstick test for detection of microalbuminuria were calculated. Based on results obtained by dipstick test, 69 urine samples were negative for presence of protein, 51 trace [ +/- ], 22 [1+], 27 [2+], and 31 [3+]. Detection limit of dipstick for urine albumin concentration ranged from 58 to 585 mg/L with a mean of 280 mg/L. When the reference method for detection of protein in urine samples was used, 35 urine specimens were negative for albuminuria, 85 with microalbuminuria, and 80 with macroalbuminuria. Dipstick test was found to produce false positive and negative results of 3 and 25%, respectively. The sensitivity, specificity, PV+, PV- of dipstick test for detection of microalbuminuria were calculated at 70, 86, 96, and 37.5%, respectively. Chemical dipstick test is of poor sensitivity for detection of microalbuminuria. However, the severity of albuminuria among considerable numbers of diabetic patients is high enough to be detectable by urine dipsticks. While the positive predictive value of chemical urine dipstick tests are more or less at acceptable limit, the negative predictive values are controversial and need to be reevaluated by more sensitive and specific methods

[Evaluation of electroimmunoassay and clinitek-100 for detection of microalbuminuria]

Detection of microalbuminuria is an important laboratory test for evaluation of diabetic complications. A reliable method for determination of urine albumin is critical in this process. In the present study, we set-up and evaluated an electroimmunoassay [EIA] method for measearing the amount of albumin in urine. The reliability of Clinitek-100 Instrument was evaluated for screening of microalbuminuria as well. In this study which was the evaluation of a diagnostic test, anti human albumin antiserum was prepared following the immunization of rabbit and the EIA method was set-up for albumin determination. The ratio of albumin to creatinine, as the index of albumin excretion rate, were calculated for 61 urine samples of diabetic patients. Finally, the reliability of EIA and clinitek-100 for detection of microalbuminuria were evaluated. An enzyme-linked immunosorbent assay [ELISA] was used as a reference method for determination of urine albumin and for detection of microalbuminuria as well. The detection limit for EIA method was 2 mg/L, with analytical range of 2-200 mg/L. The intra-assay coefficient variation [C.V] of various albumin concentrations were 3.34 to 5.57%, whereas the regression coefficient was 0.996 [r=0.996]. The sensitivity and specificity of EIA-test for detection of microalbuminuria were 95% and 83%, respectively. The sensitivity and specificity of Clinitek-100 for microalbuminuria detection were 67% and 94%, respectively. The EIA is a precise and specific method for determination of urine albumin and detection of microalbuminuria, but it is time consuming and unsuitable for single test reports. Clinitek-100 is specific and fast for delection of microalbuminuria. This method is suitable for single reports, but its negative results in test are controversial. We suggest that more care be taken for the clinitek-100 results and the negative results should be re-examined by other sensitive methods

Relationship between plasma levels of zinc and lipid oxidizability in diluted plasma

Zinc [Zn] is an essential trace element that has been regarded as having antioxidant properties. Some epidemiological studies have indicated the protective effect of Zn on lipid and lipoprotein peroxidation, but the underline mechanism is poorly understood. This study was conducted to evaluate the relationship between plasma Zn and copper-induced lipid peroxidation parameters in diluted plasma. in 100 healthy adult men [36.82 +/- 10.33 years], fasting plasma levels of Zn, lipids, bilirubin, urate, malondialdehyde [MDA] and copper induced lipid peroxidation were evaluated. Lipid oxidation estimated by monitoring the change of conjugated dienes in 60-fold diluted plasma after addition of 60 maicroM Cu[2+] and MDA was determined by thiobarbituric acid method. A significant correlation [r=0.24, p=0.024], between Lag-time [104 +/- 33min] and plasma Zn levels [128.76 +/- 108.33 microg/dl] was found; however, no significant correlation was found between other parameters of lipid oxidation kinetics and MDA with plasma Zn levels. Based what the results indicated there is a delay in Cu-induced plasma lipid oxidation by higher levels of plasma Zn, but Zn level has no effect on finals oxidation products. It seems that Zn interferes with for Cu in the formation of an active oxidizing complex

[Evaluation of correlation between fructosamine and glycated hemoglobin]

Fructosamine or glycated plasma proteins are used to assess the short term diabetes control. Fructosamine concentration dependends on blood glucose level, protein concentration and half-life of proteins. Some have reported that measuring fructosamine without considering protein concentration is of no value. To investigate the relation between fructosamine, albumin and total protein and also the effect of fructosamine correction on capacity of this assay to assess the glycemic condition. Fifty diabetic patients from diabetes center in Yazd [Iran] were selected. The levels of fructosmine, albumin and total protein were determined once a month for a duration of two months followed by measurement of glycated hemoglobin after two months. Fructosamine and glycated hemoglobin were measured by colorometric method based on nitro blue tetrazulium and ion exchange chromatography method, respectively. The correlation between glycated hemoglobin and fructosamine, fructosamine corrected with albumin and total protein were 0.941, 0.908 and 0.9 [P<0.001]. No correlation was found between fructosamine, albumin, and total protein. Mean of albumin and total proteins were 4.3 and 6.3 g/dl. Regarding our data, fructosamine correlation at normal range of albumin and total protein did not affect fructosamine capacity in assessing diabetes control and under such condition albumin and total protein showed no effect on fructosamine concentration