ABSTRACT
Background : Diabetes mellitus is the leading cause of chronic renal failure . As the period of diabetes progresses there is simultaneous increase of inflammatory markers like high sensitive C reactive protein (hsCRP) with degree of renal involvement, suggested by albumin creatinine ratio and also dyslipidemia in diabetic patients. Materials & Methods: 120 diabetic individuals aged (30-60) yrs, divided in 3 groups of 40 subjects in each, namely: a) newly diagnosed˂5 years b) 5-10 years after diagnosis and c) ≥10 years after diagnosis were recruited as study subjects from a tertiary care hospital in sub Himalayan region. Results : Descriptive studies showing mean values of hsCRP ,ACR & lipid parameters were done in all 3 groups. One-way ANOVAwith post hoc analysis after Bonferroni correction in 3 different groups enunciated a significant and statistical increase (p <.001) of both hsCRP &ACR with duration of diabetes unlike the lipid parameters. hsCRP, ACR, cholesterol & LDLeven illustrated a very significant correlation between each other (p<0.001) , TG to hsCRPwhile HDLshowed no correlation to any parameters. Conclusion: Early detection, monitoring of inflammatory markers hsCRP, ACR & deranged lipid parameters are predictors of diabetic nephropathy that can help in modulating diabetes and its complications.
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Background: Microalbuminuria in type 2 diabetic patients is speculated to be accompanied by elevated serum high sensitivity C reactive protein (hsCRP). . Establishing a correlation between hsCRP & microalbuminuria relative to duration of diabetes suggests activation of inflammatory pathways in progression of kidney disease . Materials &Methods: 120 diabetic individuals aged (30-60) yrs ,divided in 3 groups of 40 subjects in each, namely: a) newly diagnosed˂5 years b) 5-10 years after diagnosis and c) ≥10 years after diagnosis were recruited from a tertiary care hospital in sub Himalayan region according to some inclusion and exclusion criteria. Result: Mean values of hsCRP were 0.04 ± 0.005, 0.08 ± 0.011, & 0.10 ± 0.017 and that of micro albumin were 95.42 ± 12.30, 116.79 ± 4.87 & 130.56 ± 7.65 in group 1,2 ,3 respectively. One way ANOVA with post hoc analysis after Bonferroni correction depicted that both hsCRP & micro albumin increased significantly and statistically with duration of diabetes in all 3 groups along with a very significant correlation between them . Conclusion:Both serum hsCRP and microalbuminuria increases with period of diabetes.So the increasing trend of these inflammatory markers needs to be noted early and monitored to prevent progression of diabetic nephropathy
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Background & objectives: Insulin resistance (IR) is a major confounding factor in polycystic ovarian syndrome (PCOS) irrespective of obesity. Its exact mechanism remains elusive till now. C/T polymorphism in the -34 promoter region of the CYP17 gene is inconsistently attributed to elucidate the mechanism of IR and its link to hyperandrogenemia in obese PCOS patients. In the present study we aimed to evaluate any association of this polymorphism with IR in non-obese women with PCOS. Methods: Polymorphism study was performed by restriction fragment length polymorphism (RFLP) analysis of the Msp A1 digest of the PCR product of the target gene in 75 PCOS cases against 73 age and BMI matched control women. Serum testosterone, BMI and HOMA-IR (homeostatic model of assessment-insulin resistance) were analyzed by standard techniques. A realistic cut-off value for the HOMA-IR was obtained through receiver operating characteristic (ROC) curve for exploring any possible link between IR and T/C polymorphism in the case group. Results: Significant increases in serum testosterone and HOMA-IR values were observed among the case group (P<0.001) without any significant elevation in BMI and FBG compared to controls. Cut-off value for IR in the PCOS patients was 1.40 against a maximum sensitivity of 0.83 and a minimum false positivity of 0.13. The analysis revealed an inconclusive link between the C/T polymorphic distribution and insulin resistant case subjects. Interpretation & conclusions: The results showed that CYP17A1 gene was not conclusively linked to either IR or its associated increased androgen secretion in non-obese women with PCOS. We propose that an increased sensitivity of insulin on the ovarian cells may be the predominant reason for the clinical effects and symptoms of androgen excess observed in non-obese PCOS patients in our region.
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Aims: In conjunction with triglyceride (TG) and HDLc, changes in the Lp (a) level in hypothyroidism have shown variable results. In the present study we made an effort to evaluate the role of Lp(a) as cardiovascular risk factor in both subclinical(SH) and overt hypothyroidism(OH) along with its dependence with dyslipidemic changes found in both groups. Study Design: It was a cross sectional, observational, non interventional, hospital based study Place and Duration of the Study: The study period was one year spanning a duration from February 2014 to January 2015 in the Dept. of Biochemistry, Calcutta National Medical College, Kolkata. Methodology: We evaluated the changes in Lp(a) TG, HDLc and fT4 levels in 30 overt and 34 subclinical hypothyroid patients and compared them with 34 control subjects in a hospital based cross-sectional study. Data were compared for difference between mean values and obtaining dependence of Lp(a) on lipid parameters. Results: Mean values of Lp(a), TG, TC and LDLc were found to be increased most in the OH group followed by that in the SH patients, the difference between two groups being significant statistically (p < 0.001). In contrast, fT4 and HDLc showed decreased levels in both SH and OH groups with a significant difference between them. Results of multiple linear regression analysis revealed that changes in the Lp(a) levels showed significant positive and negative dependence on the TG (β = 0.377 for OH and 0.296 for SH), and fT4 (β= -0.699 for OH and -0.380 for SH) and HDLc (β= -0.341 for OH and -0.393 for SH) respectively. Conclusion: Dyslipidemic features are evident in patients with SH as well as in the OH group that play also an important predictive role on the changes in Lp(a), indicating that in addition to traditional dyslipidemia, nontraditional risk factors like Lp (a) play a major role in initiating cardiovascular adverse events even in the early stages of hypothyroidism (SH).