Total and LDL combined vitamin E concentrations in plasma patient with non insulin dependent diabetes mellitus

Patients with diabetes mellitus are susceptible to oxidant-antioxidant imbalance. Diabetic complications such as nephropathy, neuropathy and retinopathy increase 'this susceptibility. Other traditional atherogenic risk factors such as hypertension, cigarette smoking and dyslipidemia can also induce oxidant stress. It is possible that the existence of two or more of the atherogenic risk factors may enhance oxidant-antioxidant imbalance. However, this proposal has not been fully studied. Aim: To determine plasma vitamin E concentrations, both total and the fraction within LDL particles in patients with sole noninsulin-dependent diabetes mellitus [N-1DDM] or N1DDM associated with one or more of the other risk factors of atherosclerosis. This study was conducted on 60 patients with NIDDM [32 males and 28 females]. They were classified into four groups: [1] sole diabetic [n=20], [2] diabetic-hypertensive [n=10], [3] cigarette smoking diabetic [n=10] and [4] diabetic with multiple atherogenic risk factors [n=20]. Also, twenty clinically healthy individuals were investigated as a control group. Vitamin E was measured by high performance liquid chromatography [HPLC] while a plasma thiobarbituric acid reactive substance [malondialde-hyde] was determined colorimetrically. Plasma total vitamin E [VE] and vitamin E in LDL [VE-LDL] concentrations were significantly decreased while plasma malondialdehyde [MDA] levels were significantly increased in sole N1DDM, diabetic hypertensive, smoking diabetic and diabetic with multiple atherogenic risk factors groups in comparison to the corresponding values of the control group. These changes were noted more frequently and more severely in patients with multiple risk factors than those with single DM or DM with another risk factor. In these groups, vitamin E content in HDL showed significant negative correlation with LDL-C concentrations and significant positive correlation with HDL-C concentrations. Multiple regression analysis showed that vitamin E in HDL particles was an independent risk factor for coronary heart disease. The subnormal vitamin E content in LDL panicles may be a result of enhanced LDL oxidation in patients

Homocysteine in type 2 diabetes mellitus: relation to diabetic vascular complications

Hyperhomocysteinemia has recently been recognized as an independent risk factor for cardiovascular disease. Diabetes mellitus [DM] is know to increase the risk of atherosclerotic vascular diseases. Insulin resistance syndrome is characterized by clustering of cardiovascular risk factors like hyperinsulinemia, hypertension .etc, that has been hypothesized to play an important role in atherosclerosis. The reason for the high susceptibility of diabetic patients to atherosclerosis remain incompletely understood. Plasma homocysteine [HCY] status in diabetics is still a matter of controversy. The aim of our work .was to study plasma level of HCY in type 2 diabetic patients and to study the relation of plasma HCY level to different diabetic vascular complications. The study included 40 patients with type 2 [DM] [aged 52.9 +/- 6.3 years]. and 25 apparently healthy controls matched in age and sex with the patients. Both groups were evaluated thoroughly and the following parameters were assessed, fasting blood post prandial blood glucose [PPBG], uric acid, serum creatinine, lipid fasting plasma insulin [FPI], homeostasis model assessment of insulin resistance [HOMA-IR] and plasma HCY level. Our study revealed significant increase in systolic blood pressure [SBP], diastolic blood pressure [DBP], FBG, PPBG, plasma cholesterol, triglycerides [TG] and low density lipoprotein cholesterol [LDL-c] but significant decrease in high density lipoprotein cholesterol [HDL-c] in diabetic patients vs control group. We found also significant increase in plasma HCY, FPI and HOMA-IR in diabetic patients vs control group, all [p<0,001].Thestudy also showed highly significant increase in plasma HCY in patients with macrovascular complications vs those with microvascular complications [31 +/- 1.69 vs 22.3 +/- 226, p<0.001]. In patients with type 2 DM there were significant positive correlation between HCY level and age, SBP, DBP, FBG, PPBG, serum creatinine, total cholesterol TG, LDL-c, FPI, proteinuria and HOMA-IR but significant negative correlation with HDL-c [all p<0.001]. From this study, it is concluded that hyperhomocysteinemia is present in type 2 DM especially in patients with concomitant macrovascular complications, and it can be considered as a definite risk factor for vascular complications in those patients

Eosinophil cationic protein [ECP] and skin prick tests in children with steroid-responsive nephritic syndrome [SRNS]

To assess the atopic state in patients with SRNS, serum ECP levels were measured by chemiluminescent enzyme immunornetric assay and skin prick tests were done in 32 children with SRNS and 10 age- and sex-matched healthy children without evidence of atopy. Out of the nephrotic patients, 19 children had active disease [Group I] and 13 were in remission [Group II]. Among group I, 7 children were frequent relapsers [FR] while 12 were infrequent relapsers [IR] or non-relapsers [NR]. We found that 37.5% of our patients had positive skin prick tests. Serum ECP levels were elevated in group I patients [= 25.3 and Interquartile range [IQR] = 13.8-33.6 ng /ml] and group II patients [median = 14.2 and IQR = 12.0-20.2 ng/ml] compared to controls [median = 9.1 and IQR = 7.2-13.5 ng/ml, P < 0.0001 and 0.006 respectively]. Similarly, patients with negative skin prick tests in group land group II had higher ECP levels compared to controls [P = 0.007 and 0.07 respectively]. Among group I, ECP levels were higher in patients with positive skin prick tests to those with negative tests [P < 0.0001] and in FR compared to IR and NR [P = 0.05]. Moreover, there was an association between the development of frequent relapses and positivity of skin prick tests [Fishers Exact = 0.07 relative risk = 6.4 and confidence interval = 1.0-41.2]. In conclusion, serum ECP levels are elevated in children with active SRNS. ECP could be considered as one of the neutralizing cations involved in the pathogenesis of proteinuria in these patients. Atopy could be assumed as a risk factor for the development of frequent relapses, so the value of a course of non-steroidal anti-inflammatory drug [as ketotifen] infrequently relapsing nephrotic children should be evaluated