ABSTRACT
Background: Chronic kidney disease (CKD) includes irreversible destruction of nephrons leading to progressive decline in glomerular filtration rate. A preferential defect in Homocysteine disposal could hypothetically occur in CKD and subsequently lead to hyperhomocysteinemia. Understanding the status of Homocysteine and other parameters in CKD is useful in the management of the disease. Objective of the study is to estimate serum Homocysteine in CKD patients and its association with renal function and serum albumin in patients with CKD.Methods: The study design involves hospital based observational comparative study. The study was conducted in Department of Biochemistry in association with Department of Nephrology of Mahatma Gandhi Medical College and Hospital, Jaipur between May 2017 to June 2018. 100 diagnosed patients of CKD, visiting the Outpatient Department of Nephrology were enrolled as cases for the study. Patients having cardiovascular disease, Chronic liver disease, Age more than 60 years and pregnant females were excluded from study. The control group consists of 100 age and sex matched healthy individuals.Results: The mean serum creatinine levels of case and control group were 7.50±3.74 mg% and 0.83±0.22 mg% respectively. The mean of serum homocysteine levels of subject group was 27.35±12.52 µmol/L while the mean serum homocysteine levels of control group was 11.06±3.52 µmol/L. The serum homocysteine levels were significantly higher in the CKD patient group. The serum level of albumin in CKD patients and control group were 2.86±0.86 g/dl and 4.10±0.58 g/dl respectively. A positive correlation was found between serum creatinine and serum homocysteine levels. A negative correlation between serum homocysteine and serum albumin was found.Conclusions: Findings of the present study exhibit that serum homocysteine levels are elevated in CKD in comparison to healthy controls and it is positively correlated with serum creatinine level.
ABSTRACT
Background: Type 2 Diabetes Mellitus has emerged as a common endocrine disorder in india. Thyroid dysfunction may complicate glycaemic control of diabetic patients. For better management of diabetes, it is necessary to detect and treat thyroid dysfunction in these patients.Methods: This was an observational study conducted at SMS Hospital Jaipur, Rajasthan, India, between March 2016 to November 2017. Total 100 patients were included out of which 50 were Diabetic patients and 50 were age and sex matched nondiabetic controls reported in outpatient department of SMS Hospital, Jaipur. Patients of type 1 Diabetes, previously known case of thyroid disorder, patients having endocrine disorder or autoimmune disorder other than Diabetes, critically ill patients and pregnant females were excluded from study. Serum Fasting Blood Sugar, Free T3, Free T4, TSH were measured in all study subjects and results were analysed statistically to find out if there is any difference in prevalence of thyroid dysfunction in Diabetic patients and non-diabetic controls.Results: Thyroid dysfunction was present in 16 (32%) of 50 type 2 diabetics and 3 (6%) of 50 nondiabetic controls. The prevalence of thyroid dysfunction in type 2 diabetic females and males was 43.3% and 15% respectively. Mean fasting blood sugar was higher in diabetic patients having thyroid dysfunction (209.12 mg/dl) as compared to euthyroid diabetic subjects (173.58 mg/dl). Twelve (75%), out of 16 study subjects with thyroid dysfunction have secondary hypothyroidism. Three (18.75%) of them have mild (sub-clinical) hypothyroidism. One person (6.25%) has subclinical hyperthyroidism.Conclusions: Prevalence of thyroid dysfunction is higher in type 2 diabetic patients as compared to nondiabetic. Better glycaemic control is observed in euthyroid diabetic patients as compared to diabetic patients having thyroid dysfunction.