Role of leptin and dyslipidemia in chronic kidney disease

Chronic kidney disease [CKD] patients are at an increased risk of cardiovascular complications and plasma leptin level is elevated in cardio renal syndrome. We wanted to explore leptin levels in patients with different stages of CKD and find its association with risk of cardiovascular disease. This cross-sectional study was conducted in Nephrology Department of Jinnah Post Graduate Medical Centre [JPMC] from January 2014 to September 2014. Group I comprised of controls [GFR=116+/-8.3, n = 44] acquired from general population, CKD patients were grouped as II, III and IV respectively with GFR; 85.77+/-9.9 [n = 42], 53.84+/-9.9 [n=42] and 20.22+/-8.4 [n = 42].CKD patients with any inflammatory disease, Diabetes Mellitus and on steroid therapy were excluded. Serum leptin, lipid profile and C reactive proteins [CRP] were measured. Leptin and CRP levels increased significantly with progression of CKD. High density lipoproteins [HDL] to low density lipoproteins [LDL] ratio was significantly high in control as compared to CKD groups [p<0.001]. A positive correlation of leptin was observed with CRP and HDL/LDL ratio [r= 0.994,p<0.001 and r=-0.403 p<0.001] respectively. Hyperleptinemia observed with progression of CKD contributed to pathogenesis of cardiovascular disease by decreasing HDL/LDL ratio

Status of lipid profile in different stages of chronic kidney disease

To estimate and compare dyslipidemia in patients with different stages of chronic kidney disease as compared to healthy controls and to determine whether dyslipidemia is independently associated with rapid renal impairment. This study was conducted in department of Biochemistry Basic Medical Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC] Karachi. A total of 150 participants were recruited for the study from the Nephrology department of JPMC. These were grouped as 30 stage II CKD patient, 30 stage III CKD patient, 30 stage IV CKD patient, 30 stage V CKD patient and 30 normal healthy individuals. Cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, urea and creatinine were measured by commercially available kit method. Statistical analysis was done using SPSS version 11. Serum Cholesterol, Triglyceride and LDL-C among all groups were significantly increased when compared with control p<0.05. Serum HDL-C among all study groups was significantly decreased p<0.05, along with increase in LDL / HDL ratio among all study groups when compared with control p<0.05. Dyslipidemia occurs gradually in CKD patients as disease progresses. Evaluation of dyslipidemia in early stages of CKD is useful to assess the risk for future cardiovascular disease in these patients

Zinc and copper levels fluctuate with altered glucose homeostasis

Background: Type 2 diabetes mellitus is becoming one of the major health problems worldwide. Especially in South East Asia, type 2 diabetes has gained critical significance. As pre-diabetes prevalence is increasing worldwide, it has become an important concern to prevent diabetes at an early stage. Trace elements have been gaining attention in improving the glucometabolic conditions like pre-diabetes and diabetes. Zinc and copper are the major trace elements present in the human body and they play a significant role in the pathogenesis of diabetes mellitus and pre-diabetes

Objectives: The purpose of this study was to compare serum zinc and copper levels in type 2 diabetes and pre-diabetes

Methods: This study was conducted in department of Biochemistry BMSI, JPMC Karachi. Total 90 subjects were taken out of which 30 were type 2 diabetics, 30 were pre-diabetics and 30 were normal healthy individuals. Serum fasting glucose was measured by glucose oxidase method. Serum zinc and copper were measured by colorimetric method. Statistical analysis was done using SPSS version 16

Results: Serum zinc levels were significantly lower in type 2 diabetics as compared to pre-diabetics and normal individuals [mean differences were 45.17+/-15.63 micro g/dl, 59.97+/-13 micro g/dl and 86.57+/-14.34 micro g/dl respectively]. Serum copper was significantly increased in type 2 diabetics compared to pre-diabetes and control samples [mean differences were 325.55+/-88.34 micro g/dl, 175.53+/-47.45 micro g/dl and 126.87+/-21.57 micro g/dl respectively]

Conclusion: it was concluded that serum zinc was significantly lower in type 2 diabetics and pre-diabetics and is inversely related to serum fasting glucose while serum copper is significantly higher and positively related with fasting blood glucose

Role of fetuin-A in insulin resistance in type 2 diabetes mellitus

To determine the role of fetuin-A in triggering insulin resistance and leading to development of type 2 diabetes. A cross sectional, case control study was conducted at Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC]. Time duration of the study was from February 2012 to September 2013. A total of 150 subjects were included by random sampling out of which 50 were known type 2 diabetics, 50 were having impaired fasting glycaemia [IFG] and 50 were normal healthy individuals. Detailed history taking, clinical examination and body mass index [BMI] calculation were done. Laboratory investigations included serum fasting glucose, measured by glucose oxidase method and serum insulin and serum fetuin-A levels that were measured by ELISA method. Insulin resistance was calculated by Homeostatic model assessment, [HOMA IR]. Statistical analysis was done by using SPSS Version 16. We observed that serum fetuin-A levels were significantly higher in known type 2 diabetics as compared to impaired fasting glycaemics and controls [p<0.01]. Serum insulin and HOMA IR were also significantly elevated in known type 2 diabetics when compared to impaired fasting glycaemics and healthy individuals [p<0.01]. Body mass index was also significantly higher in known type 2 diabetics and impaired fasting glycaemics when compared to controls [p<0.01]. Our findings suggested that higher serum fetuin-A levels have a possible role in promoting insulin resistance and development of diabetes mellitus type 2