ABSTRACT
Diabetes mellitus has been associated with increased risk of oxidative stress. There is limited information on the significance of an early marker of oxidative stress which can reflect the total antioxidative activity, especially in poorly controlled diabetes mellitus. The aim of this study was to establish association of glycaemic control determinants and total antioxidant activity and also to evaluate the frequency of occurrence of reduced antioxidant activity in poorly controlled glycaemia. This was a cross sectional study carried over three months. The study population consisted of two hundred type 2 diabetes mellitus patients attending the diabetic clinics of Lagos State University Teaching Hospital, Ikeja and General Hospital, Gbagada. These categories of patients were males and females between the ages of 40 and 60 years. Glycaemic control was assessed using fasting plasma glucose, fructosamine and glycosylated haemoglobin. Biochemical parameters were compared using students't test, Pearson's correlation coefficient and analysis of variance. This study demonstrated reduced total antioxidant activity in Nigerian diabetics in comparison with control subjects [p < 0.05] and was observed to be much lower in complicated diabetes mellitus patients. Consistent negative association of total antioxidant activity with short, medium and long term glycaemic control determinants fasting plasma glucos "r = -0.43, p = 0.001", fructosamine "r = -0.42, p = 0.002" and glycosylated haemoglobin "r = - 0.35, p = 0.030" was observed. The clinical usefulness of total antioxidant activity as a surrogate marker of glycaemic control is shown. This may be useful in the early detection of diabetic complications. Significant reduction of total antioxidant activity especially among diabetics with complications suggests a possible role of this in the pathogenesis of diabetic complications
ABSTRACT
Neopterin and H2O2 are products of cellular [macrophage] activation. The exact roles of these secretions by activated macrophages in protection against tuberculosis remain unclear. In the present study, the changes in the levels of neopterin and total plasma peroxides [TPP] were assessed in pulmonary tuberculosis [PTB] patients on chemotherapy with [C+M] or without [C- M] micronutrient supplementation. Thirty-eight newly diagnosed PTB patients were selected for this study. Twenty patients were treated with anti-tuberculosis drugs and micronutrient [C+M] while 18 PTB-patients were treated with only anti-tuberculosis chemotherapy [C-M]. Plasma neopterin and TPP concentrations were measured by enzymes linked immunosorbent assay [ELISA] and colorimetric method respectively. All PTB patients had elevated neopterin [p=0.02] and TPP [p=0.00] levels when compared with the non-PTB controls. Plasma level of neopterin and TPP declined significantly in C+M after 2 weeks of treatment [p= 0.00, p=0.01 respectively] and also after 4 weeks of treatment [p = 0.01 and p=0.00 respectively] when compared with baseline levels before treatment. No significant change was observed in the levels of neopterin and TPP in C-M after 4 weeks of treatment when compared with baseline value before treatment. Micronutrient supplementation enhanced the decline in the levels of neopterin and TPP after two weeks of treatment. Chemotherapy alone did not produce significant reduction. Therefore, micronutrient supplementation of PTB drugs with synthetic antioxidants or naturally occurring ones [fruits and vegetables] should be attempted