Lipoprotein oxidizability and antioxidant activity in type 1 diabetics: relation to duration, glycemic control and hyperketonemia, and the effect of vitamin E supplementation

Among many hypotheses, oxidizability of lipoproteins has been implicated in the hyperlipidemia and the development of atherosclerosis and cardiovascular disease in diabetics as well as in the general population. Children with type 1 diabetes are particularly at high risk of early development of atherosclerosis. Studies evaluating LDL oxidizability in type 1 diabetics reported conflicting results and the benefit of anti-oxidants supplementation is still debatable. The present study included 70 [29 males, 41 females] children and adolescents with type 1 diabetes, attending the Diabetic Endocrine Metabolic pediatric Unit at Children's Hospital of Cairo University, who were investigated and compared to a control group of 36 [18 males, 18 females] healthy children and adolescents regarding lipid profile, susceptibility of LDL to in vitro oxidation as well as antioxidant activity. Special emphasis was done on the relation of increased lipid peroxidation to diabetes duration, glycemic control and hyperketonemia. The benefit of Vitamin E supplementation [400IU/day] was tested in 46/70 type 1 diabetics regarding lipid peroxidation, lipid profile and glycosylation. Results revealed significantly higher mean levels of fasting blood glucose, glycated hemoglobin, acetoacetate, beta-hydroxybuterate, total cholesterol, triglycerides. LDL and phospholipids in diabetics compared to controls. Diabetics also showed significantly increased oxidative stress [LDL oxidizability and serum malondialdehyde] as well as significantly lower antioxidant profile [reduced glutathione, serum vitamin E and vitamin E/cholesterol]. While hyperlipidemia increased significantly with diabetes duration, the increased LDL oxidizability and decreased antioxidant activity did not show significant difference with the diabetes duration, and LDL oxidizbility didn't show correlation with diabetes duration or glycated hemoglobin level. On the other hand, diabetics with subclinical hyperketonemia, showed significantly increased oxidative stress [LDL oxidizability and serum malondialdehyde] compared to the normoketonemic, and LDL oxidizability correlated significantly with acetoactate levels in diabetics. Vitamin E supplementation [400IU/for 3 moths] achieved a significant decrease in glycosylation with improvement of HbA[1] in 30/46 diabetics, a significant improvement of lipid profile, as well as a significant reduction in LDL oxidizability, and serum malondialdehyde, with a significant increase in reduced glutathione and vitamin E levels. There was also a significant increase in vitamin E/cholesterol and HDL/cholesterol indicating cardiovascular protection. Type 1 diabetics are at risk of hyperlipidemia with increased LDL oxidizability and reduced antioxidant activity. LDL oxidizability and antioxidant activity were not related to the duration of diabetes or the level of glycated hemoglobin, but were a significantly related to increased serum actetoacete levels. Hyperketonemic type 1 diabetics appear to be at higher risk of increased LDL oxidizability and reduced antioxidant activity. Vitamin E supplementation in a dose of 400IU given daily for 3 months was beneficial with improvement of glycated hemoglobin and lipid profile, reduced oxidative stress, and increased antioxidant activity

Role of hepatocyte growth factor, vasointestinal peptide, angiotensine ii and alpha 2-macroglobulin in male fertility

The aim of this work is to assess the prognostic validity of some seminal plasma parameters in male infertility and spermatogenesis; such as Hepatocyte Growth Factor [HGF], Vasoactive intestinal Peptide [VIP], Angiotensin II, Alpha-2 Macroglobulin, Total proteins, Albumin, Globulin and Albumin /Globulin ratio. In the current study, 105 infertile cases of different categories according to their semen analysis were compared to 15 normozoospermic fertile cases. The infertile case were divided into; OAT with and without varicocele, AT with and without varicocele, obstructive azoospermia and NOA [TESE +ve and TESE -ve]. Azoospermic cases were subjected to testicular biopsy for both histopathology and diagnostic TESE. Seminal plasma ELISA estimation of hepatocyte growth factor, vasoactive intestinal peptide, angiotensin II, alpha-2 macro-globulin. Seminal plasma total proteins, albumin, globulin were estimated calorimetrically. Seminal plasma testicular contribution was evident in all tested factors except hepatocyte growth factor [VIP 56.4%, AT II 64.1%, alpha-2 M 57.7%, total protein 41.1%, albumin 41% and globulin 42.9%]. Varicocele affects adversely with significance the contribution of different studied parameters in seminal plasma. Also there was significant reduction in the testicular size in left sided varicocele. SP A/G ratio and alpha-2 macroglobulin can differentiate between TESE+ and TESE-. Otherwise, other factors have poor ability. SP HGF, VIP, ATII and alpha-2 M can confirm differentiating OA and NOA. There was negative significant correlation between abnormal form percentage and sperm motility percentage. There was significant positive correlation between SP total protein and sperm concentration in OAT- group and between SP globulin and sperm motility percentage in AT- group. Albumin has no correlation with seminal sperm parameters, in all groups except positive significant correlation with abnormal form percent in AT+. There was positive significant correlation between alpha2-M and total proteins in all studied groups. SP factors appear to act in coordination and harmony more than individually or separately