mRNA Expression of Podocyte Associated Proteins in Peripheral Blood Mononuclear Cells of Type 2 Diabetes Mellitus Patients with and without Nephropathy.

Background: Diabetic nephropathy is the leading causeof End-Stage Renal Disease (ESRD) emerging indeveloped as well as developing countries, with thecomplicated pathogenesis. The study of expression ofthe genes related to kidney cells e.g. podocytes has beenshown to be associated with the condition, helping in theelucidation of pathogenesis of the disease. Previouslythe gene expression associated was studied in urinesamples. Material and Methods: In the present study, itwas attempted to analyze the mRNA expression ofpodocyte related genes viz. podocalyxin, podocin andsynaptopodin in Peripheral Blood Mononuclear Cells(PBMCs) in patients with diabetes with and withoutnephropathy in comparison with healthy controls byreverse transcriptase Polymerase Chain Reaction(PCR), followed by semi-quantitative PCR. Results:The expression of Synaptopodin (SYNPO) wasincreased in diabetics than the controls, while nosignificant difference was found for Podocalixyn(PODXL) and Podocin (NPHS2). The expression ofPODXL and NPHS2 was significantly up-regulated;SYNPO was unaltered in microalbuminuric patientsthan healthy controls. PODXL and SYNPO wereincreased significantly in nephropathy subjects thancontrols, with no significant change in NPHS2. Theexpression of only PODXL was found to be upregulated in microalbuminuric patients as compared toT2DM patients without nephropathy. PODXL, SYNPOwere significantly up-regulated and NPHS2 wassignificantly down-regulated in nephropathy subjects ascompared to T2DM patients without nephropathy. Asignificant down-regulation was found for NPHS2expression in nephropathy patients than microalbuminuric patients of T2DM with nephropathy.Conclusion: The detection of gene expression of theseproteins can be used as an early marker for the detectionof development of nephropathy in T2DM patients andpreventive measures can be taken to prolong the onsetof nephropathy in these patients, increasing the lifeexpectancy.

Distribution of Angiotensin Converting Enzyme I/D Polymorphism in Diabetic and Diabetic Nephropathy Patients at a Tertiary Care Hospital in Maharashtra.

Background: Diabetes Mellitus (DM) is one of theleading non-communicable disorders, leading tovarious complications viz. cardiovascular diseases,retinopathy, nephropathy, neuropathy and peripheralvascular disorders. Diabetic Nephropathy (DN)patients further develop into End Stage Renal Disease(ESRD) and they have to undergo the repeated bloodtransfusions, increasing the social and economicburden. The number of risk factors are known forcausation of diabetic nephropathy including theenvironmental, biochemical as well as genetic factors.The association of nephropathy with various genes hasbeen proved. Aim and Objectives: In the present studywe attempted to check the association ofInsertion/Deletion (I/D) polymorphism of AngiotensinConverting Enzyme (ACE) in diabetic patients withand without nephropathy and also with thebiochemical markers. Material and Methods: Eachgroup consisted of 110 individuals viz. diabetics withand without nephropathy and age and gender matchedhealthy controls. Results: The determination of I/Dpolymorphism by polymerase chain reaction revealedthe significant increased 'D' allele frequencies inpatients of diabetes with and without nephropathy thanthe controls, while no significant difference was notedin genotype frequencies. The odds ratios for thispolymorphism were calculated to be 1.84 and 2.41 forDM and DN respectively in comparison with thehealthy controls. The regression analysis indicated I/Dpolymorphism is associated positively with all thelipid parameters, except High Density LipoproteinCholesterol (HDL-C) which was negatively associatedwith the polymorphism. The levels of lipid parameterswere also significantly increased in patients of diabeteswith and without nephropathy carriers for 'D' allelethan the patients having 'I' allele, while the level ofHDL-C was significantly decreased. Conclusion: Theconclusion can be made from these results that, thepresence of I/D polymorphism of ACE may increasethe risk of development of nephropathy in generalpopulation, with the role of 'D' allele in its causation,along with its effect on the biochemical markers.

Evaluation of high sensitivity C - reactive protein and serum lipid profile in prehypertension and essential hypertension.

Background: Hypertension is a common, asymptomatic, readily detectable disease that leads to lethal complications if left untreated. Vascular inflammation may be involved in both the initiation and development of hypertension that is evident from the elevated levels of inflammatory markers like Tumor necrosis factor-α, Interleukin-6 and C-reactive protein (CRP) found in people with hypertension with no evidence of cardiovascular disease. hsCRP is associated with an increased risk of incident hypertension at all baseline blood pressures and among individuals without traditional coronary heart disease risk factors. Objectives: The present cross-sectional study was an attempt to evaluate the relationship of serum hsCRP levels and serum Lipid profile in prehypertensives and hypertensive. Material & methods: The study group included thirty diagnosed cases of prehypertension and hypertension each, attending medicine OPD at a tertiary care hospital. A healthy group of normotensive volunteers were taken as controls. Fasting blood samples were collected for measurement of serum lipid profile and hsCRP (by CLIA).Results: There was statistically significant rise in hsCRP levels in hypertensives as compared to controls and normotensives (p<0.001). The concentration of cholesterol, triglycerides and LDL-C were significantly high in hypertensives as compared with normotensives (p<0.001). Conclusion: Findings of higher levels of hsCRP in hypertension along with atherogenic lipid profile suggests that elevated hsCRP and hypertension can be independent determinants of cardiovascular risk.

Assessment of thyroid function in euthyroid obese medical students.

Background: It is well known that Thyroid Hormones play a key role in regulating energy homeostasis. The association between thyroid hormones and energy expenditure is well established. There is inverse relationship between obesity and energy expenditure. There is a limited data on thyroid function in euthyroid obese young individuals. Objectives: The present study was designed to evaluate the relationship between thyroid function and obesity in euthyroid young individuals. Materials & Methods: Obesity was defined as per Body Mass Index. (BMI)Undergraduate medical students were grouped as normal, overweight and obese as per their Body Mass Index Thyroid function was assessed by measuring fT3, fT4 and TSH levels by using automated chemiluminescence immunoassay system. Results: We found that the levels of TSH showed significant increase in overweight and obese subjects (p< 0.001) however there was no statistical difference in the levels of fT3and fT4 in overweight and obese students as compared to normal(p> 0.05). Interpretation & Conclusion: Our results suggest that thyroid function though within the normal range could be one of several factors acting in concert to determine body weight in a population. Even slightly elevated serum TSH levels are associated with an increase in BMI.