Study of Serum Sialic Acid and Copper as Inflammatory Markers in Type 2 Diabetes Mellitus.

The study aims to understand the relationship between increased serum levels of acute- phase reactants like Sialic Acid (SA) and transitional metals like Copper (Cu) which are indicated to be associated with the etiology and pathogenesis of type 2 diabetes mellitus (DM) and its various chronic complications. Serum SA and Cu levels, measured colorimetrically using Ehrilch’s reagent and Atomic Absorption Spectrophotometer (AAS) respectively among 30 cases each of type 2 DM with and without long-term complications, were significantly higher in all the cases compared to controls. The values are even higher in cases with complications, compared to diabetics without complications. Serum lipid profile was significantly altered in both the experimental groups. Serum SA and Cu levels are positively correlated to duration and degree of impaired glycemic status and altered lipid profile in type 2 DM. Measurement of these new serum markers can explain the inflammatory process, implicated towards the development of diabetic complications like cardiovascular diseases and microangiopathies thereby helping in early medical intervention.

Lipoprotein associated phospholipase A2 activity & its correlation with oxidized LDL & glycaemic status in early stages of type-2 diabetes mellitus.

Background & objectives: Lipoprotein associated phospholipase A2 (Lp-PLA2) is an important risk predictor of coronary artery disease (CAD). This study was aimed to evaluate Lp-PLA2 activity and oxidized low density lipoprotein (oxLDL) in newly diagnosed patients of type 2 diabetes mellitus and to determine the correlation of Lp-PLA2 activity with oxLDL and plasma glucose levels. Methods: Blood samples were collected in patients with newly diagnosed type 2 diabetes (n=40) before any treatment was started and healthy controls (n=40). These were processed for estimating plasma glucose: fasting and post prandial, ox LDL, and Lp-PLA2 activity. The parameters in the two groups were compared. Correlation between different parameters was calculated by Pearson correlation analysis in both groups. Results: Lp-PLA2 activity (24.48 ± 4.91 vs 18.63 ± 5.29 nmol/min/ml, P<0.001) and oxLDL levels (52.46 ± 40.19 vs 33.26 ± 12.54 μmol/l, P<0.01) were significantly higher in patients as compared to those in controls. Lp-PLA2 activity correlated positively with oxLDL in both controls (r=0.414, P<0.01), as well in patients (r=0.542, P<0.01). A positive correlation between Lp-PLA2 activity and fasting plasma glucose levels was observed only in patients (r=0.348, P<0.05). Interpretation & conclusions: Result of this study implies that higher risk of CAD in patients with diabetes may be due to increase in Lp-PLA2 activity during the early course of the disease. A positive correlation between enzyme activity and fasting plasma glucose indicates an association between hyperglycaemia and increased activity of Lp-PLA2. This may explain a higher occurrence of CAD in patients with diabetes. A positive correlation between oxLDL and Lp-PLA2 activity suggests that Lp-PLA2 activity may be affected by oxLDL also.

Liver Function Tests in Type 2 Diabetes Mellitus Patients with and without Oral Hypoglycemic Agents and Statin Intake.

Background: Type 2 diabetes (T2DM) is often associated with liver function abnormalities, covering the entire spectrum from asymptomatic transamnitis to cirrhosis. The oral drugs used in diabetes are also associated with hepatic insult. Aims: Here we have tried to assess the prevalence the liver function test abnormality in type 2 diabetes mellitus patients with special reference to intake of oral hypoglycemic agents (OHA) and statins. Methods: We selected 101 patients of Type 2 Diabetes mellitus (T2DM). Among those diabetic patients 50 were on oral hypoglycemic drugs (OHA) and statins for at least last 6 months. Another 51 age and sex matched patients were diabetic but not on these drugs. The patients were screened for any existing liver disease by biochemical tests. Results and analysis: Our results showed that the prevalence of elevated liver enzymes and bilirubin is more in Diabetic patient than normal values but the oral hypoglycemic drugs and statins had no added effect. Altogether 70 patients (69.3%) had at least one liver function test abnormality. In our study, 4.95% of the patients had elevated bilirubin (>2.5 mg/dL). 24.75% of the study patients had ALT levels above normal (40 U/L) although high values (>100 U/L) were present only in 5 (4.95%). High AST levels (>40) was found in 34.65% cases. Mean alkaline phosphatase levels in 2 groups were similar (213.96 ± 46.2 vs. 222.75 ± 42.52 U/ L). Serum proteins, INR and alkaline phosphatase did not also show any association with drug intake in our study. Conclusion: Thus screening for liver function abnormalities can be a useful test in diabetic population to prevent future complications.