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.

Serum and salivary sialic acid as a biomarker in oral potentially malignant disorders and oral cancer.

Background: Aberrant glycosylation is the universal feature of cancer and components of various glycoconjugates, such as sialic acid is found to rise in various malignancies. The objective of this study was to evaluate the serum and salivary sialic acid in oral potentially malignant disorders (OPMD) and oral cancer (OC) to investigate the possibility of using this as a diagnostic marker. Materials and Methods: The study included 85 subjects, who were grouped as control (30), OPMD patients (25), and oral cancer patients (30). Serum and unstimulated whole saliva was collected from subjects of all groups and sialic acid estimation was done using spectrophotometry. The results were tabulated and analyzed statistically. Results: The mean serum sialic acid levels in normal, OPMD, and oral cancer group were 7.515, 19.620, and 55.235 mg/dL, respectively, whereas the levels of salivary sialic acid were 1.5113, 2.3302, and 9.0304 mg/dL, respectively. A very highly significant rise (P < 0.005) in serum and salivary sialic acid was observed in the study subjects compared with that of the control. Conclusions: The present study showed a significant and gradual increase in serum and salivary sialic acid from control to oral potentially malignant disorders to oral cancer. From this study we can suggest that sialic acid can be used as a reliable biomarker. As this monosaccharide is observed in saliva in detectable quantity, saliva can be used as a diagnostic medium for screening and early detection of oral cancer.

Relationship between serum nitric oxide and sialic acid in coexisted diabetes, hypertension and nephropathy

This study was designed to study the relationship between serum nitric oxide and sialic acid in patients of diabetic nephropathy. Total 210 diabetic patients including 115 males and 95 females, suffering from diabetes and nephropathy [DN] were selected followed by informed consent and approval from institutional ethical committee. Equal number of age and sex matched normal healthy subjects were selected without any known history of hyperglycemia, hypertension and renal insufficiency as controls. Fasting blood samples from patients and controls were collected and analyzed for serum nitric oxide, sialic acid, fasting blood glucose [FBG], serum urea, creatinine, HbA1c and golmerular filtration rate [GFR]. The raised levels [p<0.05] of systolic and diastolic blood pressures, BMI, FBG, HbA1c, serum urea, creatinine and sialic acid were noted in DN patients as compared to controls. Significantly lower levels of GFR and serum nitric oxide [p<0.05] were observed in DN patients as compared to controls. Strong negative correlation was found between serum sialic acid and nitric oxide levels in patients diabetic nephropathy [p<0.05]. The relationship between the levels of serum nitric oxide and sialic acid may be considered as a strong biochemical indicator for micro and macro vascular complications of diabetes such as hypertension and nephropathy. These parameters should be taken into account during screening procedures regarding identifications of the diabetic patients to get them rid of progressive renal impairment to ESRD

Serum sialic acid and its lipid and protein bounds as possible biomarkers of acute myocardial infarction in Erbil city

Myocardial infarction [MI] usually occurs when coronary blood flow decreases abruptly after a thrombotic occlusion of a coronary artery previously affected by atherosclerosis. Sialic acid [SA] is attached to non reducing residues of the carbohydrate chains of glycoproteins and glycolipids. An elevation in serum TSA, LBSA and PBSA concentrations has been observed in a number of pathological conditions .The aim of the study was to determine the serum TSA and its LBSA and PBSA in patients with acute myocardial infarction [AMI]. Serum TSA, LBSA and PBSA concentrations were evaluated by UV/VIS spectrophotometry in [100] apparently healthy individuals and [100] newly diagnosed AMI patients. The mean levels of serum TSA, LBSA and PBSA in AMI patients were significantly higher [P<0.05] than those of apparently healthy individuals. The results indicate that the serum values of TSA, LBSA and PBSA appeared to be of a value in diagnosis of AMI

Ácido siálico sérico, carga aniónica y agregación eritrocitaria en pacientes diabéticos e hipertensos / Serum sialic acid, cellular anionic charge and erythrocyte aggregation in diabetic and hypertensive patients

El objetivo de este trabajo fue estudiar la relación del ácido siálico sérico (AS) y la carga aniónica eritrocitaria (CAE) con la agregación eritrocitaria en dos grupos de pacientes: diabéticos (DBT n= 20) e hipertensos (HTA n= 21), comparados con un grupo control (n= 20). Se trabajó con sangre anticoagulada con EDTA y suero. La agregación eritrocitaria se estudió por observación microscópica de los agregados y cuantificación a través de un parámetro de forma denominado ASP (Aggregation Shape Parameter). La CAE se determinó por unión a colorante alcian blue y el AS por método espectrofotométrico con reactivo de Erlich. Los valores de ASP y AS resultaron significativamente aumentados en los HTA y DBT respecto de los normales. Los HTA y DBT presentaron agregados amorfos, lo que se refleja en los valores alterados de ASP, significativamente mayores (p < 0.005) respecto de los individuos normales. Los valores de CAE resultaron significativamente inferiores en los HTA y DBT respecto del grupo control (p < 0.0001). En este trabajo se demostraron anormalidades en la agregación eritrocitaria, detectadas por los valores de ASP, CAE y AS que podrían estar involucradas en las complicaciones vasculares de vasculopatías como la hipertensión y la diabetes.

The aim of this work was to study the relationship between serum sialic acid (SSA) and erythrocyte anionic charge (EAC) with erythrocyte aggregation in two groups: diabetic (DBT, n=20) and hypertensive (HT, n=21) patients, compared to a control group (n=20). We worked with anticoagulated blood with EDTA and serum. The erythrocyte aggregation was studied by microscopically observing and quantifying aggregates using an ASP (Aggregate Shape Parameter). The EAC was determined by binding an Alcian blue dye to the membrane sialic acid and SSA was determined by spectrophotometric method with an Erlich reactant. The values of ASP and SSA increased significantly in HT and DBT patients compared to the control group. The HT and DBT groups showed amorphous aggregates, evident in an alteration in the values of ASP, which were significantly higher ( p< 0.005) than in healthy patients. The EAC values were much lower in HT and DBT patients than in the control group (p < 0.0001). In this work, abnormalities in the erythrocyte aggregation could be detected by the values of ASP, EAC and SSA, which might be involved in vascular disorders of diseases such as hypertension and diabetes.

Insulin dependent diabetes mellitus; correlation between sialic acid and diabetic retinopathy

To test the hypothesis that an increased plasma concentration of sialic acid, a marker of the acute-phase response, is related to the presence of diabetic retinopathy in type 1 diabetes mellitus or Insulin Dependent Diabetes Mellitus [IDDM].We investigated the relationship between plasma sialic acid concentration and diabetic retinopathy in a cross-sectional survey of 1,369 people with type 1 diabetes. Subjects were participants in the IDDM Complications Study, which involved diabetic centers of four different hospitals in Lahore. There was a significantly increasing trend of plasma sialic acid with severity of retinopathy [P

Serum and tissue mucoproteins and sialic acid in thyroid diseases

To find the correlation coefficient of serum mucoproteins and sialic acid to thyroid tissue in thyroid diseases. The study was carried out at J.P.M.C, Karachi. A total of twenty four thyroid patients and twenty normal subjects were studied. The cases were divided into non toxic goiter fourteen, and toxic goiter ten on the basis of clinical and physical examination, thyroid scanning and hormone analysis. Thyroid hormones were estimated in serum. Mucoproteins and sialic acid were estimated in serum as well as in thyroid tissue. Estimations of thyroid hormones and thyroxine binding globulin [T.B.G.] are useful clinically to evaluate the functions status and diagnosis of different thyroid disorders. Thyroid tissue is mainly composed of glycoprotein, thyroglobulin, and different studies showed that serum glycoprotein fractions varied in different thyroid diseases. Significantly increased levels of T[4] were observed in toxic goiter group. The levels of TBG was significantly increased in non toxic goiter, toxic goiter patients while T[4]/TBG ratio was significantly decreased in non toxic goiter. Coefficient correlation [r] of serum to tissue mucoproteins shows an inverse relationship in non toxic goiter and toxic goiter patients. In non toxic goiter and toxic goiter patients the serum sialic acid levels to tissue sialic acid levels also shows an inverse relationship. Correlation coefficient analysis showed an inverse relationship of serum mucoproteins and sialic acid to thyroid tissue. It signifies that carbohydrate moieties are increased in the blood when the tissue are hyperactive and in the pathological state. It further concludes that thyrotoxic state might be converted into nodular form even into cancerous form later on

Study of serum nitric oxide, soluble Fas and total sialic acid levels in patients with liver cirrhosis and their correlation with the stage and complications of the disease

Cirrhotic liver claims many lives in Egypt. Some factors may play a role in the pathogenesis of cirrhosis and its complications such as nitric oxide [NO] and soluble Fas [sFas]. However, others may be a consequence of liver damage as total sialic acid [TSA]. The aim of this study was to evaluate serum level of NO, sFas and TSA in patients with compensated and decompensated cirrhosis, with and without hepatitis C virus [HCV], and their correlation with the stage of the disease. The study included 34 patients with biopsy-proven cirrhosis [group I], categorized according to Child Pugh classification into three subgroups: group IA [11 patients with class A], group IB [13 patients with class B], and group IC [10 patients with class C], in addition to 15 age and sex matched healthy individuals as a control group [group II]. The mean age was 56.35 +/- 9.28 and 53 +/- 5.52 years, for group I and II, respectively. All studied individuals were subjected to full history taking, clinical examination, abdominal ultrasound, laboratory tests including liver function tests, hepatitis B surface antigen [HBsAg], hepatitis C virus antibodies [HCVAb], serum levels of NO, sFas and TSA. The study showed that, there was a significant increase in serum level of NO, TSA and sFas in cirrhotic patients group, when compared to the control group [P<0.001]. Serum NO and TSA levels were significantly increased with disease progression from grade A to grade B to grade C subgroups [P<0.001]. There was a significant increase of serum NO and TSA in cirrhotic patients with positive HCVAb, history of bleeding esophageal varices [O.V.], those with ascites, and those with spontaneous bacterial peritonitis [SBP], when compared with those with negative HCVAb, without bleeding O.V., without ascites, and without SBP, respectively. There was a positive correlation between serum NO and TSA with ALT [P<0.001] in cirrhotic patients subgroups, while there was no significant correlation as regards to sFas [P>0.05]. Serum NO is increased in patients with cirrhosis, particularly for those with positive HCVAb, and this increase is proportionate to the grade of cirrhosis. Understanding the role of NO in the pathophysiology of cirrhosis may help in initiating new lines of management. The increase of serum sFas in cirrhotic patients suggests the role of apoptosis in liver damage. Increased serum TSA in advanced cirrhosis, compared with early [Child's A] cirrhosis and controls, suggests that serum total sialic acid become a useful, non-invasive test, in the diagnosis and ftdlow up of cirrhosis

Serum total sialic acid and cathepsin-D increase the accuracy of free-to-total PSA ratio in diagnosis of BPH and prostate cancer

To evaluate the combination of free-to-total PSA ratio, serum total sialic acid and serum cathepsin-D in differentiation of patients with benign prostatic hyperplasia from those with prostate cancer. From June 2004 to June 2007, sixty eight patients with ages ranging from 51 to 80 years, and a control group of 25 healthy males volunteers were included in this study. Blood samples were obtained from every patient and control by venipancture before any manipulation of the prostate to assay total PSA [t/PSA], free PSA [f/PSA], total sialic acid [TSA] and cathepsin-D. All patients had serum total PSA less than 20 ng/ml. TRUS examination of the prostate and TRUS guided biopsy were done to all patients. The patients were classified in two groups, the first group included 38 patients, with histopathologically proved BPH. The second group included 30 patients with organ confined or locally advanced prostate cancer. Mean serum level of total sialic acid and mean serum cathepsin-D were significantly elevated in patients with prostate cancer compared with those of controls and patients with benign prostatic hyperplasia. Patients with prostate cancer showed statistically significant lower free-to-total PSA ratio in comparison to those of benign prostatic hyperplasia. The combined measurement of free-to-total PSA ratio with total sialic acid and serum cathepsin-D elevate the efficacy of free-to total PSA ratio in differentiation between benign prostatic hyperplasia and prostate cancer

Sialic acid as a predictor of type 2 diabetes mellitus

Inflammatory markers predict type 2 diabetes. Gestational Diabetes Mellitus [GDM] predicts type 2 diabetes. To examine the association of inflammatory markers with GDM, we investigated total sialic acid [TSA] in women with and without previous GDM. All women with GDM and a random sample of women from diabetic center of Sir Ganga Ram Hospital, Lahore were taken after an interview, an oral glucose tolerance test and anthropometry were performed. A total of 46 women with and 50 women without previous GDM completed the protocol. Mean TSA was significantly higher in women with [71.8 +/- 11.1 mg/dl] than without [67.5 +/- 9.8 mg/dl] previous GDM [P< 0.05]. In a linear regression model, TSA was 4 mg/dl [P< 0.05] higher in women with previous GDM, after adjustment for BMI and fasting insulin sensitivity. In a similar model, current 2-h plasma glucose levels were associated with higher TSA levels after adjustment for waist-to-hip ratio and the log of triglycerides. TSA was strongly correlated with individual components and aggregates [r = 0.55, P< 0.001] of the metabolic syndrome. Increased TSA levels are associated with previous GDM and are strongly linked to the metabolic syndrome. These findings in young women suggest that a chronic mild systemic inflammatory response is an early feature of the metabolic syndrome and that GDM may be a window for its investigation

Some biomarkers in acute myocardial infarction

Several changes in serum biochemical factors occur in acute myocardial infarction [AMI]. Recently alterations in serum levels of homocysteine [Hcy], sialic acid [SA] and high sensitive C-reactive protein [HS-CRP] has been attended as risk factors and index for prediction. This study was aimed to show the alterations in these factors and their relationships in AMI. Thirty four patients with AMI were enrolled in this case-control study. Also 51 apparently healthy individuals were selected as control group. Serum was prepared from all subjects in fasting state. Hcy and HS-CRP were measured using ELISA and SA was determined by Erlich method. Serum levels of Hcy, SA and HS-CRP in AMI patients were 14.35 +/- 2.55mmol/l, 73.54 +/- 2.82 mg/dl, and 17.32 +/- 3.45 mg/l, respectively and in the control group they were 8.31 +/- 2.66 micro mol/l, 59.82 +/- 2.70 mg/dl and 2.77 +/- 1.98 mg/l, respectively. Statistical analysis of data showed that serum level of Hcy, SA, and HS-CRP in the patients with AMI was significantly higher than those of control [P < 0.001]. Also significant correlation was observed between Hcy-HS-CRP [r = 0.63], SA- Hcy [r = 0.73], and SA - CRP [r = 0.75] [P < 0.05 for all items]. Our findings showed increased level of HS-CRP, SA, and Hcy in AMI patients. Also ob_tained data indicated a direct and significant correlation between HS-CRP as an inflammation index and Hcy and SA. Hence these two factors can be used as biomarkers in this disease

Relationship between serum sialic acid and cardiovascular risk factors in Egyptian children and adolescents with type 1 diabetes mellitus

The aim of the present study was to investigate the relation between serum sialic acid and cardiovascular risk factors in Egyptian children and adolescents with uncomplicated type 1 diabetes mellitus. The study included 40 [25 males and 15 females] type 1 diabetic children aged 4 to 16 years and 20 non diabetic healthy controls with age and sex matched. All children were subjected to full clinical examination, blood pressure measurement, anthropometrical measurements [weight, height, body mass index]. The children were investigated for biochemical variables: total cholesterol [TC], triglycerides [TG], high-density lipoprotein cholesterol [HDL], low-density lipoprotein cholesterol [LDL], fasting blood glucose [FBG], glycated hemoglobin [HbA1c] serum sialic acid [TSA] and serum creatinine. There was no significant difference between mean serum TSA in type 1diabetic children [69.77 +/- 8.38] and their controls [67.77 +/- 7.7]. In diabetic children, mean serum TSA was significantly higher in females [72.03 +/- 3.04] than in males [67.29 +/- 8.7] p<0.05. Significant correlations were found between serum TSA and each of diabetic duration [p,0.02], BMI [p, 0.01], cardiovascular risk factors: TC [p,0.01], TG [p, 0.001], LDL [p, 0.0001]. In diabetic children mean serum TSA was significantly higher in children with family history of cardiovascular disease [p, 9.04], BMI [kg/m 2] >/= 85 percentile [p, 0.03], poor glycemic control; HbA1c >9% [p, 0.02], raised LDL [p, 0.03]. Serum TSA might be considered as a marker for cardiovascular disease [CVD] risk factor, especially in diabetic children

relationship between serum total sialic acid levels and adenosine deaminase activity in obesity

To evaluate the relationship between serum adenosine deaminase [AD] activity and serum total sialic acid [TSA] levels in obese individuals. We performed this study at the Department of Chemistry, Division Biochemistry, Kahramanmaras Sutcu Imam University Arts and Science Faculty, Turkey from 2003 to 2004. Fifty obese subjects and 25 non-obese healthy controls were included in the study. The serum AD activity and TSA concentrations were measured by spectrophotometric methods. The AD activity [p<0.01] and TSA concentrations [p<0.001] were significantly higher in the sera of obese subjects than those of non-obese control subjects. But, there was no statistically significant difference in the serum TSA levels and AD activity of the obese subjects with metabolic syndrome properties compared with those without metabolic syndrome properties. A significant correlation between the serum TSA and AD was found in the obese subjects [p<0.05, r: 0.33]. Our findings suggest that there may be a closer interaction between the inflammatory events and obesity. However, our observations need to be confirmed by further studies to understand more regarding the underlying mechanisms

Detection of cancer cervix by estimation of sialic acid.

The study was undertaken to determine the sialic acid concentration of cervical tissue and serum of women with healthy and unhealthy cervix. The sialic acid value in local tissue of cervix and in serum showed slight elevation in benign inflammatory lesions, moderate elevation was found in severe dysplasia and preinvasive carcinoma and marked elevation in invasive carcinoma cervix. The values, both in the serum and in the cervical tissue, increased gradually with the advancement of grading of frank malignancy. The elevation of sialic acid in the serum was slow to start with but persisted for a longer period, wereas the concentration in local tissue was found to be increasing with the pathological process.

Evaluation of glycoproteins as prognosticators in head and neck malignancy.

Although several serum glycoprotein assays have been conducted for identifying tumor markers and prognosticators of malignancies, presently assessment of effectiveness of treatment of these malignancies remains subjective and good and effective tumor markers and prognosticators of head and neck malignancies are yet to be identified. In our study, serum samples from forty patients with head and neck cancers who were divided into four groups of ten patients each on the basis of their clinical staging and serum samples from ten healthy individuals comprising the control group was taken and subjected to biochemical analysis of serum protein bound hexose, serum fucose, serum sialic acid levels before starting treatment of the cancers and after completion of the cancer treatment and compared with the levels of these serum glycoproteins amongst the control group. All the head and neck cancer patients showed elevated levels of the serum glycoproteins as compared to the control group. It was further noted that the increased levels of the serum glycoproteins correlated well with the clinical staging of the malignancies. Post-treatment levels of all the serum glycoproteins were decreased significantly but, only the serum sialic acid level in 6 out of 10 patients with stage-I malignancy returned to the base line levels as seen in the control group. Serum sialic acid levels showed very close correlation with tumor staging and maybe considered as a good tumor marker and prognosticator for detection of cancer and evaluation of effectiveness of treatment of head and neck malignancies.

Importance and clinical significance of serum sialic acid and lactate dehydrogenase determination in cervical cancer patients

In an attempt to establish a blood-based biochemical index for diagnosis of cervical cancer patients, serum levels of total sialic acid [TSA] and lactate dehydrogenase [LDH], were estimated. Serum concentrations of the markers in 30 untreated cervical cancer patients were compared with the levels of the biomarkers in 20 healthy, ages matched female individuals with the same socio-economic status as controls. Cancer cervix patients were divided into 2 groups; group [A], early disease [stages I and II] n=18, and group [B] advanced disease [stages III and IV] n=12. The levels of all markers were found to be significantly higher [P<0.001] in untreated cervical cancer patients versus to the control group. TSA was found to be the most sensitive [86.6%] marker for diagnosis of cervical cancer. Combined use of the markers revealed higher sensitivity [93.3%]. In comparison between advanced [stages III and IV] and early [I and II malignant disease, the markers showed higher levels in advanced disease, but this increase was found to be insignificant [P<0.05]. These results suggest that combined evaluation of these markers is helpful for diagnosis of cervical carcinoma patients in conjunction with the studies of cervical smear and other conventional diagnostic methods

role of sialic acid in the development of anemia in chronic renal failure

Shortened life span of erythrocytes has been suggested as one of the causes of anemia in chronic renal failure. Decreased sialic acid content of erythrocytes lead to their rapid removal from the circulation. Abnormalities in metabolism of this substance with increased neuraminidase activity in sera of these patients may be responsible for this phenomenon. To clarify this hypothesis, sera of 50 patients with end stage renal failure were examined before and after dialysis for neuraminidase activity by assessing their effect on desialylation of erythrocytes of healthy subjects, matched for blood group and of fetuin [substrate rich in sialic acid] together with determination of total and lipid bound sialic acid content of their RBCs. The results were compared with corresponding values of 20 controls. The study showed a significantly enhanced neuraminidase like activity in sera of patients with chronic renal failure in comparison with sera of healthy controls [P<0.001] associated with significant decrease of total and lipid bound sialic acid of RBCs. The present data are indicating that increased neuraminidase activity in sera of patients with chronic renal failure could be a contributing factor involved in the mechanism of producing the marked anemia in uremic subjects by acting on erythrocytes, rendering them more liable to be cleared faster by the liver and spleen, shortening their life span, moreover, it could act on erythropoietin depriving it from its sialic acid content, shortening its life span therefore reevaluation of the therapeutic modalities of anemia in these patients whether blood transfusion or erythropoietin is needed