RESUMEN
Background: Serum gamma glutamyl transferase is widely used as a marker for alcohol induced liver disease. Recently it has gained importance due to its role in type2 diabetes mellitus. A raised serum gamma glutamyl transferase level indicates hepatic steatosis and visceral fat deposition, leading to insulin resistance and diabetes. In the present study we examined the association between serum gamma glutamyl transferase levels with lipids and lipoproteins in diabetes mellitus. Methods: The study was carried out on 50 subjects with type 2 diabetes mellitus and compared with 50 age and sex matched healthy controls attending outpatient department of general medicine, Narayana medical college, Nellore. Serum gamma glutamyl transferase was measured by calorimetric kinetic assay. Fasting blood sugar was measured by glucose oxidase method using automated analyzer. Serum triglycerides, total cholesterol and high density lipoprotein are measured by standard enzymatic procedures and low density lipoprotein by Friedwald equation. Results: Serum gamma glutamyl transferase levels in diabetic cases were significantly elevated compared to normal healthy controls (P <0.001). There was a positive correlation between gamma glutamyl transferase, lipids and low density lipoprotein and inverse correlation with high density lipoprotein (r = -0.298). Conclusion: Our results suggest a possible role of gamma glutamyl transferase in the pathophysiology and progression of type 2 diabetes mellitus.
RESUMEN
Background & objectives: TNF-α is an adipocytokine that has been implicated in the development of insulin resistance. Dysregulation of TNF-α production has been implicated in a variety of human diseases including type 2 diabetes mellitus. We aimed to find out the association of TNF-α levels with insulin resistance, body mass index and waist hip ratio; and to elicit its role with respect to duration of the disease, if any. Methods: 50 type-2 diabetic patients attending Narayana Medical Hospital, Nellore, were studied. Body mass index and Waist hip ratio were calculated. Homeostasis model assessment method was used to calculate insulin resistance (HOMA IR) and per cent β cell function (HOMA B) . Insulin was estimated by chemiluminescence method and TNF-α by ELISA method. The subjects were arbitrarily categorized into three groups based on duration of diabetes. Group 1 included subjects with diabetes of less than 5 yr duration, group 2 included diabetics of 6-10 yr duration and group 3 greater than 10 yr duration. Results: Our study revealed a significant correlation between TNF-α levels and BMI (P=0.006), the correlation being stronger in males when compared to females. A significant correlation was found between per cent β cell function and TNF-α (P=0.008). TNF-α correlated significantly with HOMA IR, HOMA B and insulin, in group 2 diabetes. Interpretation & conclusions: Our results suggest the possible role of TNF-α in the pathogenesis of type-2 diabetes mellitus and the importance of reducing obesity to prevent elevated levels of the cytokine and related complications.