Copper and ceruloplasmin relation to different stages of diabetic nephropathy

Impaired trace elements metabolism may be involved in some of the metabolic dysfunctions, and contribute to the development of vascular complications in diabetic patients. Copper is one of the trace elements which was essential and integral component of many metalloenzymes, including ceruloplasmin which is one of the acute phase reactant protein and may play a role in the antioxidant defense. Prospective studies have reported associations among various markers of inflammation as ceruloplasmin and incidence of diabetes and its complications. This study was conducted to evaluate the state of serum and urinary copper and ceruloplasmin in type 2 diabetes mellitus and their relation to different degrees of diabetic nephropathy. The study included 60 patients divided into 4 groups: group I included 15 healthy volunteers, the other 3 groups included 45 patients with type 2 diabetes mellitus, group II included 15 diabetic patients with normoalbuminuria, group 111 included 15 diabetic patients with microalbuminuria, group IV included 15 diabetic patients with macroalbuminuria. The results showed that there was no significant difference in serum copper levels between control subjects, normoalbuminuric, microalbuminuric and macroalbuminuric patients. Serum ceruloplasmin was significantly higher in the microalbuminuric and macroalbuminuric patients than control subjects and normoalbuminuric patients [P <0.05 for each group] while no significant difference was found between control subjects and normoalbuminric patients, also no significant difference was found between microalbuminuric patients and macroalbuminuric patients. Urinary copper was significantly higher in the macroalbuminuric patients than control, normoalbuminuric and microalbuminuric patients [P <0.001] for each group, while no significant difference was found between control subjects and normoalbuminuric and macroalbuminuric patients. In conclusion, serum copper levels are normal in diabetic patients and are not related to the degree of diabetic nephropathy. While, serum ceruloplasmin levels are significantly higher in diabetic nephropathy and may indicate a role of oxidative stress and inflammation in the pathogenesis of this complication. However, the very high levels of urinary copper in macroalbuminuric patients may suggest that copper overloading to the renal tubular cells in these patients may produce cytotoxic effects on these tubular cells and contribute to the progression of diabetic nephropathy

Effects of cigarette smoking and its cessation on body weight and plasma leptin levels in old male

To determine whether the weight reducing effect of cigarette smoking is mediated by leptin, fasting leptin levels in 22 male smokers [mean age 62 +/- 1 year] and 22 non-smoker males [mean age 64 +/- 1 year] with an age average of 60-65 years for both groups were measured. Mean body mass indices were 27.61 +/- 0.7 and 27.6 +/- 0.07 kg/m2, respectively. Mean leptin levels were 8.4 +/- 1.3 and 5.2 +/- 0.6 ng/ml, respectively. Smokers had a significantly higher leptin levels than nonsmokers. Fasting leptin levels and BMI were re-measured in 13 smokers who successfully gave up smoking for 6 months. Although body weight and BMI significantly increased after six months of smoking cessation, the mean leptin level did not decline significantly. These findings suggested that cigarette smoking directly elevates circulating plasma leptin concentration and this increase may be one of the mechanisms for lowering body weight of smokers in comparison with nonsmokers. However, the effect of cigarette smoking on body weight does not appear to be directly due to the changes in leptin level as evidenced by an insignificant difference between leptin levels in smokers and ex-smokers. Other factors such as hormones involved in body weight regulation and influencing the weight gain after cessation of cigarette smoking should be investigated

Lipoprotein [a] as an independent risk factor in ischemic[thombotic] strokes

The role of lipoprotein [a] [LP[a]] in cerebral infarction is still ill defined. The present study aimed at finding a correlation between LP[a] and severity of cerebral strokes as well as degree of carotid stenosis based on LP[a] level. A hundred and sixty cases were included in this study; 120 patients with cerebral infarction of more than 3 months duration [to exclude effect of acute phase reactant] and 40 cases matched for age, sex and body mass index as control. Patients with cardiac, hepatic, renal, connective tissue diseases or diabetes mellitus were excluded from this study. Complete lipid profile, echocardiography, carotid duplex, C.T. and/or MM [Brain] were done for all cases. Modified Ranking scale for assessment of severity of strokes and step with logistic regression analysis for all lipid parameters were used as predictors of developing stroke. We found that there is a correlation between both degree of carotid stenosis, and severity of cerebral strokes with LP [a] plasma level rather than all other lipid parameters. We can conclude that LP [a] is an independent risk factor for cerebral ischemic strokes, and can be used as a predictor of developing stroke