RESUMO
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency may be one of the risk factor for type 2 diabetes mellitus. Objective: To observe erythrocyte G6PD status in type 2 female diabetic patients and also to find out its relationship with glycosylated hemoglobin. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka from January to December 2009. For this, 60 female patients with type 2 diabetes mellitus, age ranged from 40 to 60 years were included in the study group (group B). On the basis of glycosylated hemoglobin level ( HbA1C) they were further subdivided into group B1, consisting of 30 controlled diabetics (HbA1C 4.8-6%) and group B2, consisting of 30 uncontrolled diabetic (HbA1C>6%) patients. They were selected from Out Patient Department of Bangladesh Institute of Health Science Hospital. For comparison, age & sex matched 30 apparently healthy non diabetic females (group A) were also studied. Erythrocyte G6PD level was measured by Spectrophotometer, HbA1C level by Flex reagent cartridge and serum bilirubin, Hb%, total count of RBC and reticulocyte% were measured by standard laboratory techniques. For statistical analysis ANOVA, independent sample t test, χ2 test and Pearson’s correlation coefficient test were performed as applicable. Results: In this study, erythrocyte G6PD level was significantly lower in both the diabetic groups (p <0.001) than those of control group but their difference when compared between B1 and B2 was not statistically significant. In controlled diabetics 20% and in uncontrolled diabetics 6.7% patients were found G6PD deficients. No G6PD deficient subjects were found in control group. HbA1C showed negative correlation with Erythrocyte G6PD which was only significant for uncontrolled diabetes (p < 0.05) Conclusion: This study concludes that G6PD deficiency may be one of the risk factor for type 2 diabetes mellitus irrespective of blood glucose control status..
RESUMO
Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample “t” test and Pearson’s correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia.