Study of some acute phase proteins in type I diabetic patients with and without ketoacidosis

ABSTRACT

Five serum acute phase proteins haptoglobin [HG], transferrin [TF]. alpha 1 glycoprotein [AGL], alpha 2 macroglobulin [AMG] and C reactive protein [CRP] were studied together with random serum glucose [RSG].total and differential white cell count and erythrocytes sedimentation rate [ESR] in 14 type I diabetic patients during ketoacidosis. They comprised 8 males and 6 females with a a mean age of 21 +/- 4.2 years. Ten apparantly healthy subjects: 6 males and 4 females with a mean age of 22 +/- 5 years served as controls. Ketoacidosis was controlled, then diabetes was treated properly with insulin and dieting. 14 to 18 days after ketoacidosis control [end of study], 12 out of the 14 patients were reexamined and resampled. AMG was significantly higher [S P<0.05] during ketoacidosis than at the end of study with non significant [NS P>0.05] difference between patients with and without infection. NS difference was found between levels of HG, TF and AGL during ketoacidosis and at the end of study. Similarly NS difference was found between their levels in patients [either during ketosis or at end of study] and controls. However TF level was significantly lower in patients with infection than those without together with a concomitant significantly higher ESR, neutrophilic and positive CRP. A strong positive correlation was found between AMG and RSG values [p<0.001], while, a strong negative correlation [p<0.001] was found between TF and both neutrophil count and ESR. This suggests that AMG value is directly proportional to the degree of hyperglycaemia, while, both low TF level and positive CRP are mainly related to occurrence of infection in type I DM