Plasma malondialdehyde levels and risk factors for the development of chronic complications in type 2 diabetic patients on insulin therapy.

BACKGROUND: We assessed plasma malondialdehyde (MDA) levels as a biomarker of lipid peroxidation in type 2 diabetic patients on insulin therapy. Associations among MDA levels and some risk factors for the development of chronic complications of diabetes were also evaluated. METHODS: MDA, fasting glucose, fructosamine, urinary albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, creatinine, uric acid, serum albumin, lactate, high sensitive C reactive protein (hsCRP), and vitamin E were measured in 53 type 2 diabetic patients and 26 healthy subjects. RESULTS: MDA levels were higher in type 2 diabetes insulin users (12.8 +/- 3.0 micromol/L) and type 2 diabetes no insulin users (10.3 +/- 2.1 micromol/L) compared to control subjects (8.2 +/- 2.1 micromol/L). Fasting glucose, fructosamine, urinary albumin, and hsCRP were higher in all type 2 diabetic patients compared to controls. Significant correlations were observed between MDA and fasting glucose (r = 0.685, p < 0.001), fructosamine (r = 0.526, p < 0.001), urinary albumin (r = 0.516, p < 0.001), and the duration of type 2 diabetes (r = 0.401, p = 0.005). CONCLUSIONS: MDA levels increased in type 2 diabetes, especially in patients on insulin therapy. Chronic hyperglycemia and other biomarkers, such as urinary albumin, were correlated with MDA levels, suggesting the involvement of lipid peroxidation in the pathogenesis of diabetes complications.

Association between DNA strand breakage and oxidative, inflammatory and endothelial biomarkers in type 2 diabetes.

Evidence has been presented recently that type 2 diabetes patients have an increased level of DNA damage. This DNA damage could be associated with oxidative, inflammatory, and endothelial biomarkers and could represent a possible indication of injury in the endothelium and induction of inflammation in type 2 diabetes. To confirm this possible association, DNA strand breakage was evaluated by use of the comet assay and its association with oxidative, inflammatory, and endothelial biomarkers in type 2 diabetes patients. A case-control study (30 healthy controls and 32 subjects with type 2 diabetes) was performed to evaluate the association between DNA damage and NOx (nitrate/nitrite), interleukin-6 (IL-6), urinary albumin, fasting glucose, and glycated hemoglobin (HbA(1c)) levels. Type 2 diabetes patients presented higher DNA damage than control subjects, higher levels of IL-6 and urinary albumin, and lower NOx. Significant correlations between DNA damage and NOx (r=-0.303, p=0.016), IL-6 (r=0.845, p<0.001), urinary albumin (r=0.496, p<0.001), fasting glucose (r=0.449, p<0.001), and HbA(1c) (r=0.575, p<0.001) were reported. Our findings showed an increase of DNA damage in type 2 diabetes especially in those patients with poor glycemic control and associations among NOx, IL-6 and urinary albumin levels with DNA damage.

Assessment of urinary γ-glutamyltransferase and alkaline phosphatase for diagnosis of diabetic nephropathy.

BACKGROUND: Urinary biomarkers of tubular damage can be useful for early diagnosis of diabetic nephropathy. Thus, the aim of this study was to test the diagnostic accuracy of the urinary excretion of γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) for diagnosis of diabetic nephropathy (DN). METHODS: Fasting glucose, fructosamine, serum creatinine, glomerular filtration rate (GFR), serum uric acid, serum albumin, and urinary albumin, creatinine, GGT and ALP were assessed in 74 type 2 diabetic patients without nephropathy and 38 type 2 diabetic patients with nephropathy. RESULTS: Urinary GGT and ALP were threefold higher in type 2 diabetic patients with nephropathy. Significant correlations were observed between urinary albumin and GGT (r=0.439, P<0.001) and urinary albumin and ALP (r=0.305, P<0.01). Areas under the curve for GGT and ALP were 0.7696 (P<0.001) and 0.7233 (P<0.001), respectively. At a cut-off value of 72U/g creatinine, GGT demonstrated a sensitivity of 96.0% and a specificity of 52.6%. At a cut-off value of 20U/g creatinine, ALP demonstrated a sensitivity and specificity of 83.8% and 36.8%, respectively. CONCLUSIONS: Urinary GGT and ALP have potential value in the diagnosis of nephropathy in type 2 diabetic patients, but GGT has a slightly higher ability to discriminate nephropathy than ALP.

Ischemia-modified albumin as an oxidative stress biomarker in obesity.

OBJECTIVE: We evaluated the levels of ischemia-modified albumin (IMA) and its association with body mass index (BMI) in patients who are obese. DESIGN AND METHODS: Fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, malondialdehyde, and IMA levels were assessed in 148 subjects. RESULTS: IMA, malondialdehyde, and fasting glucose levels were significantly higher while the HDL cholesterol levels were lower in obese population. CONCLUSIONS: IMA levels increase in overweight and obese subjects.

Association between ischemia modified albumin, inflammation and hyperglycemia in type 2 diabetes mellitus.

OBJECTIVES: The aim of this study was assess serum ischemia modified albumin (IMA) in type 2 diabetes patients and determine its correlation with other risk factors for chronic complications such as inflammation and hyperglycemia. DESIGN AND METHODS: Fasting glucose, glycated albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, creatinine, uric acid, albumin, lactic acid, high-sensitivity C-reactive protein (hs-CRP) and IMA were measured in 80 patients with type 2 diabetes and 26 controls. RESULTS: Fasting glucose, glycated albumin, triglycerides, creatinine, IMA and hs-CRP were significantly higher in patients with type 2 diabetes. Correlations were weak but significant between IMA and fasting glucose, IMA and hs-CRP, hs-CRP and HDL cholesterol and hs-CRP and fasting glucose were observed. CONCLUSIONS: We have shown higher levels of IMA and hs-CRP in type 2 diabetes. Hyperglycemia and inflammation reduces the capacity of albumin to bind cobalt, resulting in higher IMA levels.

Resultados da terapêutica com Iodo radioativo na Doença de Graves / Using radiodine (RI) to treat Graves Disease

Foram estudados, retrospectivamente, 53 pacientes com hipertireoidismo por Doença de Graves, submetidos a terapêutica de radioiodo (RI) no período de 1980-1993 no Hospital Nossa Senhora da Conceiçäo, Porto Alegre, RS. A média de idade foi de 37 anos, predominando pacientes do sexo feminino (86,6 por cento). A dose média de RI empregada foi de 17,4 MCI e o tempo de acompanhamento dos pacientes foi em torno de 6 anos.Um percentual de 88,8 por cento dos pacientes usavam drogas antitireoidianas antes do uso do RI e 24,4 por cento continuaram usando após a dose de RI. Cura foi relatada em 93,3 por cento dos casos, 27 pacientes desenvolveram hipotireoidismo, 15 ficaram eutireoideos e 3 permaneceram hipertireoideos. 55,5 por cento dos pacientes apresentaram hipotireoidismo no primeiro ano após o RI, 82,2 por cento dos pacientes necessitaram apenas uma dose. Näo houve outras complicaçöes relacionadas com o uso de RI. Concluiu-se que o grande percentual de hipotireoidismo precoce deve estar relacionado a altas doses de RI empregados, em relaçäo à preconizada na literatura

Diabetes mellitus tipo II: estudo de quarenta casos / Diabetes Mellitus type II: study of 40 cases

Este trabalho estudou o perfil clínico e laboratorial de quarenta pacientes diabéticos näo insulino-dependentes atendidos no ambulatório de endocrinologia do Hospital Säo Vicente de Paulo, Passo Fundo (RS), no período de seis meses. Nesta amostra predominou a raça branca, baixo nível de escolaridade, idade média de 46 anos e o diagnóstico de diabetes há cerca de 5 anos. A maioria dos pacientes usava dieta e hipoglicemiante oral, apresentava peso excessivo, obesidade androgênica e hipertensäo arterial sistêmica. A neuropatia periférica foi a complicaçäo crônica mais freqüente. Prevaleceu o mau controle glicêmico e a hipertrigliceridemia foi a displipidemia mais observada neste grupo