Does vitamin D have any role in the improvement of diabetic peripheral neuropathy in type 1 diabetic patients?

AIM: The aim of this study was to evaluate the relationship between diabetic peripheral neuropathy (DPN) and vitamin D, nerve growth factor (NGF) and oxidative stress markers in patients with type 1 diabetes. METHODS: Ninety-six patients with type 1 diabetes were included in the study. All patients were evaluated for DPN with Michigan Neuropathy Screening Instrument. Fasting blood glucose, HbA1c, lipid parameters, 25 (OH) D3, NGF, total oxidant status, total antioxidant status and oxidative stress index were measured. RESULTS: Twenty-six patients (27 %) had DPN (group 1) and 70 patients did not have neuropathy (group 2). When the groups were evaluated with respect to general demographic characteristics, no differences were detected. Mean age, duration of diabetes and retinopathy were found significantly higher in patients who had neuropathy. Glomerular filtration rate levels were significantly lower in the neuropathy group. Between the groups, 25 (OH) vitamin D levels were significantly lower in the neuropathy group, while there were no differences in NGF levels or in oxidative stress markers. Michigan neuropathy examination score was positively correlated with age, and diabetes duration was negatively correlated with 25 (OH) vitamin D levels. In addition, 25 (OH) vitamin D was positively correlated with NGF. In the logistic regression analysis to determine the independent variables that will affect the development of neuropathy, duration of diabetes was detected as the only factor (p = 0.039, OR = 1.071). CONCLUSION: It seems that the most important risk factor for the development of neuropathy in type 1 diabetic patients is disease duration.

Do patients with newly diagnosed type 2 diabetes have impaired physical fitness, and energy expenditures?

BACKGROUND: The disease-related components such as physical fitness and daily energy expenditure may change in each progressive period of type 2 diabetes. The purpose of this study was to compare the maximal aerobic capacity (VO2 max), muscle strength, trunk flexibility, total energy expenditure, daily physical activity, resting metabolic rate (RMR), body composition, and body fat distribution in newly diagnosed type 2 diabetic patients with those of healthy controls. METHODS: Eighty patients (40 male, 40 female) with type 2 diabetes and 80 (40 male, 40 female) controls were included in this study. All participants completed the measurements. RESULTS: It was determined that the VO2 max, muscle strength, daily number of steps, and total energy expenditure were lower, and the body fat percentage, and central obesity were higher in male and female type 2 diabetic patients, when compared with the controls. In addition, the lean body mass was decreased in male diabetic patients, compared with the controls. The fasting plasma glucose showed negative correlations with the maximal aerobic capacity, daily number of steps, and muscle strength in the patients in both genders. RMR and trunk flexibility values were not significantly different between the patients and the controls in either gender. CONCLUSION: We suggest that using exercise intervention especially comprised of strength training and aerobic activities, including not only daily slow activities but also moderate to vigorous activities, as a lifestyle modification in newly diagnosed type 2 diabetic patients might be helpful for the development of earlier and more successful illness management strategies.

Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity.

BACKGROUND: The aims of this study were to investigate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in inflammatory bowel disease (IBD). METHODS: Sixty-six patients (22 CD, 44 UC) and 41 healthy controls were enrolled in the study. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and complete blood count (CBC) were measured. The neutrophil and lymphocyte counts were recorded and NLR was calculated. The patients with active or inactive UC and CD were classified according to the severity of the disease. RESULT: The serum NLR values of active CD patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively). NLR values of active UC patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively. The optimum NLR cut-off point for active CD and UC was 3.2 and 3.1. CONCLUSION: This study demonstrates that NLR in subjects with IBD is strongly associated with active disease and correlated with clinical and laboratory indices (Tab. 5, Fig. 2, Ref. 31).

Evaluation of serum paraoxonase and arylesterase activities in subjects with asthma and chronic obstructive lung disease.

BACKGROUND: Asthma and chronic obstructive lung disease (COPD) are characterised by airway inflammation. Paraoxonasel (PON1) and arylesterase (AE) enzymes have the ability to protect HDL from oxidation and may have antiatherogenic, antioxidant, and antiinflammatory features. We carried out a study to assess if there is a difference between PON1 and AE activities and biochemical values between asthmatics and COPD patients and if there is a difference between comorbid or pure COPD patients. METHODS: 40 asthmatics, 20 pure COPD, 20 comorbid COPD patients, and 20 healthy controls were included. We excluded patients with hypertension, metabolic syndrome, diabetes mellitus, thyroid, renal, hepatic, rheumatic, cardiac, cerebrovascular, malignant, and infectious diseases to establish the asthma and pure COPD groups. Patients using drugs which could affect PON1 and AE were excluded in these groups. There were 11 hypertensive, 5 diabetic, and 4 cardiac patients in the comorbid COPD group. PON1 and AE activities were measured spectrophotometrically. RESULTS: Mean age was higher and male gender was more prevalant in COPD than other groups. Fasting blood glucose, LDL-cholesterol, triglyceride, leucocyte counts, erythrocyte sedimentation rate, and hs-CRP levels were higher in COPD patients. Although PON1 and AE were lower in patients than controls, no difference was found between the asthma and COPD groups, nor between pure and comorbid COPD patients. CONCLUSIONS: Although asthma and COPD are two different conditions PON1 and AE activities cannot be markers of differantial diagnosis as they overlap. Comorbid COPD patients may have similar enzyme levels because of the drugs such as statins and aspirin.