Plasma protein glycation status in Pakistan type 2 diabetic patients with or without nephropathy

Abstract

Background: Amadori-modified glycated plasma proteins play an important role in diabetic microangiopathy. Many of the pathogenic changes that occur in diabetic nephropathy (DN) may be induced by non-enzymatic glycation (NEG). Objective: The aim of this study was to determine prevalence of DN and non-enzymatic glycation levels in diabetic population. Methodology: One hundred patients with type 2 diabetes and forty healthy control subjects were recruited after consent. Case participants were further divided into two groups as type 2 diabetics with nephropathy (n = 22) and type 2 diabetics without nephropathy (n = 78). Non-fasting plasma glucose (Trinder GOD-PAP method), total plasma proteins (biuret method), Erythrocyte sedimentation rate (Westergren's method), HbA1c (glycohemoglobin spectrophotometry A1c Kit) and non-enzymatic glycation (TBA colorimetric technique) were assayed. Results: Diabetic patients with nephropathy had higher ESR (55.33 ± 24.68 mm/1st hour vs. 46.88 ± 23.95 mm/1st hour vs.12.73 ± 2.34 mm/1st hour), total proteins (15.71 ± 4 g/dL vs.14.01 ± 4 g/dL vs 6.18 ± 1.16 g/dL) and non-enzymatic glycation (1.73 ± 0.48 mol./mol. vs.1.47 ± 0.58 mol./mol. vs. 0.48 ± 0.18 mol./mol.) measurements as compared to those without any similar renal complications and controls. Appreciable correlation existed between hyperglycemia and non-enzymatic glycation. Conclusion: Although the clinical consequences of NEG of circulating proteins remain ambiguous. In diabetic patients, however, extensively glycated species could exhibit significant alterations in function. Present study suggests DN as a frequently prevalent secondary complication of diabetes with a potential link with elevated NEG and glycemic control. Key words: Diabetic microangiopathy; nephropathy; glycated serum proteins.DOI: 10.3329/bjms.v9i2.5654Bangladesh Journal of Medical Science Vol.09 No.2 Apr 2010 pp.68-75