Dharmveer Sharma

Abstract

Introduction: Type 2 diabetes mellitus (T2DM), is a chronic metabolic disorder. Due to its complex pathophysiology, several biomarkers have been studied for identifying its complications. Fetuin A has been proposed to be linked with insulin resistance and its comorbidities and may be helpful in understanding the pathophysiology of the disease condition. Therefore, the present study is aimed to evaluate the Fetuin A levels in Type 2 diabetes mellitus patients and its correlation with blood sugar, renal profile and lipid profile. Materials and Methods: This prospective study was conducted in SRVS Government Medical College, Shivpuri, Madhya Pradesh, India. In this study, 90 T2DM patients as cases and 90 healthy subjects as controls were recruited. Demographic details, physical and clinical examination were done. Patients with cardiovascular diseases, thyroid diseases, liver disease, pregnant women were excluded from the study. Under aseptic conditions, 5 ml of fasting venous blood samples were collected, centrifuged to obtain serum sample. The obtained serum sample was used for the estimation of fasting glucose, post-prandial glucose, renal profile (serum urea, creatinine and uric acid), lipid profile (serum total cholesterol, triglycerides, HDLC, LDLC and VLDL) using commercially available autoanalyzer kits. Serum Fetuin A levels were estimated by using ELISA method. Whole blood sample was used for the estimation of HbA1c. The results were represented as Mean±SD. and percentage. Spearman’s correlation was applied. The p value Results: In this study, in T2DM cases, males were 51 and females were 39 and in controls, males were 50 and females were 40. In the current study, age (63.8±5.7 years), BMI (26.2±1.6 kg/m) SBP (130.8±13.2 mmHg), DBP (90.6±12.7 mmHg), FBS (158.7±14.5 mg/dl), PPBS (228.5±31.8 mg/dl), HbA1c (7.8±0.7 %), Urea (32.1±9.4 mg/dl), Creatinine (1.0±0.1 mg/dl), Uric acid (6.2±2.8 mg/dl), total cholesterol (228.4±33.0 mg/dl), triglycerides (160.0±15.2 mg/dl), LDLC (165.6±33.6 mg/dl), VLDL (32.0±3.0 mg/dl) and Fetuin A (363.9±126.2 micg/ml) levels were significantly increased and HDLC (30.7±3.9 mg/dl) levels were reduced in T2DM cases than the healthy controls. Fetuin A level were significantly positively correlated with FBS (r=0.686), PPBS (r=0.656), HbA1c (r=0.694), Urea (r=0.342), Creatinine (r=0.564), Uric Acid (r=0.588), Total Cholesterol (r=0.700), Triglycerides (r=0.405), LDLC (r=0.728), and VLDL (r=0.528) and negatively correlated with HDLC (-0.681). Conclusion: Elevated fetuin A and atherogenic lipid profile may be a risk for cardiometabolic diseases. Keywords: Atherogenic lipid profile, Fetuin A, Type 2 diabetes mellitus

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Abstract

Introduction: A main cause of morbidity and mortality in Worldwide is Diabetes mellitus. Acute phase reactant like hs-CRP acts as a non-specific marker of inflammation. Action of insulin becomes resistant on peripheral tissues of human body in Insulin resistance (IR). Pathogenesis of type - 2 diabetes mellitus is strongly linked with Insulin resistance. Aim: The aims of this study is to assess between type-2 diabetic subjects and non-diabetic healthy subjects about the status of pro- inflammatory markers as hs-CRP and IR. Material and Methods: This study was conducted in Govt. Medical College, Shivpuri (MP). A total of 200 subjects were included in this study. Out of these, 100 were type-2 diabetes mellitus cases and 100 were non diabetic healthy subjects. They were evaluated by measurement of several physiological and biochemical parameters such as Blood Pressure, Body Mass Index, blood parameters as –Fasting Blood Sugar, Post Prandial, HbA1c, Triglyceride, Total Cholesterol, Low Density Lipoprotein, Very Low Density Lipoprotein, High Density Lipoprotein, high sensitive-C Reactive Protein, Fasting Insulin level and Homeostasis Model Assessment of Insulin Resistance. Result: hs-CRP is usually extensively increased in diabetic cases. The raised level of hs-CRP is noteworthy in diabetes mellitus cases as compared to healthy subjects. Serum Total Cholesterol, Triglyceride, VLDL and LDL levels were highly increased, whereas HDL level were significantly lower in patients of diabetes when compared to controls. hs-CRP had considerable positive correlation with insulin resistance markers and whereas negative associations with insulin sensitivity markers. Conclusion: hs-CRP and IR were strongly related with the metabolic variables and markers of Type- 2 diabetes mellitus subjects with and without complication. Results of this study show that hs-CRP can play a major role in the early detection of IR in diabetes mellitus cases. Keywords: High sensitivity C-reactive protein, (hs-CRP), Insulin resistance (IR), Homeostasis model assessment for Insulin resistance (HOMA-IR).

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Abstract

Introduction: Non alcoholic fatty liver disease (NAFLD) is a disease occurring in patients without any significant alcohol consumption. It includes a broad spectrum and advanced forms of liver diseases, from simple steatosis to nonalcoholic steatohepatitis, fibrosis, and cirrhosis and is associated with diabetes mellitus, insulin resistance, obesity, dyslipidemia and metabolic syndrome. The aim of this study is to evaluate the metabolic significance of NAFLD in obese and type-2 diabetic subjects compare to healthy group of individuals and those independent factors associated with NAFLD. Materials and Methods: Our study was conducted in Govt. Medial College, Banda (UP) as well as G. R. Medical College, Gwalior (MP). A total of 200 subjects were involved in our study, diagnosis being based on ultrasonography. Out of these, 100 were obese with type-2 diabetic patients and 100 were healthy subjects. They were evaluated by measurement of BMI and several biochemical blood parameters such as fasting blood glucose, lipid profile, liver function tests (ALT, ALP and GGT) and hs-CRP level. Results: An increase in the BMI and levels of FBS, total cholesterol, triglycerides, LDL, VLDL, GGT, ALT, ALP and hs-CRP level and a decrease in HDL was observed in NAFLD group of individuals. The values of these biochemical markers were found higher in NAFLD patients and the variations were found to be statically significant. BMI and triglycerides were positively correlated with fatty liver. Conclusion: Obesity, hyperglycemia, dyslipidemia and increased liver enzymes and hs-CRP level are seen more commonly in non alcoholic fatty liver in type-2 diabetic obese patients. Keywords: NAFLD, BMI, High sensitive C-reactive protein.

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