Padmaja Nikam

Abstract

Background: Reference interval is the common tools used for interpreting various biochemical parameters. The age, gender, diet, ethnicity, socioeconomic conditions affect the physiology of population and thereby affecting the reference intervals. Thus, it is needed to set up our own reference intervals which are specific to particular gender, region and population. Aim and Objectives: To establish the gender specific reference interval for hepatic enzymes at BIMS Hospital, Belagavi. Materials and Methods: This was a hospital based cross-sectional study involving 450 subjects. The selected subjects were from the general population, health professionals, medical students and those attending the Out-Patient Department (OPD) for general health check ups. The serum Alanine transaminase (ALT), serum Aspartate transaminase (AST), serum Alkaline phosphatase (ALP) were estimated based on the recommendations of IFCC without pyridoxal phosphate and serum Gamma glutamyl transferase (GGT) by enzymatic colorimetric method. The 97.5th percentile and 2.5th percentile was used to obtain the reference intervals. Results: The serum AST and serum GGT showed the statistically significant difference between the male and female values. Thus separate reference should be considered for both males and females. There was no statistically significant difference in serum ALT and serum ALP levels. Thus generalized reference intervals were established. Conclusion: The study revealed the difference in reference intervals of serum AST and serum GGT between males and females. Keywords: Hepatic enzymes, Reference intervals, AST, ALT, GGT, ALP.

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Introduction: Type 2 diabetes mellitus (T2DM) is the leading cause of death among non-communicable diseases. The cause for T2DM is multi-factorial and the consequence of hyperglycaemia are many like altered lipid profile, increased oxidative stress, increased amount of altered albumin in circulation i.e., ischemia modified albumin (IMA). All these alterations would lead to microvascular and macrovascular complications. Therefore treating T2DM with hypoglycaemic drugs and insulin alone is failing to achieve the long term glycaemic control. Hence there is need for supportive therapy like yoga. The aim of the study was to determine the effect of yoga practicing on IMA, lipid profile and antioxidant enzymes in T2DM patients on oral hypoglycaemic drugs (OHD). Materials and Methods: This was a prospective cohort study, conducted from June 2017 to October 2018. Two hundred T2DM patients were included in the study. In group I 100 T2DM patients on Metformin and Glimipride (500 mg BD + 2 mg OD, respectively) along with yoga practicing were included and in group II there were 100 T2DM patients of age and duration of T2DM ma tched with out practicing yoga. The levels of Fasting plasma glucose (FPG), Post prandial plasma glucose(PPPG), Glycated hemoglobin (HbA1c), Ischemia modified albumin (IMA), Lipid profile (TC, Tg, LDL-C, VLDL-C, HDL-C), lipid peroxidation (Malondialdehyde levels) and activity of enzymatic antioxidants (Superoxide dismutase, catalase, Glutathione peroxidase) were measured in both groups. Glycemic profile (FPG, PPPG, HbA1C, IMA), Lipid profile and oxidative stress were comparable in patients of both groups. Patients on oral hypoglycemic drugs (OHD) and yoga practicing showed significantly lower ed levels of FPG, PPPG, HbA1C, IMA, TC, TG, LDL-C and MDA and significantly increased levels of HDL-C, SOD, Catalase and GPx in comparison with T2DM patients those who were only on OHD. Reduced Oxidative stress, decreased lipids profile and Glycemic control was seen in yoga practicing T2DM patients than in those who were only on OHD. Practicing of yoga with OHD in T2DM patients will improve the glycemic index, reduce risk of MI and help to prevent the CVD complications. Hence this study suggests to practice yoga with OHD to reduce further complications of T2DM. Keywords: T2DM, Ischemia modified albumin, Lipid profile, Oxidative stress.

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Abstract

Introduction: Ischemia modified albumin (IMA), is new biomarker of oxidative stress and ischemia. IMA being increased in Diabetes Mellitus has been described in many studies. Diabetes Mellitus (DM) a metabolic disorder is characterised by hyperglycemia, hypertension and hyperlipidemia. So, our aim was to estimate the levels of IMA in type 2 DM subjects. Also to evaluate the relationship of IMA with all the parameters in lipid profile (TC, LDL, HDL, TG) in type 2 DM subjects. Materials and Methods: 120 subjects were selected from the medicine OPD of Justice K S Hegde Charitable Hospital, Mangalore for study. The subjects attending the hospital were from coastal areas of southern India. Out of which 60 subjects were type 2 DM patients as per the ADA guidelines and 60 subjects were age and sex matched controls. The biochemical parameters estimated were FPS, 2hr-PG, HbA1C, Lipid profile (TC, TG, LDL, VLDL, HDL) and IMA. The results were expressed in absorbance units (ABSU). Data obtained was analyzed using SPSS 20. Results: The Fasting and postprandial plasma glucose, HbA1c, serum TG, TC, LDL, HDL, IMA were significantly increased in type 2 DM patients than in control subjects with the p value Conclusion: The present study suggests that measuring IMA in dyslipidemic diabetic patients will provide an early index of ischemia and its severity. This would help in the better management and prognosis of DM. Keywords: Hyperglycemia, Hyperlipidemia, Type 2 Diabetes mellitus, IMA.

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