International journal of Clinical Biochemistry and Research

1-4

Authors: Chandrika N., Usha S.M.R..

Introduction: Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin secretion, insulin resistance or both. In the initial asymptomatic phase there is hyperinsulinemia, as insulin resistance progress and beta cell function deteriorates ‘Prediabetes’ an intermediate hyperglycemic state prone for diabetic complications ensues. A chronic sub-clinical inflammation is associated with insulin resistance and it can be assessed using a pro-inflammatory marker like serum ferritin. Aim: We intend to evaluate serum ferritin levels in normoglycemics, intermediate hyper glycemics and overt cases of T2DM and also to investigate if any correlation exists between blood glucose and serum ferritin levels at these three different stages of glycemia. Materials and Methods: In accordance with World health organisation guidelines, we inducted forty seven pre-diabetics and thirty seven T2DM patients in the first and second groups of our study respectively. Twenty three healthy controls constituted the third group. Serum ferritin, fasting and 2 hour postprandial blood glucose were estimated in all subjects. Results: The mean ± SD of Log serum ferritin levels in prediabetic, diabetic group and Controls groups are 4.21±0.96, 4.25±1.07 and 3.59±0.95µg/L respectively. Mean Log serum ferritin levels is significantly higher in pre-diabetics and diabetics with p=0.012. A positive and statistically significant association was noticed between serum ferritin and blood glucose levels when the subjects of the three groups were considered together (p=0.036) but not when the groups were considered separately. Conclusion: Serum ferritin levels are elevated in prediabetes and T2DM when compared to healthy controls and it reflects the inflammation associated with prediabetes and T2DM.

12-16

Authors: Pampareddy B Kollur, Kiran Kumar Akka, Basawarajeshwari P Kollur, Sangappa Virupaxappa Kashinakunti.

Introduction: Chronic obstructive pulmonary disease (COPD) is an important lung disorder. Tobacco smoking accounts for 80% of patients of COPD cases and the remaining 20% are due to exposure to environmental tobacco smoke, occupational dusts and chemicals, and indoor air pollution from biomass fuel used for cooking and heating in poorly ventilated buildings. The oxidative stress seen with COPD patients is due to the oxidants present in cigarette smoke and from increased amounts of reactive oxygen species released from leucocytes, from both in air spaces and blood. Materials and Methods: This was prospective, case-control study conducted at a tertiary care teaching hospital (medicine department) from April 2015 to August 2015. After obtaining written informed consent a total of 84 participants were explained about the study. The anti-oxidant parameters i.e. Vitamin C and E, superoxide dismutase, whole blood reduced glutathione and oxidative stress markers i.e. malondialdehyde, serum nitric oxide were measured both in COPD patients and controls. The study was approved by institutional ethics committee. The results are expressed as mean and standard deviation of the parameters evaluated. The unpaired ‘t’ test wass used for comparing different biochemical parameters between cases and controls. The p value of < 0.05 was considered as statistically significant. Results & Discussion: There was no statistically significant difference in the demographic data between the cases and controls. Maximum patients were in stage 3 COPD. Tobacco smoking is an important cause for development of COPD by formation of reactive oxygen species and other free radicals There was statistically significant difference (p<0.001) in anti-oxidant levels (Vitamin C and E, superoxide dismutase, Whole blood reduced glutathione) and oxidative stress markers (malondialdehyde, serum nitric oxide) and between cases and controls. Conclusion: The results of the present study indicate a disturbance in oxidant/antioxidant status in COPD patients. The periodic measurements of oxidative stress markers and antioxidant status in COPD patients might be useful in prognosis of the disease. These results may contribute for the development of novel therapeutic interventions.

23-25

Authors: Manoj Naphade, Tushar Bansode.

Introduction: Iron deficiency anemia (IDA) is a major public health problem in world and India too. It has been found that HbA1c level rise in patients of IDA without raised blood glucose level. Materials and Methods: Study consists of 30 cases of Iron deficiency anemia and 30 controls of age and sex match between the ages of 18 to 60 years. This is a prospective case controlled study done over a period of two years. Blood samples were collected from subjects and HbA1C, Serum iron, TIBC, Serum ferritin, Blood glucose level and Hematological parameters were measured. Observations and Result: Serum iron and Ferritin levels were highly significantly decreased (p<0.001) in IDA group patients compared to controls. TIBC levels were highly significantly increased (p<0.001) in IDA group patients compared to control. HbA1c levels were also highly significantly increased (p<0.001) in IDA group patients compared to control. Mean BSL-F and BSL-PP showed no significant difference in glycemic status of both case and control groups. Conclusion: Apart from blood glucose, iron deficiency anaemia also affects HbA1c level.

31-34

Authors: Hiren Sanghani, Asha Khubchandani, Sandip Sendhav.

Introduction: Previous studies suggest a protective role of the essential trace elements against cardiovascular disease, whereas wistful epidemiological data remains controversial. We aimed to investigate the alteration in concentration of zinc (Zn) and copper (Cu) in patients presented with coronary artery disease. Materials and Methods: In this case control study 100 normal healthy controls and 100 patients diagnosed with acute coronary artery diseases were enrolled. Serum copper and serum zinc concentration were measured in both the groups. Results and Observations: Serum copper concentration was significantly higher in patient of acute coronary artery disease (141.0±15.2) compared to controls (97.0±10.8). Serum zinc concentration was significantly lower in patient of acute coronary artery disease (70.0±8.8) compared to controls (100.0±13.2). And the ratio of serum Cu: Zn almost double in patient of acute coronary artery disease patients compared to normal healthy individuals. Conclusion: From the present study, it is concluded that decreased serum zinc and increased serum copper levels are associated with coronary artery disease. Moreover, results demonstrate that increased serum Cu: Zn ratio can diagnose occurrence of vascular events even in CAD patients.

41-45

Authors: Moneka Sai T., K. Sameera.

Obesity, obesity related hypertension is increasing at higher rates among adolescents these days. An increase in leptin level and a decrease in adiponectin level were observed in obese individuals with hypertension. Our study aimed to know the association of obesity with hypertension and the levels of adipocytokines. The study was carried out among school children aged 12-16years, 60 students (30 cases & 30 controls). Anthropometric data, Blood pressure (BP) were measured. 30 Students with increased waist circumference to height ratio and elevated BP were selected. Biochemical parameters were investigated in these students and compared with age & gender matched controls. A significant relationship was observed between obesity and waist circumference to height ratio (p<0.0002). SBP showed more significance than DBP with obesity. Extremely significant relationship was found in serum leptin (p<0.0001), serum adiponectin (p<0.0001), lipid profiles. Our study observed a relation between obesity, hypertension & levels of adipocytokines among adolescents. Further studies in more number of people, in both the genders and programmes for increasing awareness among obese children helps to prevent future morbidity and mortality.

49-53

Authors: Sunita M. Aghade, Jayashree S. Bavikar.

Introduction: The Polycystic Ovary Syndrome (PCOS) is one of the most common reproductive endocrine disorders, affecting 5–10% of women in the reproductive age. Insulin resistance is the hallmark of this disorder. PCOS has been epidemiologically linked to an increased risk for type 2 diabetes mellitus and cardiovascular diseases. The present study was planned to study glycated hemoglobin (HbA1c) and uric acid level in patients of PCOS. Materials and Methods: The study comprised of 60 women with PCOS as cases and 60 healthy females as controls. HbA1c and uric acid level were measured in all participants. Results: Glycated hemoglobin and serum uric acid were significantly increased in PCOS group and showed positive correlation with body mass index and waist: hip ratio. The prevalence of raised HbA1c was 40% in PCOS women. Conclusion: In our study we found significant alterations in HbA1c and uric acid level in cases of PCOS. Early identification of these changes and timely intervention can reduce morbidity due to type 2 diabetes mellitus and cardiovascular diseases in PCOS. This will help to redefine the paradigms of PCOS care in India.

61-65

Authors: Bhaktavachalam Prudhvi, Boddepalli Venkataramarao.

Introduction: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia and associated micro and macro vascular complications on long duration. Insulin resistance is associated with onset of type 2 DM and various studies point its connection to iron overload in the body. Hyperinsulinemia due to resistance to insulin may be responsible for increasing serum Ferritin. Objectives: The present study was carried out to determine the relationship between serum Ferritin and type 2 diabetes mellitus and to establish correlation between serum Ferritin and fasting blood glucose as well as with HbA1c. Materials and Methods: An observational study for one year at a tertiary care hospital was carried on 50 diabetic male cases and 50 age matched controls. BMI, serum ferritin, HbA1c, FBS and PPBS were estimated on all the cases and controls as per standard guidelines and compared between cases and controls. P value less than 0.05 was considered statistically significant. Results: In the present study, 41-50 years was the common age group, and BMI (kg/m2), Fasting blood sugar, Post prandial blood sugar parameters were statistically significant between cases and controls. The mean HbA1c% in cases was 9.48 ± 2.65 and greater than controls and significant correlation with serum ferritin levels which was 359.11 ± 87.18 was observed. Greater levels of Serum ferritin was observed in cases with elevated levels of HbA1c%. A strong positive correlation was found between serum ferritin and HbA1c, FBS and PPBS levels in the study. Discussion: This study clearly explains that there is a significant increase in the serum ferritin in cases of diabetes mellitus compared to normal controls and hyperferritenemia may be one of the causes for decreased insulin production and development of insulin resistance in diabetic individuals. Study of iron and related parameters may be a useful offshoot of the conventional studies on diabetes and its complications. Hence monitoring the prevalence of serum ferritin is beneficial in long rum among the diabetics.

72-77

Authors: Ratnashree Biswas, G.S.R. Kedari, Gurupavan Kumar Ganta.

Introduction: The main aim of our study was to assess the role of prostate specific antigen in Indian males and to determine its correlation with insulin resistance in metabolic syndrome. Materials and Methods: For this study, 62 male subjects of 40-65 years having metabolic syndrome were selected. Body mass index, fasting blood sugar, serum prostate specific antigen, serum fasting insulin and insulin resistance were analyzed using multivariate regression analysis and Annova test. Results and Conclusion: There was no statistically significant difference between body mass index and prostate specific antigen, body mass index and insulin resistance, prostate specific antigen and triglyceride, prostate specific antigen and high density lipoprotein, and prostate specific antigen and fasting blood sugar.

85-90

Authors: Mahendra Gandhe, Harshal Kawanpure, A. P. Dongre, Swapnali Gandhe.

Prevalence of Sicklecell disease (SCD) is ranging from 1 to 40% and more in state like Chhattisgarh because of more share of Tribal population by this state in India. Genetic mutation at a sixth position of the β-globin chain (replacement of glutamic acid by valine) is the biochemical basis of this abnormality. Tissue specific increase of adenosine deaminase is related with lysis of RBC membrane in sickle cell disease. To know the pathology and biochemical basis of increase in serum adenosine deaminase in SCD is ardent. Prospective case-control study is conducted by taking thirty SCD cases [from Durg District of Chhattisgarh State] attending General Medicine OPD in our Medical College. Thirty age and sex matched healthy volunteers were selected as controls from same population. ADA estimation done by enzymatic-kinetic method. Complete hemogram done by Beckman Coulter and retiuculocyte count done by direct microscopic examination. Adenosine deaminase level in SCD was higher as compare to control group and difference is statistically highly significant i.e. p value 0.00 (<0.01). Comparing to controls, Reticulocyte count was significantly less in SCD i.e. p value 0.049 (<0.05). SCD cases were having significantly increased ADA level as compared to healthy volunteers. ADA was not any having correlation with reticulocyte count. Estimation of Adenosine Deaminase level can be helpful for knowing pathophysiology of complications occurring in sickle cell disease patients.

97-100

Authors: Mariappan A, Deepa VS, Nagendran R.

Introduction: T2DM and its complications develop due to uncontrolled plasma glucose levels for long time. Long term hyperglycemia will cause glycation of various tissue proteins. It also affects the coagulation process and proteins involved in coagulation. The present study conducted to evaluate the coagulation profile in the T2DM with and without complications. Materials and Methods: This study was done in the Institute of Biochemistry, Madras Medical College, Chennai, Tamil Nadu during the period of Nov. 2008 to Dec. 2008. A total of 175 subjects were included in the study, 25 patients in group-I was considered control group. Group-II had T2DM patients without complications (n=50). Subjects with T2DM-nephropathy (n=50) were included in group-III. The group-IV (n=50) had T2DM with retinopathy. All subjects demographic data, glucose levels, lipid profile, urea, creatinine and coagulation profile were estimated and recorded. The data was analyzed by SPSS soft ware by using ANOVA. Results: More females were there in group-I and II and more males in group-III and IV. Group-II showed significant changes in glucose, lipid profile and coagulation profile levels compared to other groups. Conclusion: T2DM with complications and without complications patients showed changes in coagulation profile. Better knowledge is required about the coagulation profile in T2DM patients with complications.

106-111

Authors: E. Manideep, P. Aruna, Amar Nagesh Kumar.

Introduction: Type II Diabetes mellitus (type II DM) is a chronic metabolic disorder characterised by oxidative stress. Free radicals play a pivotal role in the progression of diabetes and its complications. The role of trace elements in type II DM is always controversial. Antioxidants are very important in reducing the impact of oxidative stress. Hyperglycemia induces oxidative stress which in turn causes damage to copper binding proteins and lead to release of copper ions. Aims and Objectives: The present study was designed to establish an association of trace elements serum copper and zinc with serum albumin and uric acid as antioxidants in type II DM. Materials and Methods: Study includes 30 type II diabetic patients as cases and 30 normal individuals as controls. Fasting blood sugar (FBS) and Post prandial blood sugar (PPBS), serum copper, zinc, uric acid and albumin levels were measured in all the subjects. In our study serum copper levels were increased and zinc levels were decreased in cases when compared to controls. FBS and PPBS levels in our study showed positive correlation with serum copper levels. Serum uric acid levels in cases were increased in comparison to controls. Although there was decrease in albumin levels in this study, it was not statistically significant. However, we could not establish an association of trace elements copper and zinc with the antioxidants like uric acid and albumin in our study probably because of the small sample size. Conclusion: Inclusion of trace elements like copper, zinc and antioxidants like uric acid, albumin in the panel of investigations for diabetes mellitus (D.M) may be useful in predicting the prognosis of type II DM and early detection of its complications.

116-119

Authors: Anil Kumar AS, Rajshree Badami, Sowmya Krishna.

Introduction: Recurrent Aphthous Stomatitis (RAS) is a chronic, relapsing inflammatory disorder of the oral mucosa. It is one of the commonest oral mucosal disorders affecting all races, age groups, geographical regions. The imbalance between production of oxidants and body’s antioxidant defences is termed as oxidative stress. The role of systemic oxidative stress in the pathogenesis of RAS needs to be fully elucidated to understand its pathogenesis. Aim: This study aims to determine the role of oxidative stress and antioxidant status in RAS subjects by comparing the serum levels of Malondialdehyde (MDA), Ascorbic acid and α-Tocopherol between RAS patients and healthy controls. Materials and Methods: The study comprised of 30 RAS subjects along with 30, age and gender matched healthy volunteers. Estimation of MDA, Ascorbic acid and α-Tocopherol was undertaken in the serum samples collected from all the subjects. Results: Serum MDA levels were significantly higher in the RAS subjects (4.25 + 0.94nmol/ml) compared to controls (2.52 + 0.67nmol/ml, p<0.001). Mean ascorbic acid levels were significantly lower in RAS subjects (10.47 + 2.88mg/L) compared to controls (12.75 + 1.69mg/L, p = 0.002). α-Tocopherol levels were also significantly lower in RAS subjects (7.75 + 1.50mg/L) compared to controls (9.87 + 1.06mg/L, p<0.001). Conclusion: Elevated MDA levels and low antioxidant levels suggest increased oxidative stress in RAS subjects.

124-127

Authors: Jithesh.T.K, Shifa. K, Liji.K, Anilamol.V.S.

Introduction: Type 2 diabetes mellitus is due to the decreased biological response to insulin or insulin resistance. Insulin resistance develops as a consequence of defects in signal transduction by insulin. These defects may also affect the exocrine pancreatic function. The aim of this study was to determine serum pancreatic enzyme levels in diabetic patients and to correlate them with insulin resistance. Materials and Methods: In this case control study we compared fasting blood sugar, serum insulin, lipase and amylase levels and insulin resistance in diabetic and normal healthy adults. The correlation of pancreatic enzymes with insulin resistance was also studied. Results: Diabetic group showed statistically significant increase in all the parameters compared to control group. Serum amylase showed a significant negative correlation with insulin resistance (p=0.007) and serum lipase a positive correlation with insulin resistance, but it was not significant (p =0.119). Conclusion: The study showed a significant alteration in the exocrine pancreatic function in diabetic patients. There is a negative correlation between serum amylase level and insulin resistance.

134-137

Authors: Smita S. Swami, Anuradha M Kanhere, Sanjay C Swami.

Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, protein and lipid metabolism. The present study was undertaken to research the association between serum lipid profile, its abnormalities and the increase risk of coronary artery disease. The study compromised of total 60 subjects out of which 30 were diabetic pateints with T2D and 30 healthy indiviuals, both from the age group 35-50 years. The results indicated that there was a considerable increase in the lipid and its parameters.

143-147

Authors: Suresh Pichandi, Desigamani Kanniyappan, Janakiraman P, Ramadevi K.

Objective: Aim of the present study is to analyse the nutritional status of iodine among pregnant women by measuring urinary excretion and do the correlation with thyroid hormone and auto antibodies. Materials and Methods: one hundred pregnant women with third trimester gestation and one hundred age-matched non-pregnant were included in study. Results: Urinary Iodine excretion and serum TSH, fT4, fT3, AMA and ATG were estimated were estimated for case and control groups. The mean urinary iodine excretion concentration (UIC) in pregnant women was 290.17±91.71 µg/L. Excess urinary iodine excretion was found in 69%. There were elevated serum AMA levels in 36 pregnant women and that positive correlated with excess iodine. Conclusion: The pregnant women had no iodine deficiency, rather had high urinary iodine concentrations indicating more than adequate iodine intake. The excess urinary iodine level may tiger the thyroid auto antibody.

154-157

Authors: Raviraja A, Vishal Babu. G. N, Deepak K, Thuppil Venkatesh.

Introduction: A Comparative study of persons working in lead based industries and non-lead based industries were undertaken to evaluate the effect of lead on liver function tests. This study was done to evaluate the ill effects of lead on liver functions as there were very few studies available to show the ill effects of lead on human liver. Materials and Methods: Subjects were classified as: Group-A: Controls- individuals who were working in non-lead based industries. Group B: individuals who were working in lead based industries. Results: The study showed that there was statistical significance between the group A and group B in BLL (p<0.001), Hb (p<0.001), ALAD (p<0.001) and ZPP (p<0.001). There was also statistically significant difference in two groups in Total Bilirubin (p<0.001), Direct Bilirubin (p<0.001), Indirect Bilirubin (p<0.001) and Total Protein (p<0.001). There was no significant difference in liver enzymes between the two groups. Conclusions: As lead being a toxic element affecting multiple organs, including liver as emphasized in this study shows the importance of regulation in lead based industries in a country like India.