A comparative study of serum myeloperoxidase activity in type 2 diabetes and diabetic nephropathy

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Date: September-December 2009
From: Biomedical Research(Vol. 20, Issue 3)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Article
Length: 3,272 words

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Byline: K. Kusuma, K. Vasudha, M. Vanitha Gowda

Inflammatory burden is high in End Stage Renal Disease (ESRD) patients. In Diabetic ESRD patients, the balance between pro- and anti-oxidant activities is shifted towards an oxidative stress. Myeloperoxidase (MPO), a bactericidal enzyme plays an active role in induction and evolution of the endothelial dysfunction associated with Type 2 Diabetes Mellitus (DM). However, whether MPO can serve as a marker in diabetic ESRD patients is doubtful. Hence, the present study was undertaken. The Fasting Blood Glucose (FBG), Serum Creatinine, Blood Urea Nitrogen (BUN) and Serum Myeloperoxidase levels were estimated in three different groups with 30 subjects each. The Control group includes healthy individuals, group I constitutes Type 2 diabetes with no nephropathy and group II includes Type 2 diabetes with nephropathy patients. Glomerular Filtration Rate (GFR) was calculated using Cockcroft Gault formula corrected for the Body Surface Area. Statistical software, namely, SPSS 15.0, Stata 8.0, MedCalc 9.0.1 and Systat 11.0 were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. Reference Ranges for MPO were established in our study. An increase in MPO levels was noticed in Group I, whereas a differential behaviour of MPO levels was noted in group II. Uremic diabetic nephropathy patients with a low MPO level may be at a lesser risk for any cardiac event compared to those uremic patients with high MPO levels. Hence, MPO may be taken as a biomarker to predict coronary events in diabetic ESRD.

Introduction

"The quality of life is dependent upon the quality of the life of your cells. If the blood stream is filled with waste products, the resulting environment does not promote a strong, vibrant healthy cell life nor a biochemistry capable of creating a balanced emotional life for an individual"

- Anthony Robbins [1]. Diabetes mellitus is characterized by elevated blood glucose levels, a continuous low-grade inflammation and endothelial activation state [2],[3]. Type 2 DM is prevalent in our country to an extent of 5.9% [4]. MPO (E.C.No. 1.11.1.7), a hemoprotein traditionally viewed as bactericidal enzyme secreted by neutrophils plays an active role in the induction and evolution of endothelial dysfunction associated with Type 2 DM [3].

The inflammatory burden is high in ESRD patients. In diabetic ESRD patients, the balance between pro- and anti-oxidant capacities is shifted towards a state of oxidative stress [5]. As increased oxidative stress and inflammation are both common features of ESRD, it has been speculated that there may be an association between them and endothelial dysfunction, contributing to increased risk for cardiovascular disease [5]. As MPO predicts endothelial function in humans, probably by regulating nitric oxide bioavailability, increased MPO activity serves as a mechanistic link among the inflammation (activated leukocytes), oxidative stress and endothelial dysfunction in ESRD [6].

There is limited data available regarding the study of serum MPO activity in patients with type 2 DM with ESRD in India. Considering this, the study was undertaken to see if MPO can serve...

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Gale Document Number: GALE|A206600663