NATURALLY OCCURRING ANTIOXIDANT VITAMIN LEVELS IN PATIENTS WITH TYPE-II DIABETES MELLITUS

Authors

  • Muhammad Ahmad
  • Mudassir Ahmad Khan
  • Abdus Sattar Khan

Abstract

Background: Type II diabetes mellitus is characterized by an inability of peripheral tissues to respond to insulin and the dysfunction of the endocrine pancreas to compensate for this resistance. Diabetes mellitus is associated with increased lipid peroxidation. Increased levels of lipid peroxides have been implicated in the pathogenesis of diabetic complications. To control and reduce the deleterious effects of lipid peroxides exist several antioxidant protective mechanisms. They comprise of enzymatic defenses and naturally occurring vitamins. The study was designed to determine and compare the antioxidant vitamin levels in Type II diabetic individuals and control healthy subjects. Methods: Blood glucose, triglycerides, total cholesterol, HDL-c, LDL-c, VLDL-c and antioxidant vitamins (β-Carotene, A, E, and C) levels were determined in 36 Type II diabetic patients and 30 healthy subjects. Results: Values of blood glucose and lipid parameters were observed to be significantly increased (P< 0.001) with the exception of HDL-c, which was significantly decreased (p<0.001) in Type II diabetes mellitus patients. The levels of antioxidant vitamins (β-Carotene, E, and C) were found to be significantly low in Type II diabetes mellitus group whereas the concentration of vitamin A showed a non-significant change when both Type II and control healthy groups were compared. Conclusions: Low levels of antioxidant vitamins observed in the study suggest, that Type II diabetes mellitus patients have significant defects of antioxidant protection.

References

Leahy IJ. Natural history of beta-cell dysfunction in NIDDM. Diabetes Care 1990;13(9):992-1010.

Soothill PW. A defective beta-cell glucose sensor as a cause of diabetes. N Engl J Med 1993;328:729-33.

Crawford JM. The Pancreas. In; Kumar V, Cotran RS, Robbins SL eds. Basic Pathology. 6th edn. Philadelphia, W.B.Saunders Company. 1997:557-75.

Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. J A M A 1997;277:472-7.

Davidson MB, Peters AL. An overview of metformin in the treatment of Type 2 diabetes mellitus. Am J Med 1997;102:99-110.

Lillioja S, Mott MD, Zawadzki KJ, Young AA, Abbott WGH, Knowler WC, Bennett PH, Moll P, Bogardus C. In vivo insulin action is familial characteristic in non-diabetic Pima Indians. Diabetes 1987;36:1329-35.

Lillioja S, Mott MD, Spraul M, Ferraro R, Foley JE, Ravussin E, Knowler WC, Bennett PH, Bogardus C. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. N Engl J Med 1993;329:1988-92.

Fink IR, Kolterman GO, Griffin J, Olefsky MJ. (1983). Mechanisms of insulin resistance in aging. J Clin Invest 71:1523-35.

Yki-Jarvinen H, Koivisto AV. Effects of body composition on insulin sensitivity. Diabetes 1983;32:965-9.

Dominguez C, Gussinye M,Ruiz E, Carrascosa A. Oxidative stress at onset and in early stages of type I diabetes in children and adolescents. Diabetes Care 1998;21(10):1736-42.

Cheeseman KH, Slater TF. An introduction to free radical biochemistry. Br Med Bull 1993;49(3):481-493.

Abdella N, Al-Awadi F, Salman A, Armstrong D. [Thiobarbituric acid test as a measure of lipid peroxidation in Arab patients with NIDDM]. Diabetes Res ,1990;15(4):173-7.

Marchioli R Antioxidant vitamins and prevention of cardiovascular disease: Laboratory, epidemiological and clinical trial data. Pharmacol Res.1999; 40(3):227-38.

Friedwald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of preparative ultracentrifuge. Clin Chem 1972;18(6):499-502.

Delong DM, Delong ER, Wood PD, Lippet K, Rifkind BM. A comparison of method for the estimation of plasma low and very low density lipoprotein cholesterol. J A M A 1986;256(17):2372-77.

Gowenlock HA, McMurray JR.Vitamins. In; Gowenlock HA, McMurray JR, McLauchlan DM. eds. Varley,s Practical Clinical Biochemistry. 6th edn. London. Heinmann Medical Books, 1988:894-930.

Bauer JD, Ackermann PG, Hohnadel DC, Kaplan LA, Stein EA, Poklis A. Liver function, lipids, and other miscellaneous tests. In; Clinical Laboratory Methods. 9th edn. St. Louis: The C.V. Mosby Company, 1982:535-65.

Quinn L. Type 2 diabetes: epidemiology, pathophysiology, and diagnosis. Nurs Clin North Am 2001;36(2):175-92.

Hauner H, Scherbaum WA. [Diabetes mellitus type 2]. Dtsch Med Wochenschr 2002;127(19):1003-5.

Gaster B, Hirsch IB The effects of improved glycemic control on complications in type 2 diabetes. Arch Intern Med; 1998;158:134-40.

Watts GF. Coronary disease, dyslipidemia and clinical trials intype 2 diabetes mellitus. Practical Diabetes Int. 2000;17(2):54-59.

Okubo M, Murase T. Hypertriglyceridemia and low HDL cholesterol in Japanese patients with NIDDM. Diabetes 1996;45(Suppl 3):S123-5.

UK Prospective Diabetes Study 27. Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex. Diabetes care. 1997;20(11):1683-7.

Agboola-Abu CF, Ohwovoriole AE, Akinlade KS. The effect of glycemic control on the prevalence and patterns of dyslipidaemia in Nigerian patients with newly diagnosed non-insulin dependent diabetes mellitus. West Afr J Med 2000;19(1):27-33.

Timimi FK, Ting HH, Haley EA, Roddy M, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. J Am Coll Cardiol 1998;31:552-7.

Soska V, Krusova D, Podrouzkova B, Lojek A, Zechmeister A. [Free oxygen radicals in patients with diabetes mellitus]. Vnitr Lek 1994;39(6):569-74.

Altomare E, Vendemiale G, Chicco D, Procacci V, Cielli F. Increased lipid peroxidation in type 2 poorly controlled diabetic patients. Diabetes Metab 1992;18(4):264-71.

Penckofer S, Schwertz D, Florczak K. Oxidative stress and cardiovascular disease in type 2 diabetes: the role of antioxidants and pro-oxidants. J Cardiovasc Nurs 2002;16(2):68-85.

Reunanen A, Knekt P, Aaran RK, Aromaa A. Serum antioxidants and risk of non-insulin-dependent diabetes mellitus. Eur J Clin Nutr 1998; 52(2):89-93.

Abahusain MA, Wright J, Dickerson JW, de Vol EB. Retinol, alpha-tocopherol and carotenoids in diabetes. Eur J Clin Nutr 1999;53(8):630-5.

Polidori MC, Mecocci P, Stahl W, Parente B, Ceccheti R, Cherubini A, Cao P, Sies H, Senin U. Plasma levels of lipophilic antioxidants in very old patients with type 2 diabetes. Diabetes Metab Res Rev 2000;16(1):15-9.

Basualdo CG, Wein EE, Basu TK. Vitamin A (retinol) status of first nation adults with non-insulin-dependent diabetes mellitus. J Am Coll Nutr 1997;16(1):39-45.

Chen LH, de Osio Y, Anderson JW. Blood antioxidant defense system and dietary survey of elderly diabetic men. Arch Gerontol Geriatr 1999;28:65-83.

Gribauskas PS, Norkus AV, Cherniauskene RC, Varshkiavichene ZZ, Masal’skene VV. Malondialdehyde, alpha-tocopherol and retinol content of the blood serum in male diabetics. Probl Endokrinol (Mosk) 1986;32(4):46-9.

Tavridou A, Unwin NC, Lake MF, White M, Alberti KG. Serum concentrations of vitamin A and E in impaired glucose tolerance. Clin Chim Acta 1997;266(2):129-40.

Banerjee A. Blood dehydroascorbic acid and diabetes mellitus in human beings. Ann Clin Biochem 1982;(Pt 2):65-70.

Stankova I, Riddle M, Larned J, Burry K, Menashe D, Hart J, Bigley R. Plasma ascorbate concentrations and blood cell dehydroascorbate transport in patients with diabetes mellitus. Metabolism 1984;33(4):347-53.

Will JC, Byers T. Does diabetes mellitus increase the reuirement for vitamin C? Nutr Rev 1996;54(7):193-202.

Will JC, Ford ES, Bowman BA. Serum vitamin C concentrations and diabetes: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Amer J Clin Nutr 1999;70:49-52.

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