Important information about diabetes
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Study group included 140 individuals of which 70 patients were suffering from type 2 diabetes mellitus (newly diagnosed and diabetics on treatment) and 70 healthy controls. Subjects with the previous history of febrile illness, renal failure, chronic diseases, benign and malignant disorder were excluded. Study was approved by Institution Ethical Committee.
Height, weight, waist circumference, and hip circumference were measured using standard methods. BMI and WHR were calculated. After obtaining the informed consent fasting
blood sample (5 ml) was drawn from all the study population by venipuncture taking aseptic precaution in a plane tube and samples were centrifuged at 3000 rpm for 15 min and serum was obtained.
Analysis of TC, TG and HDL-C was done. LDL-C was calculated by using Friedwald’s formula. Serum MPO levels were estimated by spectrophotometric method using O-Dianisidine dihydrochloride as a substrate. MDA is estimated as thiobarbituric acid reactive substances. AIP was calculated by taking the log of (TGL/HDL). Data was analyzed using analysis of variance and Karl Pearson’s correlation. All the analysis was done using the windows based SPSS statistical package (Version 10.0; SPSS Inc.; Chicago, IL, USA) and P < 0.05 were taken as the level of significance.
In comparison with non-diabetic individuals, type 2 diabetic individuals had statistically highly significant increase in BMI, WHR, serum levels of MPO, MDA, TC, LDL-C and AIP (P<001) and statistically significant decrease in serum HDL cholesterol as shown in Table 1.
When BMI, WHR, serum levels MPO, MDA,TC, LDL-C, TG and AIP were compared between type 2 diabetics with duration of diabetes <10 years and ≥10 years, individuals having diabetes for ≥10 years had statistically significant increase in levels of BMI, WHR, serum levels MPO, MDA,TC, LDL-C, TG and AIP (P < 0.05) [Table 2].
In comparison with type 2 diabetics with serum TC <200 mg/dl, the type 2 diabetic individuals with serum TC ≥200 mg/dl had statistically highly significant increase in BMI, WHR, serum levels of MPO, MDA, TG and AIP (P < 001) [Table 3].
Pearson’s correlation analysis of AIP with other risk variables in cases had shown that in type 2 diabetic patients AIP had shown a positively correlated with BMI, WHR, MPO, MDA, TC, LDL-C and TG, which was statistically significant. However, a statistically significant negative correlation was found between AIP and serum HDL-C (P < 001) [Table 4].
| Parameters | Control | Cases | P value |
| BMI (kg/m2) | 19,2 | 27,2 | <0,001 |
| WHR | 0,73 | 1,02 | <0,001 |
| MPO (μmol/min) | 21,14 | 211,71 | <0,001 |
| MDA (nanomole/100 ml) | 280 | 549 | <0,001 |
| TC (mg/dl) | 163 | 274 | <0,001 |
| LDL-C (mg/dl) | 85 | 207 | <0,001 |
| HDL-C (mg/dl) | 52 | 28 | <0,001 |
| TG (mg/dl) | 126 | 189 | <0,001 |
| AIP | 0,016 | 0,47 | <0,001 |
In the present study, we observed that diabetic subjects have higher BMI and WHR. Various studies have found that most adults with diagnosed diabetes were overweight or obese, Eric and John (2006) studies shows that prevalence of obesity was 85.2% and NHANES (2005) report indicates the prevalence of obesity was 54.8%.
Table 2: Comparison of BMI, WHR, Oxidative stress markers, lipid profile and AIP in type 2 diabetics with duration of diabetes| Parameters | Type 2 diabetics with duration of diabetes <10 years | Type 2 diabetics with duration of diabetes ≥10 years | P value |
| BMI (kg/m2) | 26,08 | 27,28 | <0,05 |
| WHR | 0,9 | 1,04 | <0,05 |
| MPO (μmol/min) | 196 | 217 | <0,05 |
| MDA (nanomole/100 ml) | 506 | 566 | <0,05 |
| TC (mg/dl) | 265 | 277 | <0,05 |
| LDL-C (mg/dl) | 180 | 210 | <0,05 |
| HDL-C (mg/dl) | 29 | 24 | <0,05 |
| TG (mg/dl) | 185 | 191 | <0,05 |
| AIP | 0,4 | 0,5 | <0,05 |
| Parameters | Type 2 diabetics with serum TC levels <200 mg/dl | Type 2 diabetics with serum TC levels ≥200 mg/dl | P value |
| BMI (kg/m2) | 22,9 | 27,8 | <0,001 |
| WHR | 0,8 | 1,05 | <0,001 |
| MPO (μmol/min) | 125 | 224 | <0,001 |
| MDA (nanomole/100 ml) | 364 | 576 | <0,001 |
| TG (mg/dl) | 167 | 192 | <0,001 |
| AIP | 0,39 | 0,48 | <0,001 |
| Parameters | r | P value |
| AIP | ||
| BMI (kg/m2) | 0,973 | <0,001 |
| WHR | 0,94 | <0,001 |
| MPO (μmol/min) | 0,907 | <0,001 |
| MDA (nanomole/100 ml) | 0,99 | <0,001 |
| TC (mg/dl) | 0,962 | <0,001 |
| LDL-C (mg/dl) | 0,974 | <0,001 |
| HDL-C (mg/dl) | -0,989 | <0,001 |
| TG (mg/dl) | 0,987 | <0,001 |
| 0,016 | <0,001 |
We observed significant increase of MPO in subjects with type 2 diabetes mellitus. These findings were in accordance to the study of Shetty et al.. Low grade chronic inflammation and endothelial dysfunction are contributing factors in the initiation and progression of CVD.
The MDA levels were elevated in diabetic subjects compared with non-diabetic subjects. These findings were in accordance to the study of Slatter et al.. The inter-molecular cross-linking of collagen through MDA is important in the late complications of diabetes mellitus because it contributes to the stiffening of the cardiovascular tissue.
Type 2 diabetes mellitus is associated with dyslipidemia, which is due to insulin deficiency, insulin resistance and hyperglycemia. The present study showed that serum TC were found to be increased in type 2 diabetics when compared with controls. Suryawanshi et al. found a statistically significant increase in TC, TG and LDL cholesterol. Increase in TC may be due to decreasing muscular exercise or inhibition of cholesterol catabolism.
