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l-Arg catabolism is driven mainly towards NO synthesis in RBCs of patients with type 2 diabetes at first clinical onset. The decreased RBC arginase activity could be considered a potential mechanism of increased RBC NO production in early diabetes. Therefore, the RBC pool would represent a potentially compensatory intravascular compartment for endothelial dysfunction in diabetes.

Increased antioxidant defense in plasma and RBCs of early type 2 diabetes patients is a potential mechanism that can overcome oxidative damage induced by reactive oxygen species overproduction, and occurs even in RBCs with a decreased life span. This observation could provide a possible explanation for the controversial effects of antioxidant supplementation in diabetes patients.

Background and aim: Nonalcoholic liver disease is considered the liver manifestation of the metabolic syndrome commonly associated with obesity, glycemic disorders, hypertriglyceridemia, hypertension and low levels of HDL cholesterol. Liver plays an important role in the glucose and lipid metabolism. Liver fat is usually increased in patients with type 2 diabetes and in nondiabetic subjects the presence of hepatic steatosis is correlated with lipid disturbances, insulin dysregulation which can be considered markers for prediction of diabetes. The aim of the study was to evaluate metabolic syndrome (MS) components in the patients with nonalcoholic fatty liver disease (NAFLD) vs without NAFLD. Material and methods: 295 patients: 123M/172W were assessed by clinic and metabolic parameters. NAFLD was diagnosed by ultrasonography. Exclusion criteria: positive markers for viral hepatitis and alcohol consumption >20g/day. Statistic program-SPSS 15.0, statistical significance p ≤ 0.05. Results: From 243 patients with NAFLD, 195 (66.1%) were with MS and 48 (16.3%) without MS, according to IDF criteria. The patients with NAFLD and without MS vs normal group had significantly higher values for: BMI, waist circumference, GGT, fasting insulin and HOMA-IR. When NAFLD was associated with MS, clinic and metabolic disorders were more pronounced. We found higher levels for: BMI, waist circumference, FPG, HbA1c, triglycerides, fasting insulin, HOMA-IR, total cholesterol to HDL-cholesterol ratio, lower for HDL-cholesterol and a higher prevalence of hypertension (67.7% vs 40.90%). Conclusions: NAFLD is associated with overweight, central fat distribution, glycemic disorders and dyslipidemia and is considered liver expression of MS which is related with a high cardiovascular risk. TC to HDL-c ratio was significantly higher only in patients with NAFLD and MS. Insulin resistance is characteristic for patients with NAFLD independent of MS presence and can be considered the link with cardiovascular risk for these patients.

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