AIM:This study was conducted to identify malondialdehyde (MDA) serum level, nerve growth factor (NGF) serum level, diabetic peripheral neuropathy score and the correlation between MDA and NGF serum level with diabetic peripheral neuropathy score.METHODS:A cross-sectional study was conducted to observe diabetic patients in the internal medicine department in Dr M. Djamil Hospital, Padang, Indonesia. The MDA serum level was measured using Beuge method with thiobarbituric acid. The NGF serum level was analysed using ELISA method. Diabetic peripheral neuropathy score was defined when history score in Michigan Neuropathy Screening Instrument (MNSI) ≥ 7 and physical assessment score in MNSI > 2.RESULTS:Thirty subjects with diabetes has diabetic peripheral neuropathy score 3.53 (± 0.91), MDA serum level 2.16 (± 2.89) nmol/ml, and NGF serum level 10.56 (± 2.89) pg/dl. There were significant correlations between the MDA serum level and the diabetic peripheral neuropathy score (r = 0.364, p = 0.048), and between the NGF serum level with the diabetic peripheral neuropathy score (r = -0.59, p = 0.001).CONCLUSION:There are high MDA serum level and low NGF serum level in patients with diabetic peripheral neuropathy. Low NGF serum level plays a bigger role than high MDA serum level in diabetic peripheral neuropathy.
Objective: This study aimed to reveal differences in levels of survivin and Raf-1 kinase in prediabetes, controlled Type 2 diabetes mellitus (T2DM), uncontrolled T2DM, and their relationship with hemoglobin A1c (HbA1c) levels and serum triglyceride levels.Methods: This study was an observational study with a cross-sectional design. The study involved 60 people with T2DM who visited the endocrine and metabolic clinic and 30 prediabetes patients. The variables were survivin levels and Raf-1 kinase enzymes that examined using enzyme-linked immunosorbent assay techniques. HbA1c values are measured by high-performance liquid chromatography and triglyceride levels measured by enzymatic method.Results: Average levels of Raf-1 kinase were significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (11.6±1.4 pg mL, 9.9±1.1 pg/mL, and 9.1±1.5 pg/mL). Survivin was significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (5.4±0.4 pg mL, 5.0±0.2 pg/mL, and 4.7±0.1 pg/mL). There was no correlation between HbA1c with Raf-1 kinase levels (R=−0.215, p=0.250), but there was a correlation between HbA1c with serum survivin levels (R=−0.6, *p<0.05). There was a correlation between the levels of triglycerides with survivin but not with Raf-1 kinase (R=−0.267, *p=0.039).Conclusion: Survivin and Raf-1 kinase levels are lower in uncontrolled T2DM. This explained the role of survivin and Raf-1 kinase against enhancement of pancreatic beta-cell apoptosis in patients with T2DM.
Prediabetes is the forerunner of diabetes mellitus. Hence it has to be carefully cared for. Main conditions causing this are insulin resistance and beta cell dysfunction. Insulin resistance can be assessed by using several methods, one of which is performed by assessing the value of HOMA-IR. Beta cell function can be determined by assessing HOMA-B. In this research we aim to obtain the description of insulin resistance and beta cell pancreas dysfunction on prediabetic patients, using the analytic observational method with cross-sectional approach. HOMA-IR and HOMA-B were assessed in 20 prediabetic patients, and their values were obtained by examining basal insulin and fasting glucose level. We found man to woman ratio 1:1, with mean (SD) age 35.8 (5.7) years old, BMI 24.9 (4.3) kg/m2, fasting blood glucose 104.8 (4.3) mg/dL, and blood glucose two hours after oral glucose tolerance test 121.7 (23.1) mg/dl. Mean of HOMA-IR on prediabetic patients was 4.1 (3.2) and mean of HOMA-B was 188.3 (155.1). The increase of insulin resistance on this study is by studies that were conducted by Nguyen and Mohtarin. The increase of HOMA-B in this study is following other studies by Mohtarin and Owei, supposedly due to beta cell compensation process against the increase of insulin resistance. We conclude that the increase of HOMA-IR in prediabetics is compensated for by an increase in HOMA-B.
Diabetes mellitus (DM) is one of the world's health problem with increasing prevalence and important medical and social impacts. Diabetes mellitus causes micro and macrovascular complications depending on the presence of blood glucose level disorder. Impaired glucose levels have two components, chronic hyperglycemia and acute fluctuations of blood glucose levels from peak to nadir. These two components cause DM with two main mechanisms, protein glycation, and oxidative stress. Glycated albumin describes uncontrolled medium range glucose level while malondialdehyde reflects oxidative stress. Nephrin is one of the damage markers of podocyte that represents diabetic kidney disease. To find out the correlation between uncontrolled blood glucose with urinary nephrin level in a patient with type 2 diabetes mellitus. This is an observational study with the cross-sectional method. Subjects are 30 types 2 DM patients. Patients serum glycated albumin (GA) are measured, along with serum malondialdehyde (MDA) and urinary nephrin. Among 30 types 2 DM patients, there is a significant increase in GA and MDA level. Mean serum GA level is 20,87% (5,91) %, serum MDA level is 9,24 (5,59-13,59) and urinary nephrin is 369,25 (6-3952) ng/ml. There is a moderate correlation between serum GA with urinary nephrin (p=0,027) and moderate correlation between serum MDA and urinary nephrin (p=0,003). There is a correlation between uncontrolled blood glucose with urinary nephrin level in type 2 diabetes mellitus.
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