Patients with chronic kidney disease (CKD) are at an increased risk of cardiovascular (CVD) morbidity and mortality, mainly due to atherosclerosis. Decreased production or reduced bioavailability of nitric oxide (NO) can result in endothelial dysfunction (ED). Multiple mechanisms are known to cause a state of NO deficiency in patients with CKD. Patients in various stages of CKD grouped as group-1 (CKD stage 1 and 2), group-2 (CKD stage 3 and 4), group-3 (CKD stage 5) and healthy controls were included in the study. Each group of patients and controls comprised 25 subjects. Plasma nitrites, L-arginine, asymmetric dimethyl arginine (ADMA) and citrulline were measured in all the subjects. Patients in all stages of CKD had lower NO and higher ADMA levels compared to controls. Further, group-2 and group-3 patients had lower levels of NO and higher levels of ADMA than group-1 patients. L-arginine levels showed no difference between patients and controls. However, group-3 patients had lower L-arginine levels compared to group-1 patients. Citrulline levels were decreased in group-3 patients. NO production was decreased in patients in all stages of CKD. The decrease could be due to decreased availability of the substrate, L-arginine or due to an increased ADMA, a potent inhibitor of endothelial NO synthase. Therapeutic interventions directed towards improvement of NO production in addition to management of other CVD risk factors may prevent development of ED and facilitate proper management of CKD patients who are at increased risk for CVD.
Background: Antioxidants play an important role in maintenance of human health and prevention of disease. Effective supplementation of antioxidants requires laboratory monitoring of antioxidant status. An understanding of the methods used to determine the TAS helps in better interpretation of values obtained using a particular method and also to select a suitable method. Material and Methods: Forty subjects including 25 healthy volunteers and 15 patients diagnosed with rheumatoid arthritis were studied. All samples were analysed for TAS using Ferric reducing ability of plasma (FRAP) method and Trolox equivalent antioxidant capacity (TEAC) assay. Results: Mean TAS values obtained by TEAC method were higher than those obtained by FRAP method (p<0.0001); no difference was observed when TEAC values were corrected for proteins and FRAP values were corrected for uric acid (p=0.420). No correlation was found between TEAC and FRAP methods (p=0.102). However, when TEAC was corrected for proteins, positive correlation was observed with FRAP (p=0.044). There was agreement between the two methods when TEAC values were corrected for proteins. Conclusion: Although the reaction conditions differ, similar compounds react in both the assays and thus TEAC and FRAP assays are comparable. However, the two methods differ with respect to-SH groups and uric acid contributions. This contributes to the higher TAS values obtained by TEAC assay. Thus, in conditions with altered protein or uric acid levels, the two methods may not be used interchangeably. The TEAC assay is to be corrected for protein for comparison of reports of the two assays.
Background: Glycated hemoglobin (HbA1c) levels are dependent not only on the average blood glucose levels over the preceding 2 - 3 months but also on the turnover of erythrocytes. Hyperthyroidism is known to be associated with an increase in erythrocyte turnover that may falsely lower the HbA1c in relation to the level of glycemia. Objectives: To assess the impact of medical correction of hyperthyroidism on HbA1c, independent of changes in the fasting plasma glucose and 2-hour post-oral glucose tolerance test plasma glucose. Methods: Adult patients with overt hyperthyroidism (n = 36) were tested for their hemoglobin, reticulocyte percentage, HbA1c and fasting and post-oral glucose tolerance test (OGTT) 2-hour plasma glucose, both at baseline and following at least three months of near normalization of serum thyroxin on Carbimazole treatment. Results: Correction of hyperthyroidism in 36 patients was associated with an increase in the hemoglobin (P = 0.004) and a rise in HbA1c (P = 0.025), even though no significant change was observed in both the fasting (P = 0.28) and post OGTT two-hour plasma glucose (P = 0.54). Also, the proportion of patients with HbA1c ≥ 5.7% rose from 3/36 to 10/36; P = 0.016, while the proportion of patients with either abnormal fasting or abnormal post OGTT 2-hour plasma glucose or both did not show any significant change (P = 0.5). The sensitivity of HbA1c to diagnose prediabetes increased from 20% to 50% post- treatment. Conclusions: Glycated hemoglobin is falsely low in relation to glycemia in patients with untreated hyperthyroidism.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.