Serum sialic acid and acute phase proteins in type 1 and type 2 diabetes mellitus

Crook, Martin; Tutt, P; Simpson, Helen; Pickup, John C.

doi:10.1016/0009-8981(93)90204-h

Cited by 76 publications

(53 citation statements)

References 11 publications

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“…We showed, however, that concentrations of the acutephase marker, serum sialic acid, are raised in Type II diabetes, even in those without diabetic tissue complications, but are not altered in uncomplicated Type I diabetic subjects of similar age and glycaemic control to the Type II diabetic group [19,20].…”

Section: Evidence For An Acute-phase Response In Type II Diabetesmentioning

confidence: 66%

“…We found that even Type II diabetic patients without microvascular or macrovascular complications had a high acute-phase response [20] but tissue complications do further increase stress reactants in Type II diabetes [52]. In non-diabetic subjects with atherosclerosis, a haematological stress syndrome' has been recognised for many years [53], consisting of high acute-phase reactants such as fibrinogen, increased blood viscosity and increased platelet number and activity.…”

Section: The Acute-phase Response and Diabetic Complicationsmentioning

confidence: 82%

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Is Type II diabetes mellitus a disease of the innate immune system?

1998

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The cause of the common type of Type II (non-insulin-dependent) diabetes mellitus, which affects at least 100 million people throughout the world, is not known. One of the foremost challenges we face is to account mechanistically for not only the defining hyperglycaemia but also for the myriad of other biochemical and physiological abnormalities which are characteristic of this disease. For example, it is now clear that Type II diabetes and lesser degrees of glucose intolerance commonly occur together with a collection of clinical and biochemical features which have been called metabolic syndrome X [1, 2].These features include central obesity, hypertension, accelerated atherosclerosis, hypertriglyceridaemia and low serum concentrations of high-density lipoprotein (HDL) cholesterol. Though insulin resistance seems to be a central abnormality, the origin of the impaired insulin action and how it explains the many other abnormalities of Type II diabetes is not known.In recent years, we have been gathering evidence that in Type II diabetes there is a cytokine-associated acute-phase reaction, part of the innate immune response. As an alternative direction for research into the aetiology of Type II diabetes, we propose that it may be helpful to consider whether the mechanisms involved in the acute-phase response can be major contributors to the pathophysiology of many of the features of Type II diabetes and syndrome X, including glucose intolerance, insulin resistance, impair- Diabetologia (1998) Summary Type II (non-insulin-dependent) diabetes mellitus is associated with increased blood concentrations of markers of the acute-phase response, including sialic acid, a-1 acid glycoprotein, serum amyloid A, C-reactive protein and cortisol, and the main cytokine mediator of the response, interleukin-6. The dyslipidaemia common in Type II diabetes (hypertriglyceridaemia and low serum levels of HDL cholesterol) is also a feature of natural and experimental acutephase reactions. We review evidence that a long-term cytokine-mediated acute-phase reaction occurs in Type II diabetes and is part of a wide-ranging innate immune response. Through the action of cytokines on the brain, liver, endothelium, adipose tissue and elsewhere, this process could be a major contributor to the biochemical and clinical features of metabolic syndrome X (glucose intolerance, dyslipidaemia, insulin resistance, hypertension, central obesity, accelerated atherosclerosis) but also provides a mechanism for many other abnormalities seen in Type II diabetes, including those in blood clotting, the reproductive system, metal ion metabolism, psychological behaviour and capillary permeability. In the short-term, the innate immune system restores homeostasis after environmental threats; we suggest that in Type II diabetes and impaired glucose tolerance long-term lifestyle and environmental stimulants, probably in those with an innately hypersensitive acute-phase response, produce disease instead of repair. [Diabetologia (1998

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Section: Evidence For An Acute-phase Response In Type II Diabetesmentioning

confidence: 66%

Section: The Acute-phase Response and Diabetic Complicationsmentioning

confidence: 82%

Is Type II diabetes mellitus a disease of the innate immune system?

1998

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“…Elevated plasma sialic acid concentration is strongly related to the presence of microvascular complications in type I diabetes (Crook et al, 2001) and cardiovascular morbidity in the general population (Lindberg et al, 1991). In type II diabetes, the circulating sialic acid concentration is elevated in comparison with nondiabetic subjects (Crook et al, 1993). Links between sialic acid and risk factors for vascular disease, such as blood lipids (Wakabayashi et al, 1992), smoking (Lindberg et al, 1991), hyperfibrinogenemia (Crook et al, 1996), and lipoprotein (Kario et al, 1994) have been reported.…”

Section: Medical Significance Of Disturbances In Sialic Acid Metabolismmentioning

confidence: 99%

The role and potential of sialic acid in human nutrition

2003

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Sialic acids are a family of nine-carbon acidic monosaccharides that occur naturally at the end of sugar chains attached to the surfaces of cells and soluble proteins. In the human body, the highest concentration of sialic acid (as N-acetylneuraminic acid) occurs in the brain where it participates as an integral part of ganglioside structure in synaptogenesis and neural transmission. Human milk also contains a high concentration of sialic acid attached to the terminal end of free oligosaccharides, but its metabolic fate and biological role are currently unknown. An important question is whether the sialic acid in human milk is a conditional nutrient and confers developmental advantages on breast-fed infants compared to those fed infant formula. In this review, we critically discuss the current state of knowledge of the biology and role of sialic acid in human milk and nervous tissue, and the link between sialic acid, breastfeeding and learning behaviour.

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“…This might provide a mechanism for most of the features of syndrome X, and some other biochemical abnormalities which have been noted in NIDDM such as hyperfibrinogenaemia [6], low plasma testosterone levels in men with NIDDM [7], as well as elevated circulating PAI-1 levels [3]. In previous studies [8,9], we found that serum sialic acid concentrations are elevated in NIDDM but not in subjects with uncomplicated insulin-dependent diabetes mellitus of comparable age, sex, diabetes duration and glycaemic control (serum sialic acid is essentially protein-bound and has been proposed as a marker of the overall acute-phase response [10] since many acute-phase proteins such as ct-1 acid glycoprotein and fibrinogen are sialylated at the terminus of the oligosaccharide chain of the glycoprotein [11]). The serum sialic acid concentration was also a highly significant univariate correlate of coronary heart disease (CHD) in a cross-sectional study of male NIDDM patients [12].…”

mentioning

confidence: 99%