Dina A. Jamil

Cardiovascular Effects of Copper Deficiency on Activity of Superoxide Dismutase in Diabetic Nephropathy

Background: Copper (Cu) is essential both for its role in antioxidant enzymes, like Cu/zinc (Zn) superoxide dismutase (SOD) and ceruloplasmin, as well as its role in lysyl oxidase, essential for the strength and integrity of the heart and blood vessels. With such a central role in cardiovascular health, Cu has been generally overlooked in the debate over improving our cardiovascular health. Cu deficiency has produced many of the same abnormalities present in cardiovascular disease. It seems almost certain that Cu plays a large role in the development of this killer disease, not because of its excess in the diet, but rather its deficiency. Aim: This study was undertaken to investigate the cardiovascular effects of Cu deficiency on the activity of SOD in patients with type 2 diabetes mellitus (T2DM) with and without diabetic nephropathy. Materials and Methods: Fifty-five patients with T2DM were recruited in this study which were divided into two subgroups based on the presence of microalbuminuria, the first group (microal buminuric group, n = 31) had a microalbuminuria between 30 and 299 μg/mg. The second group (normoal buminuric group, n = 29) had an albumin level less than 30 μg/mg. The two diabetic groups were compared to the control group (n = 37). Results: The results of our study showed a significant reduction in the levels of SOD enzyme associated with an increased urinary Cu excretion in microalbuminuric group compared to the control group at P < 0.05. Conclusions: The current study illustrates that the regulation of the blood concentrations of Cu may be a potential therapeutic target for prevention and treatment of diabetic nephropathy.

Glutathione: Glutathione Sulfide Redox Imbalance in Early Impaired Fasting Glucose

Aim : The current study aims to examine the balance between glutathione and glutathione sulfide and how this was disturbed in patients with impaired fasting glucose (IFG) level. The study also included 8-hydroxy-2’-deoxyguanosine to provide a more comprehensive picture of the overall redox state. Methodology : A cross-sectional analysis of ninety medication free participants without reported history of cardiovascular disease and/or diabetes mellitus was undertaken with data collected from the Diabetes Complications Research Initiative database at Charles Sturt University. Fasting blood glucose, HbA1c and cholesterol as standard markers for diabetes mellitus and associated complications were measured in addition to the emerging biomarkers glutathione (GSH), glutathione disulfide (GSSG), and urinary 8hydroxy-2’-deoxyguanosine (8OHdG).

A comparative study to illustrate the benefits of using ethinyl estradiol-cyproterone acetate over metformin in patients with polycystic ovarian syndrome

AIM This study was done to illustrate the clinical and biochemical effects of ethinyl estradiol-cyproterone acetate (EE-AC) and metformin in this disease. METHODS This was a randomized control trial study, done on twenty-six female patients already diagnosed as cases of PCOS. Participants were divided into two study groups: group one (Group 1), received metformin of 500mg twice daily and the second group (Group 2), was given ethinyl estradiol-cyproterone acetate for 21 consecutive days followed by 7 days drug-free. The course of the treatment for both groups was continued for three consecutive months. RESULTS Group 1 showed a statistical significant increase in serum high density lipoprotein cholesterol (HDL-C) levels (P=0.006) and a decrease in the level of triglyceride (TG) (P=0.006). In addition, Group 1 had a significant reduction in the levels of very density lipoprotein cholesterol (VLDL-C) (P=0.006). Group 2 had a significant increase in serum TG levels (P=0.01), associated with a significant decrease in serum LDL-C (P=0.04). Serum testosterone was significantly reduced in group 1 (P=0.038). This was associated with an improvement in glucose tolerance test (GTT) and BMI in the same group (group 1). Group 2, had an improvement in the menstrual cycle control; hirsutism and acne. CONCLUSION This study showed that metformin treatment is beneficial in improving serum lipids; glucose homeostasis and BMI, however, the ethinyl estradiol-cyproterone acetate is superior in improving the clinical manifestation of patients with PCOS, including menstrual cycle regulation, hyperandrogenic state.

Evaluating markers of oxidative stress in managing gestational diabetes mellitus: a cross sectional study in Iraq.

Aims: The objective of the present study was to evaluate the association of oxidative stress markers and antioxidants in gestational diabetes when compared to non-diabetic pregnant women. Methodology: This is a cross-sectional study, conducted in Al-Husayniya Medical Centre, Baghdad, Iraq and included 73 participants attending the Maternal and Childhood Unit for the period between January 2008 and May 2010. Results: Serum 8-Hydroxy-2-Deoxyguanosine was significantly greater in the gestational diabetes mellitus group compared to control group (57.2 ± 17.6ng/dl versus 19.8 ± 7.8ng/dl respectively, P Conclusions: The current study proves the importance of measuring markers of oxidative stress (expressed by serum 8-Hydroxy-2-Deoxyguanosine & serum lipids) and antioxidants (expressed by serum superoxide dismutase) in managing cases of gestational diabetes mellitus and provides a useful way of assessing the disease progression and/or remission in response to the treatment.

Impaired Fasting Glucose & 8-Iso-Prostaglandin F2α in Diabetes Disease Progression

Aims: The objective of the present study was to evaluate the changes of 8 isoprostaglandin F 2�±and other markers of oxidative stress with impaired fasting glucose when compared to non-diabetic control participants. Methodology: This is a cross-sectional study, conducted at Charles Sturt University, Albury, NSW, Australia and included 428 participa nts (female: male, 247:181) participants attending the Diabetes Complications Clinic in the School of Community Health for the period between January 2011 to October 2012. Results:Urinary 8-isoprostaglandin F 2�±was significantly greater in the impaired fa sting glucose group (1.4±1.3ng/ml) compared to control group (0.68±0.5ng/ml, P= .05). The increase in urinary 8 -isoprostaglandin F 2�±was associated with a significant elevation in

Simvastatin Use in Patients with Type 2 Diabetes Mellitus: The Effects on Oxidative Stress.

OBJECTIVES Studies have shown that people with type 2 diabetes mellitus (T2DM) may develop atherosclerosis due to the disturbance in oxidative control and progressive dyslipidemia. Our study aimed to highlight the benefits of simvastatin treatment in improving serum lipids and reducing oxidative damage in patients with T2DM. METHODS Our randomized control trial included 56 patients with T2DM and dyslipidemia. The participants were on glibenclamide (5mg/day) during the period of the study. The patients were divided into two study groups (groups 1 and 2). Group 1 was the control group and consisted of 31 patients. Group 2 consisted of 25 participants, who were given simvastatin 20mg tablet once daily for 12 weeks. The control group did not receive simvastatin. Both groups were followed-up for measurement of blood pressure, pulse rate, serum lipids, and parameters of oxidative stress. RESULTS The simvastatin treated group showed a significant improvement with reduced erythrocyte glutathione compared to the control group (p<0.001). This was also associated with a significant reduction in erythrocyte malondialdehyde in the simvastatin treated group compared to the control group (p<0.001). Serum lipids reflected a similar improvement in the levels of erythrocyte malondialdehyde. CONCLUSION Our study highlights the beneficial role of simvastatin in improving the degree of oxidative stress in patients with T2DM through its effects on serum lipids and lipid peroxidation.

Reno-protective effects of TAK-242 on acute kidney injury in a rat model

Acute kidney inschemia/reperfusion (I/R) injury is characterized by an abrupt loss of kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes. Despite the advances in therapeutic techniques, the mortality and morbidity of patients remain high and have not appreciably improved. This study aims to evaluate the potential protective effect of TAK-242 on renal ischemia/reperfusion injury using an animal model. Thirty-five adult male Sprague-dawely rats (weighing 200-300), were assigned randomly into the following experimental groups (n = 7 in each group), Control (I/R), Sham (negative control), TAK-242 (5 mg/kg body weight), TAK-242 (10 mg/kg body weight) and Vehicle (DMSO). Rats were exposed to a 30 min of ischemia then 3 h of reperfusion. At the end of reperfusion phase, rats were sacrificed then plasma, serum and tissue samples were obtained to measure markers of kidney oxidative stress and inflammation. Plasma levels of neutrophil gelatinase-associated lipocalin (NGAL), and tissue levels of interleukin-18 (IL-18) and malondialdehyde (MDA) were significantly lower in TAK-242 pretreated groups than the vehicle group and the control group (p < 0.05). Furthermore; serum levels of urea and creatinine were significantly lower in the TAK-242 pretreated groups as compared to the control group (p < 0.05). We conclude that administration of TAK-242 can be useful preventive method in attenuating the degree of acute kidney injury during ischemic reperfusion process as shown by a significant reduction of urinary inflammatory markers as well as significant reduction of urea and creatinine levels.

Trimetazidine attenuates the acute inflammatory response induced by Novolimus eluting bioresorbable coronary scaffold implantation

BACKGROUND This study aims to investigate the inflammatory response in Novolimus bioresorbable coronary scaffold implantation after a course treatment with trimetazidine (35mg tablet/twice daily for 4days). METHODS This was a randomized single blind study. Forty diabetic patients with critical coronary stenosis were subjected to elective coronary scaffold implantation in Al-Najaf Center for Cardiac Surgery and Trans-Catheter Therapy, Najaf, Iraq, between January and July 2015. All patients were informed about the nature of the study and they signed the consent form before they included in the study. Patients were randomly allocated into the two study groups: Group 1 included 20 patients who did the elective coronary scaffold implementation without trimetazidine medication. Group 2 included 20 patients who did the elective coronary scaffold implementation with a course of the trimetazidine (35mg tablet/twice daily for 4days). RESULTS There were significant reduction in the levels of the interleukin-6 and cardiac troponin-I in the trimetazidine-treated group (group 2) compared to the control group (group 1) (P<0.001), after 12h and 24h post-operative. This was associated with a significant rise in the levels of interleukin 10 in group 2 compared to group 1 (P<0.001). Pentraxin-3 was significantly reduced in group 2 but only 24h post-operative (P<0.006). CONCLUSION Our study concluded that trimetazidine minimizes the acute inflammatory response occurred due to systemic release of inflammatory markers into blood in diabetic patients undergoing elective Novolimus bioresorbable coronary scaffold implementation.