Ejilemele Aa

Antioxidant status of type 2 diabetic patients in Port Harcourt, Nigeria.

CONTEXT Oxidative stress has been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and its complications. AIMS This study was conducted to determine and compare total antioxidant status (TAS), vitamin C and E levels in T2DM patients and healthy control subjects. SETTINGS AND DESIGN Fifty-five previously diagnosed DM patients aged between 34 years and 70 years and 50 control subjects aged between 35 years and 69 years were consecutively recruited into this study. MATERIALS AND METHODS Blood pressure (mmHg), body mass index (kg/m 2 ), concentrations of plasma glucose (mmol/l), lipid profile (mmol/l), TAS (mmol/l), vitamins C (μmol/l), and E (μmol/l) were determined in all participants. STATISTICAL ANALYSIS USED Statistical Package for Social Sciences (SPSS) version 11.0 was used for statistical analysis. RESULTS The mean plasma TAS (1.18 ± 0.27 mmol/l), vitamin C (26.59 ± 7.39 μmol/L) and vitamin E (15.33 ± 4.05 μmol/l) of T2DM patients were significantly lower (P=0.0001 for all) than those of controls (1.58 ± 0.28 mmol/l, 43.56 ± 6.86 μmol/l, 31.22 ± 6.20 μmol/l respectively). TAS had a positive correlation with vitamin E (r=0.588; P=0.013) but no correlation with vitamin C (r=-0.387; P=0.139) among diabetics. CONCLUSIONS TAS, vitamin C and E levels are reduced in T2DM patients compared with those of controls.

Innate Immune Responses and Antioxidant/Oxidant Imbalance Are Major Determinants of Human Chagas Disease

Background We investigated the pathological and diagnostic role of selected markers of inflammation, oxidant/antioxidant status, and cellular injury in human Chagas disease. Methods Seropositive/chagasic subjects characterized as clinically-symptomatic or clinically-asymptomatic (n = 116), seronegative/cardiac subjects (n = 102), and seronegative/healthy subjects (n = 45) were analyzed for peripheral blood biomarkers. Results Seropositive/chagasic subjects exhibited an increase in sera or plasma levels of myeloperoxidase (MPO, 2.8-fold), advanced oxidation protein products (AOPP, 56%), nitrite (5.7-fold), lipid peroxides (LPO, 12–17-fold) and malondialdehyde (MDA, 4–6-fold); and a decline in superoxide dismutase (SOD, 52%) and glutathione (GSH, 75%) contents. Correlation analysis identified a significant (p<0.001) linear relationship between inflammatory markers (AOPP/nitrite: r = 0.877), inflammation and antioxidant/oxidant status (AOPP/glutathione peroxidase (GPX): r = 0.902, AOPP/GSH: r = 0.806, Nitrite/GPX: 0.773, Nitrite/LPO: 0.805, MDA/MPO: 0.718), and antioxidant/oxidant levels (GPX/MDA: r = 0.768) in chagasic subjects. Of these, MPO, LPO and nitrite biomarkers were highly specific and sensitive for distinguishing seropositive/chagasic subjects from seronegative/healthy controls (p<0.001, training and fitting AUC/ROC >0.95). The MPO (r = 0.664) and LPO (r = 0.841) levels were also correlated with clinical disease state in chagasic subjects (p<0.001). Seronegative/cardiac subjects exhibited up to 77% decline in SOD, 3–5-fold increase in LPO and glutamate pyruvate transaminase (GPT) levels, and statistically insignificant change in MPO, AOPP, MDA, GPX, GSH, and creatine kinase (CK) levels. Conclusions The interlinked effects of innate immune responses and antioxidant/oxidant imbalance are major determinants of human Chagas disease. The MPO, LPO and nitrite are excellent biomarkers for diagnosing seropositive/chagasic subjects, and MPO and LPO levels have potential utility in identifying clinical severity of Chagas disease.

A1c Gear: Laboratory quality HbA1c measurement at the point of care.

INTRODUCTION HbA1c is an important part of assessing the diabetic control and since the use of point-of-care devices for monitoring HbA1c is increasing, it is important to determine how these devices compare to the central laboratory. METHODS One hundred and twenty patient samples were analyzed on the Bio-Rad Variant™II and one POC analyzer (Sakae A1c Gear). Three patient sample pools containing ~5%, ~7%, and ~10% HbA1c levels were run over 20 days. Three reagent lots and three instruments were evaluated for the A1c Gear. RESULTS The 120 patient samples showed strong correlation (R(2)>0.989) when compared to the Variant™II with means=8.06% and 7.81%, for Variant IIand A1c Gear, respectively. Changing reagent lots or instruments had no impact for the A1c Gear. The ~5%, ~7%, and ~10% pools within-run and between-run imprecision was between 0.87-1.33% and 1.03-1.32%, and 1.41-2.35% and 1.24-1.89% with total imprecision of 1.67-2.35% and 1.61-2.31% for the A1c Gear and Variant II, respectively. The A1c Gear showed a small negative bias (0.25% HbA1c) across HbA1c measurement ranges of <11.5%. This bias was, however, acceptable and not considered to be clinically significant. CONCLUSIONS The A1c Gear meets the criteria of total CV <3% leading us to the conclusion that the A1c Gear can give results as precise as the laboratory at the POC.