Vijetha Belle Shenoy

Association between Vitamin D, Fasting Blood Glucose, HbA1c and Fasting Lipid Profile in Euglycemic Individuals

In addition to biological actions of vitamin D such as calcium absorption, regulation of bone and mineral metabolism, studies have shown that Vitamin D is necessary for normal insulin secretion. Vitamin D influences insulin production and secretion through its effect on calcium and phosphorous metabolism. Vitamin D modifies insulin response by acting on receptor gene. Vitamin D deficiency has been implicated in decreased insulin secretion and increased insulin resistance. Objective: To measure and correlate vitamin D with fasting plasma glucose, HbA1c and fasting lipid profile in euglycemic individuals. Methods: Ethics clearance was obtained prior to data collection. After an overnight fast, blood samples were collected for fasting plasma glucose, lipid profile, HbA1c and vitamin D from euglycemic individuals who consented to participate. Vitamin D assay was estimated in Elecsys 2010 by ECLIA method. Plasma glucose was estimated by Hexokinase method. Serum fasting lipid profile was estimated in Cobas 6000 (Roche), and HbA1c measured using ion exchange HPLC method using Biorad Variant II turbo. Results: There was an inverse correlation between vitamin D and fasting plasma glucose (p＜0.001); Vitamin D and HbA1c (p＜0.001) in groups 1 and 3. There was also a significant inverse correlation of Total cholesterol (p=0.05), total cholesterol/HDL ratio (p＜0.001) with Vitamin D and significant direct correlation of HDL with vitamin D levels in groups 1 and 3. Conclusion: Deficiency of vitamin D can predispose to dysregulation of glucose and lipoprotein metabolism. There may be a role for vitamin D in better management of diabetes and dyslipidemia.

A Case of Sanfillippo’s Disease Correlating Clinical and Biochemical Findings

The mucopolysaccharidoses (MPSs) are a heterogeneous group of rare inherited disorders caused by deficiency of lysosomal enzyme necessary to break down mucopolysaccharides or glycosaminoglycans (GAGs). We had combined clinical findings and ophthalmological features. Biochemical test for urine glycosaminoglycans was done for confirmation of diagnosis in the patient. The case of Sanfillippo’s disease was characterized by delayed development, hyperactivity with aggressive behaviour. Coarse facial feature, hirsutism and sleep disorder. Urine GAG tests for MPS was positive in the case. Based on clinical findings and biochemical tests for MPS, this case was diagnosed as a type III mucopolysaccharidoses. Urinary GAG’s electrophoresis is an important screening test for MPS suspected cases.