Swaminathan Ganesh, Mala Dharmalingam and Sara Marcus
Oxidative Stress in Type 2 Diabetes with Iron Deficiency in Asian Indians
A close relationship exists between iron metabolism, diabetes and oxidative stress. Both diabetes and redox active iron are individually known to enhance oxidative stress. However, the role of iron deficiency and oxidative stress in diabetes is not clear; hence, the levels of oxidative stress in type 2 diabetes with and without iron deficiency have been compared. Two groups of 30 patients each with diabetes were selected (one group with iron deficiency and the other group with normal iron levels) and compared with 30 normal healthy controls. The anthropometric parameters, fasting blood sugar, iron profile and oxidative stress parameters (malondialdehyde levels (index of lipid peroxidation) and serum uric acid levels (antioxidant)) were measured. While the diabetes group had significantly increased serum levels of ferritin (an acute phase reactant and antioxidant) in comparison with normal controls (P=0.040), the diabetic group with iron deficiency had decreased serum levels of iron (P =0.000), ferritin (P = 0.000) and uric acid (P = 0.006) and increased levels of malondialdehyde (P = 0.000) in comparison with diabetics without iron deficiency. This study shows an increase in oxidative stress in the diabetic group with iron deficiency together with reduction in antioxidant levels could further promote prooxidant levels and inflammation and in turn result in the development of complications in this high-risk Asian Indian population.
Oxidative Stress in Obesity and Metabolic Syndrome in Asian Indians
Oxidative stress is associated with the individual components of metabolic syndrome and has been implicated in the development of complications of these metabolic disorders. In this study oxidative stress levels have been compared in obese Indians (a high-risk population for diabetes and cardiovascular disorders) with and without metabolic syndrome. 30 adult normotensive, normoglycemic obese subjects and 35 adults with metabolic syndrome of either sex with BMI >23 kg/m2 were compared with 30 adult, healthy volunteers with BMI <23 kg/m2. Anthropometric parameters, blood pressure, biochemical parameters, hydroperoxides levels and total antioxidant capacity were estimated. The obese groups with and without metabolic syndrome had significantly increased anthropometric parameters like waist circumference and index of central obesity and aqueous phase hydroperoxides when compared with normal controls. The metabolic syndrome group also had significantly increased blood sugar levels, lipid profile and hydroperoxide levels when compared to obese or control groups. There was no alteration in the total antioxidant capacity in any of the groups. The Triglyceride/HDL-Cholesterol ratio (>3), a surrogate marker of insulin resistance, indicates insulin resistance in the metabolic syndrome group. The anthropometric profile, insulin resistance and oxidative stress seen in obesity are further elaborated in metabolic syndrome. Thus, the early identification of high-risk individuals based on anthropometric parameters, lipid profile, insulin resistance and indices of oxidative stress may help to prevent the development of complications of metabolic syndrome.
Nirupama Shivakumar, Meghanaa Kumar, Manasa Aswathanarayan, Maanasa Venkatesh, Manasa Sheshadri, Shreehari Deshmukh, Pranav Srinivasan, Mala Dharmalingam and Sara Marcus
Role of Retinol-Binding Protein 4 in Obese Asian Indians with Metabolic Syndrome
Retinol-binding protein 4 is an adipocytokine separately implicated in the development of obesity-related insulin resistance and proatherogenic lipid profile, however, its role in humans is unclear. This study was carried out to assess the role of retinol-binding protein 4 as a potential marker of metabolic syndrome in obese Asian Indians (a high-risk population for diabetes). 52 obese (BMI >23 kg/m2) Asian Indians were grouped into those with and without metabolic syndrome based on IDF criteria and compared with healthy controls. The anthropometric and biochemical parameters (fasting blood sugar, lipid profile, serum insulin, high-sensitivity C-reactive protein, and retinol-binding protein 4) were estimated. The obese groups had significantly altered adiposity indices, insulin resistance parameters (fasting blood sugar (only in the metabolic syndrome group), serum insulin, HOMA-IR and QUICKI), index of inflammation (C-reactive protein) and proatherogenic dyslipidemic profile (serum triglycerides, VLDL-cholesterol, and triglyceride/HDL-cholesterol ratio). Retinol-binding protein 4 levels were elevated in the obese groups, but were not significant. Retinol-binding protein 4 levels were correlated with anthro-pometric parameters and atherogenic lipids, while C-reactive protein was correlated with anthropometric and insulin resistance parameters in the entire group of subjects. Although these correlations were not observed in the obese groups, in the control group, retinol-binding protein 4 was correlated to the lipid parameters and C-reactive protein to adiposity indices. Thus, the role of retinol-binding protein 4 as a potential marker of metabolic syndrome is limited to the prediction of proatherogenic risk among Asian Indians.