Association of Serum Bilirubin, Serum Malondialdehyde and Glycemic Control with Retinopathy in Type 2 Diabetic Subjects
International Journal of Diabetes and Endocrinology
Volume 2, Issue 1, March 2017, Pages: 10-14
Received: Feb. 12, 2017; Accepted: Mar. 4, 2017; Published: Mar. 22, 2017
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Shumaila Shaikh, Phase I Anver Villas, New Wahdat Colony Qasimabad, Hyderabad, Sindh, Pakistan
Azhar Memon, Phase I Anver Villas, New Wahdat Colony Qasimabad, Hyderabad, Sindh, Pakistan
Muhammad Atif Ata, Phase I Anver Villas, New Wahdat Colony Qasimabad, Hyderabad, Sindh, Pakistan
Hina, Phase I Anver Villas, New Wahdat Colony Qasimabad, Hyderabad, Sindh, Pakistan
Haji Khan Khoharo, Phase I Anver Villas, New Wahdat Colony Qasimabad, Hyderabad, Sindh, Pakistan
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Objective: Determine the serum bilirubin, serum malondialdehyde (MDA) and glycemic control with retinopathy in type 2 Diabetes mellitus. Subjects and Methods: The present case control study was conducted at the Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from January 2014 to February 2015. 50 type 2 DM (controls group 1) without DR and 50 type 2 DM with DR (cases group 2) were selected. Inclusion and exclusion criteria were followed strictly. RBG, FBG, fasting insulin, HbA1c, blood lipids, serum creatinine and bilirubin were detected and HOMA model was calculated. MDA was estimated by assay kit. Data was analyzed on Statistix 8.1 (USA) software (P ≤ 0.05). Results: Blood glucose, Glycated HbA1, serum creatinine, serum bilirubin and serum malondialdehyde (MDA) showed statistically significant difference (p<0.05). Serum bilirubin was noted as 1.09±0.25 and 0.96±0.21 mg/dl in controls and cases (p=0.005). Serum MDA was significantly elevated in DR cases 5.94±2.02 µmol/dl vs. 3.88±2.24 µmol/dl in controls. Serum bilirubin showed negative correlation with blood glucose, HbA1c and MDA (r-value noted as -0.359, -0.306 and -0.302 respectively). Serum MDA showed positive correlation with blood glucose (r = 0.478) and HbA1c (r = 0.507). Conclusion: The present study reports low serum bilirubin and high serum malondialdehyde levels in diabetic retinopathy.
Malondialdehyde, Bilirubin, Glycemic Control, Diabetes Mellitus
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Shumaila Shaikh, Azhar Memon, Muhammad Atif Ata, Hina, Haji Khan Khoharo, Association of Serum Bilirubin, Serum Malondialdehyde and Glycemic Control with Retinopathy in Type 2 Diabetic Subjects, International Journal of Diabetes and Endocrinology. Vol. 2, No. 1, 2017, pp. 10-14. doi: 10.11648/j.ijde.20170201.13
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Parmar D, Vidja K, Ghugare B. Impact of duration of diabetes and age: on lipid profile and glycaemic control in type 2 diabetic patients. Int J Res Med 2013;2(1): 69-72.
Meshram R, Ghate J, Ghugare B, Koundinya S, Parmar D. Lipid Peroxidation And Erythrocyte Enzymatic Antioxidants In Type II Diabetes Without Complications. Natl J Integr Res Med 2015; 6(5): 17-21.
Giugliano D, Ceriello A. Oxidative stress and diabetic vascular complications. Diabetes Care 1996; 30(1): 257-267.
Marozas LM, Fort PE. Diabetic retinopathy-update on prevention techniques, present therapies, and new leads. US Ophthalmic Rev 2014; 7: 54-58.
Wani FA, Kaul R, Raina AA, Nazir A, Maqbool M, Bhat MH, Shah PA. Prevalence of Microvascular Complications in Newly Diagnosed Type-2 Diabetes Mellitus. Int J Sci Stud 2016; 3(10): 102-105.
Ahmed RA, Khalil SN, Al-Qahtani MA. Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia. J Family Community Med. 2016 Jan-Apr; 23(1): 18-24. doi: 10.4103/2230-8229.172225.
Su Y, Liu XM, Sun YM, Jin HB, Fu R, Wang YY, et al. The relationship between endothelial dysfunction and oxidative stress in diabetes and prediabetes. Int J Clin Pract 2008; 62: 877-82.
Wu Y, Tang L, Chen B. Oxidative stress: Implications for the development of diabetic retinopathy and antioxidant therapeutic perspectives. Oxid Med Cell Longev 2014; 2014: 752387.
Dekker D, Dorresteijn MJ, Pijnenburg M, Heemskerk S, Rasing-Hoogveld A, Burger DM, et al. The bilirubin-increasing drug atazanavir improves endothelial function in patients with type 2 diabetes mellitus. Arterioscler Thromb Vasc Biol 2011; 31: 458-63.
Cho HC. The relationship among homocysteine, bilirubin, and diabetic retinopathy. Diabetes Metab J 2011; 35: 595-601.
Kim DI, Park MJ, Choi JH, Lim SK, Choi HJ, Park SH. Hyperglycemiainduced GLP-1R downregulation causes RPE cell apoptosis. Int J Biochem Cell Biol 2015; 59: 41-51.
Zhang L, Xia H, Han Q, Chen B. Effects of antioxidant gene therapy on the development of diabetic retinopathy and the metabolic memory phenomenon. Graefes Arch Clin Exp Ophthalmol 2015; 253: 249-59.
Ram M, Singh V, Kumar D, Kumawat S, Gopalakrishnan A, Lingaraju MC, et al. Antioxidant potential of bilirubin-accelerated wound healing in streptozotocin-induced diabetic rats. Naunyn Schmiedebergs Arch Pharmacol 2014; 387: 955-61.
Abbasi A, Deetman PE, Corpeleijn E, Gansevoort RT, Gans RO, Hillege HL, et al. Bilirubin as a potential causal factor in type 2 diabetes risk: A Mendelian randomization study. Diabetes 2014.
Soliman GZ. Blood lipid peroxidation (superoxide dismutase, malondialdehyde, glutathione) levels in Egyptian type 2 diabetic patients. Singapore Med J 2008; 49: 129-36.
Huang EJ, Kuo WW, Chen YJ, Chen TH, Chang MH, Lu MC, et al. Homocysteine and other biochemical parameters in Type 2 diabetes mellitus with different diabetic duration or diabetic retinopathy. Clin Chim Acta 2006; 366: 293-8.
Inoguchi T, Sasaki S, Kobayashi K, Takayanagi R, Yamada T. Relationship between Gilbert syndrome and prevalence of vascular complications in patients with diabetes. JAMA 2007; 298: 1398- 400.
Fukui M, Tanaka M, Shiraishi E, Harusato I, Hosoda H, Asano M, et al. Relationship between serum bilirubin and albuminuria in patients with type 2 diabetes. Kidney Int 2008; 74: 1197-201.
Manning PJ, Sutherland WHF, Walker RJ. Effect of High-Dose Vitamin E on Insulin Resistance and Associated Parameters in Overweight Subjects. Diabetes Care 2004; 27: 2166–2171.
Dave A, Kalra P, Rakshitha Gowda BH, Krishnaswamy M. Association of bilirubin and malondialdehyde levels with retinopathy in type 2 diabetes mellitus. Indian J Endocr Metab 2015; 19: 373-7.
Grattagliano I, Vendemiale G, Boscia F, Micelli-Ferrari T, Cardia L, Altomare E. Oxidative retinal products and ocular damages in diabetic patients. Free Radic Biol Med 1998; 25: 369-72.
Yasuda M, Kiyohara Y, Wang JJ, Arakawa S, Yonemoto K, Doi Y, et al. High serum bilirubin levels and diabetic retinopathy: The Hisayama Study. Ophthalmology 2011; 118: 1423-8.
Najam SS, Sun J, Zhang J, Xu M, Lu J, Sun K, et al. Serum total bilirubin levels and prevalence of diabetic retinopathy in a Chinese population. J Diabetes 2014; 6:221-7.
Turk A, Nuhoglu I, Mentese A, Karahan SC, Erdol H, Erem C. The relationship between diabetic retinopathy and serum levels of ischemia-modified albumin and malondialdehyde. Retina 2011; 31: 602-8.
Vidya D, Shekhar R, Prabodh S, Chowdary NV, Das MC, Reddy MJ. Oxidative stress in diabetic retinopathy. J Clin Diagn Res 2011; 5: 994-7.
Ganjifrockwal F, Joseph J, George G. Serum Oxidized LDL Levels in Type 2 Diabetic Patients with Retinopathy in Mthatha Region of the Eastern Cape Province of South Africa. Oxidative Medicine and Cellular Longevity Volume 2016 (2016), Article ID 2063103: 1-8. http:// /10. 1155/ 2016/ 2063103.
Mandal D, Nandi M, Osta M, Bandyopadhyay U, Ray D. Oxidative stress in diabetic patients with retinopathy. Ann Afr Med 2014; 13:41-6. Available from: http:/ 2014/13/1/41/126951.
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