Study of Correlation of CD4, CD8 Count with Tuberculous Pneumonia and Non Tuberculous Bacterial Pneumonia in Type 2 Diabetes Mellitu.

AIM: Type-2 DM patients are susceptible for various types of infections. Long standing Type2 DM patients have strong predilection for tuberculosis as seen in various studies. Here, we aimed to study susceptibility of tuberculosis as compared to other non tuberculous pneumonia in type-2 DM on the basis of CD markers. MATERIAL AND METHODS: A case control study on 150 subjects was conducted in S.P. Medical College and Associated Group of P.B.M. Hospitals, Bikaner. Subjects were divided into 3 groups each of 50 type-2 diabetic patients having tuberculous pneumonia, of 50 type-2 diabetic patients having non tuberculous pneumonia and 50 patients of type 2 diabetes as a control group attending Medical Outdoor and those Admitted in Hospital IPD Wards. All participants were subjected to detailed clinical examination and relevant investigations. Flow cytometry was used for CD4 and CD8 count. RESULTS: Diabetic patients with tuberculous pneumonia have significantly (p-value <0.05) elevated numbers of CD4 and CD8 cell count in comparison of both controls and nontuberculous pneumonia. Diabetic patients with non tuberculous pneumonia have significantly (p-value <0.05) lower CD4 and CD8 cell count in comparison of diabetic controls and diabetic patients with tuberculous pneumonia. CONCLUSION: DM is associated with an alteration in the immune response to tuberculosis, leading to a induction of CD4 and CD8 mediated cellular responses and likely contributing to increased immune pathology in M. tuberculosis infection. Our study also provides an impetus to perform longitudinal studies examining the role of immunological biomarkers in the development of tuberculosis in diabetic patients.

Galectin-3 as a Potential Biomarker of Microvascular Complications in Patients with Type 2 Diabetes.

Introduction: Human Galectin-3 is a 32- to 35-kDa size lectin, mainly comprises a C-terminal carbohydrate recognition binding domain (CRD) and N-terminal domain. It acts as a powerful pro-inflammatory signalling factor, which plays an important role in the activation, chemotaxis, and cytokine release of inflammatory cells. Galectin-3 has also been studied in relation to development of insulin resistance. The levels of galectin-3 have been observed to be associated with both diabetes prevalence and incidence, independent of traditional diabetes risk factors. It is also associated with development of microvascular complications of diabetes mellitus like retinopathy, nephropathy and neuropathy. Methods: Tertiary care hospital-based cross-sectional prospective study. 150 patients selected by simple random sampling and were divided into 3 groups., Group A - Patients of Type 2 Diabetes mellitus without microvascular complications (n=50), Group B - patients of Type 2 diabetes mellitus with microvascular complications (n=50) and Group C - Healthy control (n=50). Statistical Analysis: Descriptive statistics was performed by calculating mean and standard deviation for the continuous variables. chi-square goodness-to-fit test, Student T test (unpaired) and Analysis of variance (ANOVA) and multivariate analysis were used to compare means. The p-value was taken significant when less than 0.05 (P<0.05) and a confidence interval of 95%. Results: In group A, B and C majority of patients were between 56-60 years with 34%, 40% and 36% cases, respectively. The mean BMI shows that the Patients with complications had significantly higher BMI than those without complications and controls had significantly lower BMI than patients having diabetes. The data shows statistical significance with deranged biochemical profile in patients with DM with complications as compared to patients without complications and control group. In both groups A and B patients with HbA1c between 9.1-12 had mean serum galectin level (20.2 in group A, 25.9 in group B) significantly higher than patients with HbA1c between 6.5-9 (18.5 in group A and 20.4 in group B). patients with deranged lipid profile had significantly higher serum galectin level in all 3 groups, with cases from group B having higher values than group A. While controls had the lowest value of serum galectin (P value<0.001). There was a highly significant correlation between high serum galectin levels and the incidence of both non-progressive and progressive retinopathy (P value=0.0001). The mean galectin of patients with neuropathy was 28.3 ± 3.1 ng/ml, which was significantly higher than patients from group B without neuropathy (24.5 ± 2.6 ng/ml). The mean serum galectin level of patients with macroalbuminuria was 30.1± 1.3 ng/ml which was significantly higher than those with microalbuminuria having mean galectin level of 22.8 ±4.8 ng/ml. There was a highly significant correlation between high serum galectin levels and the incidence of both micro and macroalbuminuria (P value=0.0001). Conclusion: This study concludes that elevated serum Galectin-3 levels are associated with diabetes-related chronic inflammatory processing pathway, and closely relates to the severity of diabetes in T2DM both with and without complications. Therefore, Galectin-3 may be helpful in the diagnosis and prognosis of microvascular and macrovascular complications in T2DM patients.

A Study of Correlation between Apolipoprotein B and Dyslipidemia in Type 2 Diabetes Patients and its Relation with Proteinuria- A Tertiary Care Hospital Based Study.

OBJECTIVES: Individual with diabetes may have several from of Dyslipidemia. Dyslipidemia has been considered to be factor that plays a risk in progression of micro vascular disease, especially in diabetes.1 The present study is intended to Study of correlation between Apolipoprotein B and Dyslipidemia in type 2 diabetes patients and prevalence of dyslipidemia in type 2 diabetic patients. MATERIAL AND METHODS: Prospective cross- sectional study conducted on 100 cases of type 2 diabetes mellitus. Groups are divided according to A/C ratio and association of dyslipidemia was seen. Serum Apolipoprotein B was measured using immunoturbidimetric method. RESULTS: Pearson's correlation analysis of Apo B with lipid parameters in diabetic patients showed that, LDL, TC and Tg were positively correlated with Apo- B. There was a positive and linear correlation between LDL and Tg. Apo- B was negatively correlated with HDL-C. CONCLUSION: The majority of patients studied had low HDL-C, elevated non HDL- C, elevated total cholesterol, elevated triglycerides, elevated LDL -C and elevated apo B. Apolipoprotein B had a positive linear correlation with total cholesterol, triglycerides, LDL-C, non-HDL-C. The strongest positive correlation was with nonHDL-C. Patients with low HDL-C had high apo B levels.