Interleukin Levels and Non-Alcoholic Fatty Liver Disease in Chronic Plaque Psoriasis: An Analytical Case Control Study.

Background: Psoriasis is a chronic, immune mediated inflammatory condition of the skin and imbalance in inflammatory mediators could result in insulin resistance, metabolic syndrome and facilitate the occurrence and progression of Non-alcoholic fatty liver disease (NAFLD). Objectives: Primary objectives: To study the frequency of NAFLD in cases of chronic plaque psoriasis and controlsTo study the interleukin levels in cases of chronic plaque psoriasis and controls. Secondary objectives: To study the BMI, lipid profile, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin in cases and controlsTo study the association of age, duration of psoriasis, PASI (psoriasis area severity index), BSA (body surface area) involved, BMI (body mass index), lipid profile, obesity, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin levels with NAFLD in patients of chronic plaque psoriasisTo correlate serum levels of IL1-ß, IL6 and TNF-α with NAFLD in patients of chronic plaque psoriasis. Methods: 50 clinically diagnosed cases of chronic plaque psoriasis with age ≥ 18years, diseases duration ≥ 6 months and 30 age and sex matched controls were recruited. PASI, BSA of cases was calculated and BMI, BP, WC of all subjects was measured. Serum lipid profile, FBS, PPBS, insulin level, IL1- ß , IL6, TNF- α , high frequency B-mode ultrasound, LFT and fibroscan were done in all subjects. Results: 28(56.0%) cases and 2(6.6%) controls had NAFLD with statistically significant difference. Significantly elevated WC, serum insulin, deranged lipid profile, fatty liver, transaminitis, fibroscan score, liver fibrosis, NAFLD and interleukins were found in cases vs controls. There was a significant association of NAFLD in psoriatic patients with increasing duration of psoriasis, BMI ≥23 Kg/m2, high WC, increasing BSA involved, deranged lipid profile, raised total cholesterol levels and increasing number of risk factors. Nonsignificant but positive association of NAFLD in cases was found with high levels of IL1 - ß, IL - 6, TNF-α, FBS and increasing PASI. Conclusion: Significantly increased interleukin levels and their weak positive correlation with the severity of psoriasis (PASI, BSA) in patients of chronic plaque psoriasis explains the possible role of inflammation in the causation of psoriasis. Screening may be considered in psoriatic patients with increasing duration of psoriasis, high WC, high BSA involved, high BMI, obesity, dyslipidemia and insulin resistance. Limitations: Small sample size. Conflict of Intrest: NONE.

Analysis of Non-Adherence to Medication in Patients with Type 2 Dm.

BACKGROUND: Non-adherence to medication in chronic diseases, like diabetes, is a serious problem which is associated with poor outcomes. Material and Objectives: Primary Objective: To study the proportion of non-adherence to treatment in patients with type 2 DM and factors responsible for it. SECONDARY OBJECTIVE: To correlate the degree of glycemic control, presence of target organ damage and metabolic derangements with non-adherence to medication. METHODS: A cross-sectional analytical study was conducted on 100 patients of Type 2 diabetes mellitus. Proportion of drug coverage (PDC) over the last 1 month was used to assess adherence. A questionnaire was used to collect information for variable factors responsible for non-adherence. The percentage of non-adherence and factors contributing were analyzed. OBSERVATION AND RESULTS: Out of 100 patients with T2 DM (M:F:: 35:65); 56 patients had good (>80%) adherence, 13 patients had moderate (50-80%) adherence and 31 patients had poor (<50%) adherence to medication. Following factors were assessed for non-adherence;

Transient Elastography of Liver and Serum Hyaluronic Acid Levels In Adult Transfusion Dependent Thalassemia Patients.

Iron overload occurs as a result of multiple blood transfusions and increased iron absorption in thalassemia patients. Iron deposition in liver results in liver stiffness and fibrosis. Non invasive methods including imaging and serum biomarkers have been introduced for assessment of liver fibrosis. We aimed to study liver stiffness using transient elastography and serum hyaluronic acid levels and correlate them with serum ferritin levels in adult transfusion dependent beta thalassemia patients. MATERIAL: 70 transfusion dependent thalassemia patients of age ≥18 years, registered at Thalassemia Day Care Centre were subjected to investigations like CBC, Liver function tests, viral markers, serum ferritin, serum hyaluronic acid levels and transient elastography. Fibrosis indices like FIB-4, AAR and APRI were also calculated. 45 patients had T2*MRI reports with them; which were also included and analysed. Spearman coefficient r was used to test correlations between TE values and serum HA levels with other variables. OBSERVATION: 70 patients (41 male and 29 female) with mean age of 24.09±5.38 years and BMI 20.51 ±3.47 kg/m², were enrolled. Median values of hemoglobin, AST, ALT, TE, serum HA and serum ferritin were, 9.15 g/dl, 42 IU/L, 47.50 IU/L, 9.1 kPa, 284 ng/dl and 1841 ng/ml, respectively . TE values had significant positive correlation with serum ferritin (r=0.5, p < 0.001), ALT (r=0.59, p < 0.001), AST (r=0.58, p< 0.001), APRI (r=0.5, p<0.001) and FIB-4 (p=0.02), respectively and significant negative correlation with T2* MRI (ms) (r= -0.5, p<0.001). No significant correlation of HA was found with any variable. CONCLUSION: Transient elastography can be used as a non expensive, easily accessible and non invasive marker of liver iron overload. Further detailed studies are required to establish the role of serum Hyaluronic acid in thalassemia patients.

Prevalence of Glucose Metabolism Disorder in Liver Cirrhosis and its Correlation with Risk Factors of Diabetes Mellitus: A Hospital-Based Cross Sectional Observational Study from New Delhi.

OBJECTIVES: Association between liver cirrhosis (LC) and glucose intolerance has been known since long. This study was carried out to (1) determine the proportion of LC patients having insulin resistance and glucose metabolism disorder (GMD) which includes pre-diabetes (pre-DM) and diabetes mellitus (DM) and (2) study the correlation between GMD and the presence of risk factors (RF) for DM in patients with LC. METHODS: 100 patients with LC admitted in medical wards were studied and tested with fasting plasma glucose (FPG), 2 hours post-75 gram oral glucose load plasma glucose (PPG), glycosylated hemoglobin (HbA1c) and fasting plasma insulin. They were also evaluated for the presence or absence of RF for DM and groups of LC patients with and without GMD were compared. RESULTS: Out of the 100 patients, 77% were males and 76% were between 30-59 years of age. Insulin resistance (IR) was found in 26% and GMD in 39% (pre-DM 13% DM 26%). Certain RF for DM like advanced age, positive family history (F/H) of DM, high body mass index (BMI), hypertension, high triglycerides, history of CAD/ CVA/ PVD showed positive correlation with the occurrence of GMD in LC; advanced age, hypertension and high triglycerides had a significant correlation with occurrence of IR. CONCLUSION: GMD was prevalent in about a third and IR in about a quarter of patients with LC. Traditional risk factors of DM increase the chances of an individual with LC having GMD. IR increased with advanced age, the presence of hypertension and high triglycerides and did not always predate GMD.

Coagulation Profile and its Correlation with Severity of Liver Dysfunction and Gastrointestinal Bleed in Alcoholic Liver Disease Patients.

INTRODUCTION: The study aimed to determine coagulation factor abnormalities in alcoholic liver disease (ALD) and correlate these with severity of liver dysfunction (Child's class) and gastrointestinal (GI) bleeding. METHODS: 60 patients of ALD (alcohol intake >10years and clinical, biochemical or radiological evidence of chronic liver disease) were included. Patients with Hepatitis B, Hepatitis C, HIV infection, DIC, low platelet count due to other causes, or on drugs which affect coagulation profile were excluded. OBSERVATIONS: Age was 44.42 ± 10.26 years (100% males), 53% in Childs class C. Severity of liver dysfunction showed a significant association (p<0.05) with prolongation of prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT), increasing factor VIII and D-Dimer level, low platelet counts, low protein S and factor VII activity; as well as decreasing fibrinogen levels, protein C and antithrombin (AT) III. GI bleed is associated significantly (p<0.05) with PT >20 sec and decreased plasma fibrinogen levels, while normal protein C, normal AT III, normal factor VII, normal factor VIII, normal TT, increased plasma fibrinogen levels, normal PT and normal platelet count appeared to be protective. CONCLUSIONS: Several coagulation parameters are altered in ALD variably. Alterations in PT, aPTT, TT, factor VIII, D-Dimer, fibrinogen, protein C and AT III levels can be used for grading severity of liver disease. Decreased fibrinogen, protein C activity, AT III activity, factor VII activity, and increased factor VIII activity, are associated with GI bleed.

The Syndromic Spectrum of COVID-19 and Correlates of Admission Parameters with Severity-outcome Gradients: A Retrospective Study.

BACKGROUND: Clinical and laboratory features of COVID-19 may have regional variations. This study aimed to discern their association with severity of illness and mortality in tertiary setup of Delhi, India. METHODS: Retrospective data of hospitalised COVID-19 patients over 3 months (end March to June 2020) were evaluated for symptom profile, blood investigations and chest radiograph data and classified according to COVID-19 severity and as survivors and non-survivors. RESULTS: Average age (n=182) was 46.1 years, male to female ratio 1.4:1. Fever (51.1%), cough (49.4%) and breathlessness (48.3%) were the commonest symptoms, and frequency of all the three increased with severity of COVID-19. Fever duration, leucocytosis, neutrophilia, elevated blood urea, transaminitis and higher Brixia score on chest X-ray were also more in severe COVID-19 compared to mild and moderate categories. Higher age, more comorbidities, fever, breathlessness and chest pain; longer duration of fever, leucocytosis, neutrophilia, lymphopenia, high neutrophil to lymphocyte ratio, elevated serum urea, creatinine, transaminases and hyperglycemia, and higher radiographic Brixia score were observed in non-survivors compared to survivors. CONCLUSION: Greater prevalence of symptoms (alone and in combination) and derangements in blood biochemistry are seen in severe COVID-19 compared to mild or moderate cases, and also in non-survivors compared to survivors.

Pancreatic Injury in COVID-19 Patients.

BACKGROUND AND AIM: Coronavirus disease 2019 (COVID 2019) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause multisystem dysfunction. We studied pancreatic injury (serum amylase and serum lipase levels) in COVID-19 patients. METHODS: A retrospective study involving 42 COVID-19 patients (diagnosed by real-time PCR) admitted to a tertiary care hospital was conducted. Serum amylase and serum lipase levels were analysed in relation to severity of COVID-19 and mortality. RESULTS: Mean age of patients was 50 ± 16 years, with male to female ratio of 3.7:1. Serum amylase was elevated in 14 patients (33%). Serum lipase was elevated in 7 out of 29 patients (24.1%). Mortality was seen in 18 patients (42.8%). Serum amylase or lipase did not correlate with severity of COVID-19 or its mortality. However, both patients who had high lipase (>3times) died. CONCLUSION: The prevalence of hyperamylasemia in patients of COVID-19 was 33%, while that of elevated lipase was 24.1%. Pancreatic injury failed to show any statistically significant relation to severity or outcome of COVID-19.

Microbial-assisted and genomic-assisted breeding: a two way approach for the improvement of nutritional quality traits in agricultural crops.

Both human and animals, for their nutritional requirements, mainly rely on the plant-based foods, which provide a wide range of nutrients. Minerals, proteins, vitamins are among the nutrients which are essential and need to be available in adequate amount in edible portion of the staple crops. Increasing nutritional content in staple crops either through agronomic biofortification or through conventional plant-breeding strategies continue to be a huge task for scientists around the globe. Although some success has been achieved in recent past, in most cases, we have fallen short of expected targets. To maximize the nutrient uptake and partitioning to different economic part of plants, scientists have employed and tailored several biofortification strategies. But in present agricultural and environmental concerns, these approaches are not much effective. Henceforth, we are highlighting the recent developments and promising aspects of microbial-assisted and genomic-assisted breeding as candidate biofortification approach, that have contributed significantly in increasing nutritional content in grains of different crops. The methods used to date to accomplish nutrient enrichment with recently emerging strategies that we believe could be the most promising and holistic approach for future biofortification program. Results are encouraging, but for future perspective, the existing knowledge about the strategies needs to be confined. Concerted scientific investment are required to widen up these biofortification strategies, so that it could play an important role in ensuring nutritional security of ever-growing population in growing agricultural and environmental constraints.

Profile of Community-Acquired Acute Kidney Injury Defined Using RIFLE Criteria Among Medical In-Patients: A Prospective Descriptive Single Centre Study.

AIM: To determine the proportion of patients who have Acute Kidney Injury (AKI), identify severity of AKI using RIFLE criteria and to identify associated factors with AKI. METHODS: One thousand consecutive medical in-patients were screened for AKI and severity assessed using RIFLE criteria in tertiary care hospital in Northern India. Patients with medical renal disease and obstructive uropathy were excluded. Serum creatinine of all patients were done on days 0, 3, 7 and 14. CKD cases were also excluded. AKI patients were followed at 4 weeks and 3 months. RESULTS: Amongst 1000 patients screened, 65 had AKI. 27(41.5%), 15(23.0%) and 23(35.38%) patients belonged to risk, injury and failure classes of AKI respectively as per RIFLE criteria, and there was incremental risk of mortality (25.92%, 46.33% and 86.95%, p<0.001). In-patients with pneumonia, chronic liver disease and acute gastroenteritis have greater odds of developing AKI, with chronic liver disease having a high mortality (90%). Hypotension (OR- 5.5:1, p=0.002) or leucocytosis at presentation (OR-2.8:1, p<0.001), smokers (OR-2.2:1, p=0.03) and alcoholics (OR-2.5:1, p=0.047) had greater odds of developing AKI. 33(50.7%) patients with AKI died and 27(41.5%) recovered before day 28. Five (7.7%) were seen in class L who had persistently elevated creatinine at day 90 i.e. progressed to ESRD, class E. CONCLUSION: The incidence of AKI among medical in-patients was 6.5%, with an incremental risk of mortality in risk, injury and failure classes. Pneumonia and acute gastroenteritis among infections and chronic liver disease have greater odds of developing AKI. Hypotension, leucocytosis, smoking, alcohol and aetiology are independent risk factors for AKI.

Efficacy and safety of evogliptin versus sitagliptin as an add-on therapy in Indian patients with type 2 diabetes mellitus inadequately controlled with metformin: A 24-week randomized, double-blind, non-inferiority, EVOLUTION INDIA study.

AIM: This study aimed to assess efficacy and safety of evogliptin versus sitagliptin, when added to background metformin therapy in Indian patients with uncontrolled type 2 diabetes. METHOD: Overall, 184 patients with uncontrolled type 2 diabetes (7% ≤ HbA1c < 10%) receiving ≥8 weeks of stable metformin monotherapy (≥1 g/day), were randomized to receive add-on treatment (evogliptin 5 mg or sitagliptin 100 mg) for 24 weeks. Primary endpoint was change in HbA1c from baseline to 12 weeks (non-inferiority margin: <0.35). RESULTS: Mean reductions in HbA1c at 12 weeks in evogliptin- and sitagliptin-treated patients were -0.37 (1.06) and -0.32 (1.14), respectively. The adjusted mean difference between treatment groups was -0.022 (95% CI: -0.374, 0.330; P = 0.901), that demonstrated non-inferiority. Reductions in FPG and PPG were similar between evogliptin and sitagliptin at 12 and 24 weeks. Changes in body weight were comparable between the treatment groups. Patients achieving target HbA1c < 7.0% (evogliptin, 26.7% vs. sitagliptin, 20%) was almost equal in both groups. Treatment-emergent adverse events occured in 52 patients (evogliptin, 25% and sitagliptin, 31.5%) and were generally mild. CONCLUSIONS: Evogliptin was non-inferior to sitagliptin in HbA1c reduction. It effectively improved glycemic control and was well tolerated in type 2 diabetes patients inadequately controlled by metformin alone.

Possible modulation of glycated protein levels in prehypertension by lipid peroxides.

Glycation and lipid peroxidation are two important processes known to play a key role in complications of many pathophysiological processes. Malondialdehyde (MDA) has been reported to play a possible role in the genesis of glycated proteins. This study was undertaken to unravel the possible association of MDA with glycated hemoglobin and fructosamine in prehypertensive patients. A case-control study was performed on 42 prehypertensive and 30 control subjects. Plasma glucose, MDA, fructosamine, and glycated hemoglobin were analyzed in both the groups. Partial correlation analysis was performed to predict the independent association of MDA and fasting glucose on fructosamine and glycated hemoglobin. Plasma of prehypertensive subjects revealed significantly higher concentrations of lipid peroxides and fructosamine than in controls. Glycated hemoglobin concentrations were also found to be significantly increased in test group when compared with healthy controls. When the effects of fasting glucose on the concentrations of glycated hemoglobin and fructosamine were refuted by partial correlation analysis, MDA was found to be a significant determinant of glycated hemoglobin and fructosamine in subjects with prehypertension. These data also support the premise that lipid peroxides per se could play a role in the glycation of hemoglobin and plasma proteins in prehypertension.

A clinical study of dermatoses in diabetes to establish its markers.

BACKGROUND: Cutaneous manifestations of diabetes mellitus generally appear subsequent to the development of the disease, but they may be the first presenting signs and in some cases they may precede the primary disease manifestation by many years. AIMS: The aim of our study was to study the spectrum of dermatoses in diabetics, to know the frequency of dermatoses specific to diabetes mellitus (DM), and to establish the mucocutaneous markers of DM. MATERIAL AND METHODS: The study was conducted at a diabetic clinic and our department between September 2008 and June 2010. Two hundred and twenty-four diabetic patients were included in the study group and those with gestational diabetes were excluded. Healthy age- and sex-matched individuals were taken as controls. RESULTS: The male to female ratio was 1 : 1.21. Type 2 DM was seen in 89.7% and type 1 DM in 10.3% of the patients. Dermatoses were seen in 88.3% of the diabetics compared to 36% in non-diabetic controls (P<0.05). Cutaneous infections were the most common dermatoses followed by acanthosis nigricans and xerosis in diabetics. Type 2 DM was found to have an increased risk of complications than type 1 DM. Complications of diabetes were seen in 43.7% of the diabetic cases. Diabetic dermopathy, loss of hair over the legs, diabetic foot ulcer, and so on, were found to be the cutaneous markers of DM in our group of cases. CONCLUSION: Dermatoses were more common in diabetics than non-diabetics. Cutaneous infections formed the largest group of dermatoses in DM.

A comparative study of the clinico-aetiological profile of hyponatremia at presentation with that developing in the hospital.

BACKGROUND & OBJECTIVES: Hyponatremia is a common problem encountered in patients presenting with nonspecific symptoms. We undertook this study to investigate the clinical profile of patients with hyponatremia, the precipitating factors, the response to therapy and to compare, using these parameters, hyponatremia at presentation to that developing in the hospital. METHODS: Seventy consecutive patients with serum sodium less than or equal to 125 mmol/l at presentation or at any time during hospital admission were identified and studied using a proforma. The severity of hyponatremia, therapy given and time taken for recovery were analysed. RESULTS: The mean age of patients was 48.1 ± 16.1 yr. The mean serum sodium was 117.8 ± 6.4 mmol/l. Confusion, headache and malaise were the most common symptoms, two patients had seizures, and 20.0 per cent patients showed no clinical manifestations. Nausea was significantly (P<0.05) more common in patients presenting with hyponatremia. 22 patients (31.4%) developed hyponatremia during their stay in the hospital. 3 patients (4.3%) presented with hyponatremia which got worse during the admission period. Most had multiple precipitating factors, decreased intake being the most common (82.9%), followed by increased losses (65.7%) and miscellaneous factors (70.0%). Drugs, fluid overload and inappropriate Ryle's tube feeds more commonly precipitated hyponatremia in in-hospital patients. Time taken for recovery showed negative correlation with the serum sodium. Patients with in-hospital hyponatremia took significantly longer time to recover (P<0.05). INTERPRETATION & CONCLUSIONS: Decreased intake was found to be the commonest cause of hyponatremia, thus, ensuring adequate oral intake, especially in patients on liquid diet and in manual labourers, and correction of hyponatremia as soon as an abnormality is detected is important.

Influence of CYP2C9 gene polymorphisms on response to glibenclamide in type 2 diabetes mellitus patients.

PURPOSE: The antidiabetic drug glibenclamide is metabolized by the enzyme cytochrome P450 2C9 (CYP2C9) encoded by the polymorphic gene CYP2C9. Previous studies involving healthy volunteers have shown a significant influence of variant CYP2C9 genotypes on glibenclamide metabolism. The aim of this study was to investigate the influence of genetic polymorphisms of CYP2C9 on the response to glibenclamide and on glibenclamide plasma levels in type 2 diabetes mellitus patients. METHODS: The study cohort consisted of type 2 diabetes mellitus patients (n = 80) on regular therapy with glibenclamide either alone or with concomitant metformin. Plasma levels of glibenclamide were estimated by reverse phase high pressure liquid chromatography. The variant alleles of CYP2C9, namely CYP2C9 *2 and *3, were identified by PCR-restricted fragment length polymorphism. The plasma levels of glibenclamide and occurrences of hypoglycemic adverse effects with their severity were compared between the genotype groups. RESULTS: Of the 80 patients (61 males, 19 females), 78 were on concomitant treatment with two drugs, namely, glibenclamide and metformin, and two were on monotherapy with glibenclamide. There was a significant association (p < 0.001) between genotype status of CYP2C9 and the control of diabetes in patients receiving treatment with glibenclamide. There were no statistically significant differences in hypoglycemic adverse effects between the genotype groups. CONCLUSION: The type 2 diabetes mellitus patients participating in this study with variant genotypes of CYP2C9 were found to respond better to treatment with glibenclamide than those with the normal genotype. The variant genotype CYP2C9 *1/*3 did not significantly influence the hypoglycemic adverse effects among those patients on long-term glibenclamide treatment.

Can protein carbonyl/glutathione ratio be used as a potential biomarker to assess oxidative stress in alcoholic hepatitis?

CONTEXT: Oxidative stress plays a crucial role in the pathogenesis of alcoholic liver disease (ALD). AIM: The present study was undertaken to evaluate the significance of protein carbonyl/glutathione ratio as a biomarker to assess the oxidative stress in alcoholic hepatitis. SETTINGS AND DESIGN: The study included 30 patients with alcoholic hepatitis and 30 age-sex- matched controls. Protein carbonyl (PCO) levels was estimated by modified levine's method, malondialdehyde (MDA) by thiobarbituric acid method, reduced glutathione (GSH) by dithiobis-2-nitrobenzoic acid method, total sialic acid (TSA) by modified aminoff's method, plasma transferases (GGT, AST, and ALT), total protein and albumin using commercial kits adapted to autoanalyzer respectively. STATISTICAL ANALYSIS USED: All data were expressed as mean ± SEM. Spearman's correlation analysis and receiver operating characteristic curve were performed using SPSS version 16 for Microsoft. A P value < 0.05 was considered as significant. RESULTS: Alcoholic hepatitis patients showed significantly higher levels of PCO, MDA, GGT, AST, AST/ALT, TSA, and significantly lower GSH, total protein and albumin levels. PCO/GSH ratio in these patients showed a significant positive correlation with GGT (r = 0.594, P = 0.000), AST/ALT (r = 0.443 P = 0.000), MDA (r = 0.727, P = 0.000), TSA (r = 0.729, P = 0.000), and a significant negative correlation with total protein (r = -0.683, P = 0.000) and albumin (r = -0.544, P = 0.000). ROC curve showed a cut off value of 2.735, indicating 100% sensitivity and 90% specificity of PCO/GSH at this value. CONCLUSIONS: Alcohol intake regularly for long duration leads to oxidative stress. We suggest that PCO/GSH ratio can be used as a potential biomarker to assess oxidative stress in alcoholic hepatitis.

Protein glycation, insulin sensitivity and pancreatic beta cell function in high-risk, non-diabetic, first degree relatives of patients with type 2 diabetes.

Insulin resistance and impaired beta cell function are widely recognized as features of type 2 diabetes. But it is still debated whether insulin resistance or beta cell dysfunction constitutes the primary abnormality. This study was done to evaluate the impact of family history of type 2 diabetes on insulin resistance, beta cell function and glycation of proteins. A total of 30 healthy subjects with a positive family history of type 2 diabetes and thirty two healthy age-matched subjects without any family history of type 2 diabetes were enrolled in this study. Fasting glucose, post prandial glucose, fasting plasma insulin, fructosamine and glycated hemoglobin were evaluated in both the study groups. The mean fasting glucose, fasting Insulin and HOMA-IR were significantly higher among the first-degree relatives of type 2 diabetics, but there was no alteration in HOMA-B. The levels of both glycated hemoglobin and fructosamine were significantly increased in the test group when compared with controls. In conclusion the results from the present study suggest that Indian subjects with family history of type 2 diabetes are associated with insulin resistance and enhanced glycation of proteins, but with no evidence of beta cell defect.

Association between protein-bound sialic acid and high-sensitivity C-reactive protein in essential hypertension: a possible indication of underlying cardiovascular risk.

The aim of this study was to examine the possible alteration in the levels of C-reactive protein, protein-bound sialic acid, and other lipid risk factors in newly diagnosed essential hypertensive subjects. In all, 56 hypertensive and 33 normotensive male subjects were enrolled in the study. Lipid profile, C-reactive protein, apolipoprotein-B, and protein-bound sialic acid were estimated in both the groups. Total cholesterol, triglyceride, low-density lipoprotein-cholesterol, C-reactive protein, apolipoprotein-B, and protein-bound sialic acid were significantly increased in patients with essential hypertension. Correlation analysis revealed a significant association between the protein-bound sialic acid with mean arterial pressure, C-reactive protein, and low-density lipoprotein-cholesterol. The findings of the present study suggest that in essential hypertension there is an association between protein-bound sialic acid and C-reactive protein, which reflects the clustering of cardiovascular risk factors in these patients.