Urinary hypoxanthine and xanthine levels in type 2 diabetes mellitus
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Tarih
2004
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info:eu-repo/semantics/openAccess
Özet
Amaç: Diabetes mellitus damar komplikasyonları nedeni ile önemli bir morbidite ve mortalite nedenidir. Mikrovasküler komplikasyonların yanı sıra, özellikle tip 2 diabetes mellituslu (NIDDM) hastalarda, makrovasküler komplikasyonar da ön plana geçmektedir. Hiperglisemiye bağlı psödoiskemi ve oksidatif stresin vasküler alandaki patolojilerin patogenezinde rol oynadığı düşünülmektedir. İskemik durumlarda gözlenen bozulmuş ATP metabolizması pürin yıkılım ürünlerinde, hipoksantin ve ksantin, artışa neden olmaktadır. Gereç ve Yöntemler: Bu çalışmada hipoksantin ve ksantin düzeylerinin tip 2 diabetes mellituslu hastalarda izlenen nefropati ile ilişkisi incelenmiştir. Bu amaç için 40 tip 2 diabetes mellituslu hasta (29 normoalbuminürili ve 11 mikroalbuminürili) ve 30 sağlıklı kontrol çalışmaya dahil edilmiştir. Serum kreatinin, üre, ürik asit ve idrar kreatinin, ürik asit, mikroalbumin düzeyleri belirlenmiştir. İdrar hipoksantin ve ksantin düzeyleri UV deteksiyon ile HPLC cihazında ölçülmüştür. Bulgular: Tip 2 diabetes mellituslu hasta grubunda idrar ksantin ve hipoksantin atılımı sağlıklı gruba göre istatistiksel olarak anlamlı yüksek bulunmuştur. İdrar hipoksantin ve ksantin düzeyleri miroalbuminürili ve normoalbuminürili hastalar arasında anlamlı fark göstermemiştir. Sonuç: Tip 2 diabetes mellitusta, hiperglisemiye bağlı ortaya çıkan psödoiskemi ATP metabolizmasını bozarak pürin metabolizmasında artışa yol açmaktadır. Artmış idrar ksantin ve hipoksantin düzeyleri tip 2 diabetes mellitus hastalarında yüksek seyretmektedir.
Objective: Complications of the vascular tree are the leading causes of morbidity and mortality in patients with diabetes mellitus. Besides the well-recognized microvascular complications of diabetes, there is as well a growing epidemic of macrovascular complications, particularly in the type 2 diabetic population. Hyperglycemia-induced pseudo-ischemia and oxidative stress are suggested to play a role in the patho-mechanism of vascular damage. The impaired ATP metabolism observed in ischemic conditions results in increased production of the purine degradation products, hypoxanthine and xanthine. The aim of this study was to investigate the relevance of hypoxanthine and xanthine levels to microvascular complications observed in type 2 diabetic patients. Material and Methods: The study included 40 patients with type 2 diabetes mellitus (29 patients were microalbuminuric and 11 were normoalbuminuric) and 30 sex-matched controls. Serum creatinine, urea, uric acid and urine creatinine, uric acid and microalbumin levels were determined. Urinary excretion of hypoxanthine and xanthine was assessed by HPLC with UV detection. Results: Urinary xanthine and hypoxanthine excretions were significantly increased in the patients when compared with healthy controls (p< 0.05). However, no significant difference was observed between the normoalbuminurics and microalbuminurics. Conclusion: As a consequence of hyperglycemia-induced pseudo-hypoxia, in type 2 diabetes mellitus, ATP metabolism deteriorates and an increase in purine metabolism is observed. Urinary xanthine and hypoxanthine levels are increased in diabetic patients.
Objective: Complications of the vascular tree are the leading causes of morbidity and mortality in patients with diabetes mellitus. Besides the well-recognized microvascular complications of diabetes, there is as well a growing epidemic of macrovascular complications, particularly in the type 2 diabetic population. Hyperglycemia-induced pseudo-ischemia and oxidative stress are suggested to play a role in the patho-mechanism of vascular damage. The impaired ATP metabolism observed in ischemic conditions results in increased production of the purine degradation products, hypoxanthine and xanthine. The aim of this study was to investigate the relevance of hypoxanthine and xanthine levels to microvascular complications observed in type 2 diabetic patients. Material and Methods: The study included 40 patients with type 2 diabetes mellitus (29 patients were microalbuminuric and 11 were normoalbuminuric) and 30 sex-matched controls. Serum creatinine, urea, uric acid and urine creatinine, uric acid and microalbumin levels were determined. Urinary excretion of hypoxanthine and xanthine was assessed by HPLC with UV detection. Results: Urinary xanthine and hypoxanthine excretions were significantly increased in the patients when compared with healthy controls (p< 0.05). However, no significant difference was observed between the normoalbuminurics and microalbuminurics. Conclusion: As a consequence of hyperglycemia-induced pseudo-hypoxia, in type 2 diabetes mellitus, ATP metabolism deteriorates and an increase in purine metabolism is observed. Urinary xanthine and hypoxanthine levels are increased in diabetic patients.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
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Türkiye Klinikleri Tıp Bilimleri Dergisi
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Cilt
24
Sayı
6
