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Published in: Journal of Diabetes & Metabolic Disorders 1/2013

Open Access 01-12-2013 | Research article

Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control

Authors: Mukesh G Gohel, Anusha N Chacko

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2013

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Abstract

Background

Diabetes is undoubtedly one of the most challenging health problems in 21st century. Understanding the pathogenesis and preventing long term complications have been major goals of research in diabetes mellitus (DM). Research in the past few years has linked oxidative stress and inflammation to beta cell dysfunction. Aim of this study is to evaluate serum gamma-glutamyl transferase (GGT) activity (marker of oxidative stress) and high sensitivity C reactive protein (hsCRP) level (an inflammatory marker) in type 2 DM subjects with good and poor glycemic control. Further, we investigated correlation between serum GGT and hsCRP level with glycemic control (FBS, PP2BS, HbA1c) in subjects.

Methods

A cross sectional study consists of 150 patients out of them 50 patients having type 2 DM with good control (Group II), 50 patients with type 2 DM with poor control (Group III) and 50 normal healthy control (Group I) were selected. Serum GGT, serum hsCRP, FBS, PP2BS, HbA1c, and other biochemical investigations include serum liver enzymes and lipids were measured.

Results

Mean serum GGT and hsCRP concentration were statistically significantly higher in group III patients compared to group I and group II subjects as well as increased in group II compared to group I (p < 0.001). Further significant positive correlation was observed between GGT and hsCRP concentration as well as both with HbA1c, FBS, and PP2BS.

Conclusions

Oxidative stress and inflammation appears to be a key component and also associated with poor glycemic control and further pathogenesis of diabetes and its complications. All our finding suggesting a link between oxidative stress, inflammation and glycemic control in patient with type 2 diabetes mellitus.
Appendix
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Literature
1.
go back to reference Alvin C: Powers: diabetes mellitus. In Harrison’s Principle of Internal Medicine. 16th edition. Edited by: et al, Kasper L. New York: McGraw-Hill; 2005:2152–2179. Alvin C: Powers: diabetes mellitus. In Harrison’s Principle of Internal Medicine. 16th edition. Edited by: et al, Kasper L. New York: McGraw-Hill; 2005:2152–2179.
2.
go back to reference Thakur S, Chauhan V, Negi RC: Role of HbA1C in diabetes mellitus. J Indian Acad Clin Med 2009,10(1&2):52–54. Thakur S, Chauhan V, Negi RC: Role of HbA1C in diabetes mellitus. J Indian Acad Clin Med 2009,10(1&2):52–54.
3.
go back to reference Ford ES: The metabolic syndrome and C-reactive protein, fibrinogen and leucocyte count: findings from the third national health and nutrition examination survey. Atherosclerosis 2003, 168: 351–358. 10.1016/S0021-9150(03)00134-5CrossRefPubMed Ford ES: The metabolic syndrome and C-reactive protein, fibrinogen and leucocyte count: findings from the third national health and nutrition examination survey. Atherosclerosis 2003, 168: 351–358. 10.1016/S0021-9150(03)00134-5CrossRefPubMed
4.
go back to reference Emdin M, Pompella A, Paolicchi A: Gammaglutamyltransferase, atherosclerosis, and cardiovascular disease: triggering oxidative stress within the plaque. Circulation 2005, 112: 2078–2080. 10.1161/CIRCULATIONAHA.105.571919CrossRefPubMed Emdin M, Pompella A, Paolicchi A: Gammaglutamyltransferase, atherosclerosis, and cardiovascular disease: triggering oxidative stress within the plaque. Circulation 2005, 112: 2078–2080. 10.1161/CIRCULATIONAHA.105.571919CrossRefPubMed
5.
go back to reference Karp DR, Shimooku K, Lipsky PE: Expression of gamma-glutamyl transpeptidase protects ramos B cells from oxidation-induced cell death. J Biol Chem 2001, 276: 3798–3804. 10.1074/jbc.M008484200CrossRefPubMed Karp DR, Shimooku K, Lipsky PE: Expression of gamma-glutamyl transpeptidase protects ramos B cells from oxidation-induced cell death. J Biol Chem 2001, 276: 3798–3804. 10.1074/jbc.M008484200CrossRefPubMed
6.
go back to reference Droge W: Free radicals in the physiological control of cell function. Physiol Rev 2002, 82: 47–95.CrossRefPubMed Droge W: Free radicals in the physiological control of cell function. Physiol Rev 2002, 82: 47–95.CrossRefPubMed
7.
go back to reference Rosen P, Nawroth PP, King G, Moller W, Tritschler HJ, Packer L: The role of oxidative stress in the onset and progression of diabetes and its complications: a summary of a congress series sponsored by UNESCO-MCBN, the American diabetes association and the German diabetes society. Diabetes Metabolic Research Rev 2001, 17: 189–212. 10.1002/dmrr.196CrossRef Rosen P, Nawroth PP, King G, Moller W, Tritschler HJ, Packer L: The role of oxidative stress in the onset and progression of diabetes and its complications: a summary of a congress series sponsored by UNESCO-MCBN, the American diabetes association and the German diabetes society. Diabetes Metabolic Research Rev 2001, 17: 189–212. 10.1002/dmrr.196CrossRef
8.
go back to reference Marchesini G, Brizi M, Bianchi G: Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001, 50: 1844–50. 10.2337/diabetes.50.8.1844CrossRefPubMed Marchesini G, Brizi M, Bianchi G: Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001, 50: 1844–50. 10.2337/diabetes.50.8.1844CrossRefPubMed
9.
go back to reference Lee DH, Ha MH, Kim JH: Gamma-glutamyltransferase and diabetes: a 4 year follow-up study. Diabetologia 2003, 46: 359–364.CrossRefPubMed Lee DH, Ha MH, Kim JH: Gamma-glutamyltransferase and diabetes: a 4 year follow-up study. Diabetologia 2003, 46: 359–364.CrossRefPubMed
10.
go back to reference Pfützner A, Forst T: High-sensitivity C-reactive protein as cardio-vascular risk marker in patients with diabetes mellitus. Diabetes Technol Ther 2006,8(1):28–36. 10.1089/dia.2006.8.28CrossRefPubMed Pfützner A, Forst T: High-sensitivity C-reactive protein as cardio-vascular risk marker in patients with diabetes mellitus. Diabetes Technol Ther 2006,8(1):28–36. 10.1089/dia.2006.8.28CrossRefPubMed
11.
go back to reference Amanullah S, Jarari A, Govindan M: Mohamed Ismail Basha and Saira khatheeja: association of hsCRP with diabetic and non-diabetic individuals. Jordan J Biol Sci 2010,3(1):7–12. Amanullah S, Jarari A, Govindan M: Mohamed Ismail Basha and Saira khatheeja: association of hsCRP with diabetic and non-diabetic individuals. Jordan J Biol Sci 2010,3(1):7–12.
12.
go back to reference Steven M: Haffner: the metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiology 2006, 97: 3A-11A.CrossRef Steven M: Haffner: the metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiology 2006, 97: 3A-11A.CrossRef
13.
go back to reference Chitturi S, Abeygunasekera S, Farrell GC, et al.: NASH and insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome. Hepatology 2002, 35: 373–379. 10.1053/jhep.2002.30692CrossRefPubMed Chitturi S, Abeygunasekera S, Farrell GC, et al.: NASH and insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome. Hepatology 2002, 35: 373–379. 10.1053/jhep.2002.30692CrossRefPubMed
14.
go back to reference Ikeda Y, Fujii J, Taniguchi N, Meister A: Expression of an active glycosylated human gamma-glutamyl transpeptidase mutant that lacks a membrane anchor domain. Proc Natl Acad Sci USA 1995, 92: 126–130. 10.1073/pnas.92.1.126CrossRefPubMedPubMedCentral Ikeda Y, Fujii J, Taniguchi N, Meister A: Expression of an active glycosylated human gamma-glutamyl transpeptidase mutant that lacks a membrane anchor domain. Proc Natl Acad Sci USA 1995, 92: 126–130. 10.1073/pnas.92.1.126CrossRefPubMedPubMedCentral
15.
go back to reference Moussa SA: Oxidative stress in diabetes mellitus. Rom J Biophys 2008,18(3):225–236. Moussa SA: Oxidative stress in diabetes mellitus. Rom J Biophys 2008,18(3):225–236.
16.
go back to reference Thorand B, Loewel H, Schneider A: C-reactive protein as a predictor for incident diabetes mellitus among middle-aged men: results from the MONICA augsburg cohort study, 1984–1998. Arch Intern Med 2003, 163: 93–9.20. 10.1001/archinte.163.1.93CrossRefPubMed Thorand B, Loewel H, Schneider A: C-reactive protein as a predictor for incident diabetes mellitus among middle-aged men: results from the MONICA augsburg cohort study, 1984–1998. Arch Intern Med 2003, 163: 93–9.20. 10.1001/archinte.163.1.93CrossRefPubMed
17.
go back to reference Targher G, Seidell JC, Tonoli M, Muggeo M, De Sandre G, Cigolini M: The white blood cell count: its relationship to plasma insulin and other cardiovascular risk factors in healthy male individuals. J Intern Med 1996, 239: 435–441. 10.1046/j.1365-2796.1996.815000.xCrossRefPubMed Targher G, Seidell JC, Tonoli M, Muggeo M, De Sandre G, Cigolini M: The white blood cell count: its relationship to plasma insulin and other cardiovascular risk factors in healthy male individuals. J Intern Med 1996, 239: 435–441. 10.1046/j.1365-2796.1996.815000.xCrossRefPubMed
18.
go back to reference Facchini F, Hollenbeck CB, Chen YN, Chen YD, Reaven GM: Demonstration of a relationship between white blood cell count, insulin resistance, and several risk factors for coronary heart disease in women. J Intern Med 1992, 232: 267–272. 10.1111/j.1365-2796.1992.tb00582.xCrossRefPubMed Facchini F, Hollenbeck CB, Chen YN, Chen YD, Reaven GM: Demonstration of a relationship between white blood cell count, insulin resistance, and several risk factors for coronary heart disease in women. J Intern Med 1992, 232: 267–272. 10.1111/j.1365-2796.1992.tb00582.xCrossRefPubMed
19.
go back to reference Sharma R, Sharma S, Kaushik GG: Gamma-glutamyltransferase (GGT) – a novel marker of endothelial dysfunction. JIACM 2010,11(1):26–30. Sharma R, Sharma S, Kaushik GG: Gamma-glutamyltransferase (GGT) – a novel marker of endothelial dysfunction. JIACM 2010,11(1):26–30.
20.
go back to reference Dilshad Ahmed K, Shazia Q: Evaluation of cardiac risk by oxidative stress and inflammatory markers in diabetic patients. Pak J Med Sci 2009, 25: 5. Dilshad Ahmed K, Shazia Q: Evaluation of cardiac risk by oxidative stress and inflammatory markers in diabetic patients. Pak J Med Sci 2009, 25: 5.
21.
go back to reference Sarinnapakorn V, Wanicagool W: Association between hs-CRP and Hba1c in overweight type 2 diabetic female patients. J Med Assoc Thai 2013,96(3):S54–58.PubMed Sarinnapakorn V, Wanicagool W: Association between hs-CRP and Hba1c in overweight type 2 diabetic female patients. J Med Assoc Thai 2013,96(3):S54–58.PubMed
22.
go back to reference Bahceci M, Tuzcu A, Ogun C, Canoruc N, Iltimur K, Aslan C: Is serum C-reactive protein concentration correlated with HbA1c and insulin resistance in Type 2 diabetic men with or without coronary heart disease. J Endocrinol Invest 2005,28(2):145–150.CrossRefPubMed Bahceci M, Tuzcu A, Ogun C, Canoruc N, Iltimur K, Aslan C: Is serum C-reactive protein concentration correlated with HbA1c and insulin resistance in Type 2 diabetic men with or without coronary heart disease. J Endocrinol Invest 2005,28(2):145–150.CrossRefPubMed
23.
go back to reference Thamer C, Tschritter O, Haap M, et al.: Elevated serum GGT concentrations predict reduced insulin sensitivity and increased intra-hepatic lipids. Horm Metab Res 2005, 37: 246–251. 10.1055/s-2005-861411CrossRefPubMed Thamer C, Tschritter O, Haap M, et al.: Elevated serum GGT concentrations predict reduced insulin sensitivity and increased intra-hepatic lipids. Horm Metab Res 2005, 37: 246–251. 10.1055/s-2005-861411CrossRefPubMed
24.
go back to reference Andre P, Balkau B, Born C, Charles MA, Eschwege E: Three-year increase of gamma-glutamyltransferase level and development of type 2 diabetes in middle-aged men and women: the D.E.S.I.R. cohort. Diabetologia 2006, 49: 2599–2603. 10.1007/s00125-006-0418-xCrossRefPubMedPubMedCentral Andre P, Balkau B, Born C, Charles MA, Eschwege E: Three-year increase of gamma-glutamyltransferase level and development of type 2 diabetes in middle-aged men and women: the D.E.S.I.R. cohort. Diabetologia 2006, 49: 2599–2603. 10.1007/s00125-006-0418-xCrossRefPubMedPubMedCentral
25.
go back to reference Marchesini G, Avagnina S, Barantani EG, Ciccarone AM, Corica F, Dall’Aglio E, Dalle Grave R, Morpurgo PS, Tomasi F, Vitacolonna E: Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest 2005, 28: 333–339.CrossRefPubMed Marchesini G, Avagnina S, Barantani EG, Ciccarone AM, Corica F, Dall’Aglio E, Dalle Grave R, Morpurgo PS, Tomasi F, Vitacolonna E: Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest 2005, 28: 333–339.CrossRefPubMed
26.
go back to reference Lee DH, Silventoinen K, Jacobs DR Jr, Jousilahti P, Tuomileto J: Gamma-glutamyltransferase, obesity, and the risk of type 2 diabetes: observational cohort study among 20,158 middle-aged men and women. J Clin Endocrinol Metab 2004, 89: 5410–5414. 10.1210/jc.2004-0505CrossRefPubMed Lee DH, Silventoinen K, Jacobs DR Jr, Jousilahti P, Tuomileto J: Gamma-glutamyltransferase, obesity, and the risk of type 2 diabetes: observational cohort study among 20,158 middle-aged men and women. J Clin Endocrinol Metab 2004, 89: 5410–5414. 10.1210/jc.2004-0505CrossRefPubMed
27.
go back to reference Malnick SD, Beergabel M, Knobler H: Non-alcoholic fatty liver: a common manifestation of a metabolic disorder. QJM 2003, 96: 699–709. 10.1093/qjmed/hcg120CrossRefPubMed Malnick SD, Beergabel M, Knobler H: Non-alcoholic fatty liver: a common manifestation of a metabolic disorder. QJM 2003, 96: 699–709. 10.1093/qjmed/hcg120CrossRefPubMed
28.
go back to reference Targher G: Nonalcoholic fatty liver disease, the metabolic syndrome and the risk of cardiovascular disease: the plot thickens. Diabet Med 2007, 24: 1–6.CrossRefPubMed Targher G: Nonalcoholic fatty liver disease, the metabolic syndrome and the risk of cardiovascular disease: the plot thickens. Diabet Med 2007, 24: 1–6.CrossRefPubMed
29.
go back to reference Lee DH, Blomhoff R, Jacobs DR Jr: Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res 2004, 38: 535–539. 10.1080/10715760410001694026CrossRefPubMed Lee DH, Blomhoff R, Jacobs DR Jr: Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res 2004, 38: 535–539. 10.1080/10715760410001694026CrossRefPubMed
30.
go back to reference Paolicchi A, Emdin M, Ghliozeni E, et al.: Images in cardiovascular medicine: human atherosclerotic plaques contain gamma-glutamyl transpeptidase enzyme activity. Circulation 2004, 109: 1440. 10.1161/01.CIR.0000120558.41356.E6CrossRefPubMed Paolicchi A, Emdin M, Ghliozeni E, et al.: Images in cardiovascular medicine: human atherosclerotic plaques contain gamma-glutamyl transpeptidase enzyme activity. Circulation 2004, 109: 1440. 10.1161/01.CIR.0000120558.41356.E6CrossRefPubMed
31.
go back to reference Emdin M, Passino C, Pompella A, Paolicchi A: Gamma-glutamyltransferase as a cardiovascular risk factor. Eur Heart J 2006, 27: 2145–2146. 10.1093/eurheartj/ehl151CrossRefPubMed Emdin M, Passino C, Pompella A, Paolicchi A: Gamma-glutamyltransferase as a cardiovascular risk factor. Eur Heart J 2006, 27: 2145–2146. 10.1093/eurheartj/ehl151CrossRefPubMed
32.
go back to reference Hanley AJ, Williams K, Festa A, et al.: Liver markers and development of the metabolic syndrome. The insulin resistance atherosclerosis study. Diabetes 2005, 54: 3140–3147. 10.2337/diabetes.54.11.3140CrossRefPubMed Hanley AJ, Williams K, Festa A, et al.: Liver markers and development of the metabolic syndrome. The insulin resistance atherosclerosis study. Diabetes 2005, 54: 3140–3147. 10.2337/diabetes.54.11.3140CrossRefPubMed
33.
go back to reference Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R: Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005, 111: 1448–1454. 10.1161/01.CIR.0000158483.13093.9DCrossRefPubMed Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R: Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005, 111: 1448–1454. 10.1161/01.CIR.0000158483.13093.9DCrossRefPubMed
34.
go back to reference Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, Steffes M: Gammaglutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Clin Chem 2003, 49: 1358–1366. 10.1373/49.8.1358CrossRefPubMed Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, Steffes M: Gammaglutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Clin Chem 2003, 49: 1358–1366. 10.1373/49.8.1358CrossRefPubMed
35.
go back to reference Nannipieri M, Gonzales C, Baldi S, et al.: Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care 2005, 28: 1757–1762. 10.2337/diacare.28.7.1757CrossRefPubMed Nannipieri M, Gonzales C, Baldi S, et al.: Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care 2005, 28: 1757–1762. 10.2337/diacare.28.7.1757CrossRefPubMed
36.
go back to reference Targher G, Bertolini L, Poli F, et al.: Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients. Diabetes 2005, 54: 3541–3546. 10.2337/diabetes.54.12.3541CrossRefPubMed Targher G, Bertolini L, Poli F, et al.: Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients. Diabetes 2005, 54: 3541–3546. 10.2337/diabetes.54.12.3541CrossRefPubMed
37.
go back to reference Hotamisligil GS: Inflammatory pathways and insulin action. Int J Obes Relat Metab Disord 2003,27(3):S53-S55.CrossRefPubMed Hotamisligil GS: Inflammatory pathways and insulin action. Int J Obes Relat Metab Disord 2003,27(3):S53-S55.CrossRefPubMed
38.
go back to reference Hsueh WA, Quinones MJ: Role of endothelial dysfunction in insulin resistance. Am J Cardiol 2003, 92: 10J-17J.CrossRefPubMed Hsueh WA, Quinones MJ: Role of endothelial dysfunction in insulin resistance. Am J Cardiol 2003, 92: 10J-17J.CrossRefPubMed
39.
go back to reference Van Oostrom AJ, Sijmonsma TP, Verseyden C, Jansen EH, de Koning EJ, Rabelink TJ, Castro Cabezas M: Postprandial recruitment of neutrophils may contribute to endothelial dysfunction. J Lipid Res 2003, 44: 576–583. 10.1194/jlr.M200419-JLR200CrossRefPubMed Van Oostrom AJ, Sijmonsma TP, Verseyden C, Jansen EH, de Koning EJ, Rabelink TJ, Castro Cabezas M: Postprandial recruitment of neutrophils may contribute to endothelial dysfunction. J Lipid Res 2003, 44: 576–583. 10.1194/jlr.M200419-JLR200CrossRefPubMed
Metadata
Title
Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control
Authors
Mukesh G Gohel
Anusha N Chacko
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Diabetes & Metabolic Disorders / Issue 1/2013
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1186/2251-6581-12-56

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