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- May 11, 2008 |
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"The Influence of Meal and Increment of Postprandial Glycaemia on Superoxide Production by Polymorphonuclear Neutrophils in Patients with Metabolic Syndrome"Dr. Dorota Zozulinska (biography)
English - 2005-04-15 - 21 minutes
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Summary :
Inflammatory process plays a crucial role in the development of late diabetic complications and is associated with disturbances between endothelial and inflammatory cells. The peripheral polymorphonuclear neutrophils (PMNs) are one of the main inflammatory cells and seem to significantly influence the damage of endothelium. Mechanisms of injurious effect of activated neutrophils on endothelium was shown to be related to release of large amounts of reactive oxygen species (ROS) and proteolytic enzymes. Additionally, increased neutrophil aggregation and adherence to endothelium were shown to result in leukoembolisation and capillary plugging with subsequent impairment of blood flow and tissue ischemia.
In diabetic patients, we have previously shown an increased activity of peripheral circulating PMN and simultaneously their worse response to stimuli.
Recently, a lot of articles have focused on the role of postprandial state in the development of vascular diabetic complications. Coagulation activation, excessive glycation of proteins and lipids, activation of the protein kinase C (PKC) system, oxidative stress and endothelial dysfunction accompany the postprandial state in diabetes. These changes are induced not only by excursions of plasma glucose, but also plasma triglycerides and other nutrients. The experimental, clinical and epidemiological data have demonstrated that postprandial hyperglycaemia may have a significant relation to the development of diabetic micro- and macroangiopathy, mainly in type 2 diabetes.
The aim of this study was to evaluate the influence of meal and increment of postprandial glycaemia on reactive oxygen species production by PMNs in subjects with metabolic syndrome.
The study was performed in 25 obese type 2 diabetic patients (18 women and 7 men, aged 61.7+10.5 years, diagnosed for diabetes 16.0+7.5 years, BMI 34.8+6.4 kg/m2, HbA1c 8.4+0.93 %, FPG 8.7+2.8 mmol/l, 2hPPG 12.6+4.4 mmol/l, total cholesterol 6.2+1.0 mmol/l, LDL 3.7+1.0 mmol/l, triglyceride 3.1+1.9 mmol/l, HOMA-IR 12.95). PMNs were isolated from the blood by single-step gradient centrifugation. The superoxide anion (O2-) production by PMNs was measured spectrophotometrically by cytochrom C reduction and hydrogen peroxide (H2O2) was measured spectrophotometrically by phenyl red oxidation acc. to Pick et al. We did not notice any significant changes in O2- and H2O2 production by PMNs after meal. However, we observed significant correlation between increment of glycaemia and O2- production (r=0.52, p<0.05) and H2O2 production by PMNs (r=0.43, p<0.05). The obtained results suggest that in obese Type 2 diabetic patients the increment of postprandial glycaemia, and not directly the meal itself stimulates reactive oxygen species production by PMNs. It might play an important role in the development of late vascular complications and thus have clinical implications.
Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The role of inflammatory processes in the development on metabolic syndrome and diabetes;
• The influence of meal and increment of postprandial glycemia on reactive oxygen species production.
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