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Diyabetik Nefropati, Retinopati ve Nöropatili Hastalarda Oksidatif Stres ve Serum Prolidaz Aktivitesi İlişkisi

Yıl 2023, Cilt: 18 Sayı: 1, 93 - 101, 16.03.2023
https://doi.org/10.17517/ksutfd.1079948

Öz

Amaç: Diyabetin mikrovasküler komplikasyonlarında oksidatif stresin belirteçlerini incelemek, prolidazın oksidatif stres göstergeleriyle ilişkisini incelemek, prolidazın prediktif değer olarak kullanılabilirliğini araştırmaktır.
Gereç ve Yöntemler: Çalışmaya 112 tip 2 Diyabetes Mellitusu (DM) olan hasta ve 44 sağlıklı kontrol birey alındı. Hastaların ayrıntılı anamnezleri alınıp fizik muayeneleri yapıldı. Açlık plazma glukozu (APG), hemoglobin A1c (HbA1C), kreatinin, spot idrarda mikrototal protein düzeyleri bakıldı. Göz dibi muayenesi ile diyabetik retinopati varlığı araştırıldı. Nöropati varlığı açısından nörolojik muayeneleri yapıldı. Ayrıca tüm hastaların sabah alınan kan örneğinde oksidatif stress için katalaz (CAT), superoksit dismutaz (SOD), glutatyon peroksidaz (GPx), malondialdehit (MDA), nitrik oksit (NO), serum prolidaz aktivitesi ölçümü yapıldı.
Bulgular: Tip 2 DM olan hastaların 80’inde (%71.42) komplikasyon mevcut iken 41’inde (%28.58) komplikasyon yoktu. Açlık plazma glukozu diyabetik komplikasyonu olan grupta diğer gruplara anlamlı olarak yüksekti (p<0.001). HbA1c düzeyi diyabetik komplikasyonu olan grupta diğer gruplara anlamlı olarak yüksekti (p<0.001). Antioksidan stres belirteçleri (CAT, SOD, GPx) diyabetik komplikasyonlu grupta diğer gruplara göre daha düşük olarak saptanırken oksidatif stres belirteçleri (MDA, NO) komplikasyonlu grupta diğer gruplara göre daha yüksek olarak saptandı (p sırasıyla p<0.001, p<0.001). Prolidaz düzeyi diyabetik komplikasyonlu grupta diğer gruplara göre daha yüksek olarak saptandı (p<0.001).
Sonuç: Çalışmamızda serum prolidaz aktivitesinin ve oksidatif stres parametrelerinin, komplikasyonu olan diyabetik hastalarda, sağlıklı kontrol ve diyabetes mellituslu olup komplikasyonu olmayan gruba göre istatistiksel olarak anlamlı arttığı ve prolidaz ile oksidatif stres belirteçleri arasında pozitif korelasyon olduğu bulunması nedeniyle prolidaz aktivitesinin diyabetik hastalarda mikrokomplikasyonları belirlemede prediktif değeri olacağını düşünmekteyiz.

Destekleyen Kurum

Destekleyen kurum mevccut değil

Teşekkür

Asistan tezi olarak sunulmuştur

Kaynakça

  • Satman I, Yilmaz T, Sengul A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and riskcharacteristics in Turkey: results of the Turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25:1551-1556.
  • Sies H. Oxidative stress: from basic research to clinical application. Am. J. Med. 1991;91:31-38
  • Pham-huy LA, He H, Pham-huy C. Free radicals, antioksidants in disease and health. Int J Bıomed Sci. 2008;4(2):89-96.
  • Hardenbergh PH, Munley MT, Bentel GC. Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin: preliminary results. Int J Rad Oncol Biol Phys. 2001;49:1023-1028.
  • Huang Y, Mironova M, M.F. Lopes-Virella M.F. Oxidized LDL stimulates matrix metalloproteinase-1 expression in human vascular endothelial cells. Arterioscler Thromb Vasc Biol. 1999;19(11):2640-2647.
  • Eren MA, Torun AN, Tabur S, Ulas T, Demir M, Sabuncu T, et al. Serum prolidase activity in diabetic foot ulcers. Acta Diabetol. 2013;50:423-427.
  • Altindag O, Erel O, Aksoy N, Selek S, Celik H, Karaoglanoglu M. Increased oxidative stress and its relation with collagen metabolism in knee osteoarthritis. Rheumatol Int. 2007;27:339–344.
  • Uzar E, Tamam Y, Evliyaoglu O, Tuzcu A, Beyaz C, Acar A, et al. Serum prolidase activity and oxidative status in patients with diabetic neuropathy. Neurol Sci. 2012;32:875–880.
  • Zanaboni G, Dyne KM, Rossi A. Prolidase deficiency: biochemical study of erythrocyte and skin fibroblast prolidase activity in Italian patients. Haematologica. 1994;79:13-18.
  • Hui KS, Lajtha A. Prolidase activity in brain: Comparison with other organs. J Neurochem. 1978;30:321–327.
  • McRae PA, Porter BE. The perineuronal net component of the extracellular matrix in plasticity and epilepsy. Neurochem Int. 2012;61:963-972.
  • Levidiotis V, PowerDA. New insights into the molecular biology of the glomerular filtration barrier and associated disease. Nephrology (Carlton). 2005;10(2):157–166.
  • Brosset B, Myara I, Fabre M, Lemonnier A. Plasma prolidase and prolinase activity in alcoholic liver disease. Clin Chim Acta. 1988;175:291–295.
  • Myara I, Marcon P, Lemonnier A, Chatelier B, Mangeot M. Determination of prolinase activity in plasma. Clin. Biochem. 1985;18:220–223.
  • Demirbag R, Yildiz A, Gur M, Yilmaz R, Elci K, Aksoy N. Serum prolidase activity in patients with hypertension and its relation with left ventricular hypertrophy. Clin. Biochem. 2007;40:1020–1025.
  • Erbagci AB, Araz M, Erbagci A, Tarakcioglu M, Namiduru ES. Serum prolidase activity as a marker of osteoporosis in type 2 diabetes mellitus. Clin Biochem. 2002;35:263–268.
  • Evrenkaya TR, Atasoyu EM, Kara M, Unver S, Gultepe M. The role of prolidase activity in the diagnosis of uremic bone disease. Ren Fail. 2006;28:271–274.
  • Verma AK, Chandra S, Singh RG, Singh TB, Srivastava S, Srivastava R. Serum prolidase activity and oxidative stress in diabetic nephropathy and end stage renal disease: a correlative study with glucose and creatinine. Biochem Res Int. 2014;2014:291458.
  • Sayın R, Aslan M, Kucukoglu ME, Luleci A, Atmaca M, Esen R et al. Serum prolidase enzyme activity and oxidative stress levels in patients with diabetic neuropathy. Endocrine. 2014;47:146-151.
  • Myara I, Charpentier C, Lemonnier A. Optimal conditions for prolidase assay by proline colorimetric determination: Application to imminodipeptiduria. Clin Chim Acta. 1982;125:193–205.
  • Iijima T, Suzuki S, Sekizuka K. Follow-up study on urinary type IV collagen in patients with early stage diabetic nephropathy. J Clin Lab Anal. 1998;12(6):378–382.
  • Yagame M, Suzuki D, Jinde K. Significance of urinary type IV collagen in patients with diabetic nephropathy using a highly sensitive one-step sandwich enzyme immunoassay. J Clin Lab Anal. 1997;11(2):110–116.
  • Xu X, Wu Z, Zhou Q. The role of determining the levels of serum kollagen type IV in diagnosing early diabetic nephropathy. Ren Fail. 2002;24:747-753.
  • Matsumoto E, Matsumoto G, Bessho H, Kikuoka H, Nanjo K. Serum concentrations of intact type IV collagen in diabetics. J Diabetic Complication. 1991;5:189-190.
  • Hayashi Y, Makino H, Shikata K, Haramoto T, Yamasaki Y, Kumagai I, et al. Increased concentrations of the basement membrane component type IV collagen in sera and urine pf diabetics. J Diabetic Complication. 1991;5:195-196.
  • Hayashi Y, Makino H, Ota Z. Serum and urinary concentrations of type IV collagen and laminin as a marker of microangiopathy in diabetes. Diabetic Med 1992;9:366-370.
  • Tomono S, Kawazu S, Kato N, Ohno T, Utsugi T, Murata K. Clinical implications of serum levels of basement membrane components in diabetic patients with and without albuminuria. J Diabetic Complication. 1991;5:193-194.
  • Okazaki R, Matsuoka K, Atsumi Y, Maruyama K, Matsuki H, Okazaki I. Serum concentrations of basement membrane proteins in NIDDM as a prognostic marker for nephropathy. Diabetic Res Clin Pract. 1995;27: 39-49.
  • Ishimura E, Nishizawa Y, Shoji S, Mori H. Serum type III, IV collagens and timp in patients with type II diabetes mellitus. Life Sci. 1996;58:1331-133.
  • Ellis D. Forrest K. Erbey J. & Orchard T.J. Urinary measurement of transforming growth factor-b and type IV collagen as new markers of renal injury: application in diabeticnephropathy. Clinical Chemistry. 1998;44,5:950–956.
  • Sabuncu T, Boduroglu O, Eren MA, Torun AN, Aksoy N. The Value of Serum Prolidase Activity in Progression of Microalbuminuria in Patients With Type 2 Diabetes Mellitus. J Clin Lab Anal. 2016;30(5):557-562.
  • Way JM, Kaul K, Chopra M, Kohner EM, Chibber R. Pathophysiology of diabetic retinopathy. ISRN Ophthalmol. 2013;2013:343560.
  • Wayner DD, Burton GW, Ingold KU, Barclay LR, Locke S.J. The relative contributions of vitamin E, urate, ascorbate and proteins to the total peroxyl radical-trapping antioxidant activity of human blood plasma. Biochim. Biophys Acta. 1987;924:408–419.
  • Verma AK, Chandra S, Singh RG, Singh TB, Srivastava S, Srivastava R. Serum prolidase activity and oxidative stress in diabetic nephropathy and end stage renal disease: a correlative study with glucose and creatinine. Biochem Res Int. 2014;2014:291458.
  • Shah S, Iqbal M, Karam J, Salifu M, McFarlane SI. Oxidative stress, glucose metabolism, and the prevention of type 2 diabetes: pathophysiological insights. Antioxidants and Redox Signaling. 2007;9:911–929.
  • Robertson RP, Harmon JS. Diabetes, glucose toxicity, and oxidative stress: a case of double jeopardy for the pancreaticislet 𝛽 cell,Free Radical Biology and Medicine 2006;41(2):177–184.
  • Susztack K, Raff AC, Schiffer M, Böttinger EP. Glucose induced reactive oxygen species cause apoptosis of podocytes and podocyte depletion at the onset of diabetic nephropathy. Diabetes. 2006;55(1):225–233.
  • Monnier L, Mas E, Ginet C. Activation of oxidative stressby acute glucose fluctuations compared with sustained chronichyperglycemia in patients with type 2 diabetes, Journal of theAmerican Medical Association. 2006;295:1681–1687.
  • Surazynski A, LiuY, Miltyk W, Phang JM. Nitric oxide regulates prolidase activity by serine/threonine phosphorylation. J. Cell. Biochem. 2005;96:1086–1094.
  • Aslan M, Sabuncu TA, Kocyigit A, Celik H, Selek S. Relationship between total oxidant status and severity of diabetic nephropathy in type 2 diabetic patients. Nutr Metab Cardiovasc Dis. 2007;17:734–740.

The Relationship Between Oxidative Stress and Serum Prolidase Activity in Patients with Diabetic Nephropathy, Retinopathy and Neuropathy

Yıl 2023, Cilt: 18 Sayı: 1, 93 - 101, 16.03.2023
https://doi.org/10.17517/ksutfd.1079948

Öz

Objective: To examine the markers of oxidative stress in microvascular complications of diabetes, to examine the relationship of prolidase with oxidative stress indicators, to investigate the usability of prolidase as a predictive value.
Material and Methods: 112 patients with type 2 diabetes mellitus (DM) and 44 healthy controls were included in the study. Detailed anamnesis of the patients was taken and physical examinations were performed. Fasting plasma glucose (FPG), hemoglobin A1c (HbA1C), creatinine, micrototal protein levels in spot urine were measured. Presence of diabetic retinopathy was investigated by fundus examination. Neurological examinations were performed for the presence of neuropathy. In addition, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA), nitric oxide (NO), serum prolidase activities were measured for oxidative stress in the morning blood sample of all patients.
Results: Eighty (71.42%) patients with type 2 DM had complications, while 41 (28.58%) had no complications. Fasting plasma glucose was significantly higher in the diabetic complication group than in the other groups (p <0.001). The HbA1c level was significantly higher in the diabetic complication group than in the other groups (p <0.001). While antioxidant stress markers (CAT, SOD, GPx) were found to be lower in the diabetic complication group than in the other groups, oxidative stress markers (MDA, NO) were found to be higher in the complicated group than in the other groups (p<0.001, p<0.001, respectively). Prolidase level was found to be higher in the group with diabetic complications compared to the other groups (p<0.001).
Conclusion: We think that prolidase activity will have a predictive value in determining microcomplications in diabetic patients, since serum prolidase activity and oxidative stress parameters were found to be statistically significantly increased in diabetic patients with complications compared to healthy controls and those with diabetes mellitus but without complications, and there was a positive correlation between prolidase and oxidative stress markers.

Kaynakça

  • Satman I, Yilmaz T, Sengul A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and riskcharacteristics in Turkey: results of the Turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25:1551-1556.
  • Sies H. Oxidative stress: from basic research to clinical application. Am. J. Med. 1991;91:31-38
  • Pham-huy LA, He H, Pham-huy C. Free radicals, antioksidants in disease and health. Int J Bıomed Sci. 2008;4(2):89-96.
  • Hardenbergh PH, Munley MT, Bentel GC. Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin: preliminary results. Int J Rad Oncol Biol Phys. 2001;49:1023-1028.
  • Huang Y, Mironova M, M.F. Lopes-Virella M.F. Oxidized LDL stimulates matrix metalloproteinase-1 expression in human vascular endothelial cells. Arterioscler Thromb Vasc Biol. 1999;19(11):2640-2647.
  • Eren MA, Torun AN, Tabur S, Ulas T, Demir M, Sabuncu T, et al. Serum prolidase activity in diabetic foot ulcers. Acta Diabetol. 2013;50:423-427.
  • Altindag O, Erel O, Aksoy N, Selek S, Celik H, Karaoglanoglu M. Increased oxidative stress and its relation with collagen metabolism in knee osteoarthritis. Rheumatol Int. 2007;27:339–344.
  • Uzar E, Tamam Y, Evliyaoglu O, Tuzcu A, Beyaz C, Acar A, et al. Serum prolidase activity and oxidative status in patients with diabetic neuropathy. Neurol Sci. 2012;32:875–880.
  • Zanaboni G, Dyne KM, Rossi A. Prolidase deficiency: biochemical study of erythrocyte and skin fibroblast prolidase activity in Italian patients. Haematologica. 1994;79:13-18.
  • Hui KS, Lajtha A. Prolidase activity in brain: Comparison with other organs. J Neurochem. 1978;30:321–327.
  • McRae PA, Porter BE. The perineuronal net component of the extracellular matrix in plasticity and epilepsy. Neurochem Int. 2012;61:963-972.
  • Levidiotis V, PowerDA. New insights into the molecular biology of the glomerular filtration barrier and associated disease. Nephrology (Carlton). 2005;10(2):157–166.
  • Brosset B, Myara I, Fabre M, Lemonnier A. Plasma prolidase and prolinase activity in alcoholic liver disease. Clin Chim Acta. 1988;175:291–295.
  • Myara I, Marcon P, Lemonnier A, Chatelier B, Mangeot M. Determination of prolinase activity in plasma. Clin. Biochem. 1985;18:220–223.
  • Demirbag R, Yildiz A, Gur M, Yilmaz R, Elci K, Aksoy N. Serum prolidase activity in patients with hypertension and its relation with left ventricular hypertrophy. Clin. Biochem. 2007;40:1020–1025.
  • Erbagci AB, Araz M, Erbagci A, Tarakcioglu M, Namiduru ES. Serum prolidase activity as a marker of osteoporosis in type 2 diabetes mellitus. Clin Biochem. 2002;35:263–268.
  • Evrenkaya TR, Atasoyu EM, Kara M, Unver S, Gultepe M. The role of prolidase activity in the diagnosis of uremic bone disease. Ren Fail. 2006;28:271–274.
  • Verma AK, Chandra S, Singh RG, Singh TB, Srivastava S, Srivastava R. Serum prolidase activity and oxidative stress in diabetic nephropathy and end stage renal disease: a correlative study with glucose and creatinine. Biochem Res Int. 2014;2014:291458.
  • Sayın R, Aslan M, Kucukoglu ME, Luleci A, Atmaca M, Esen R et al. Serum prolidase enzyme activity and oxidative stress levels in patients with diabetic neuropathy. Endocrine. 2014;47:146-151.
  • Myara I, Charpentier C, Lemonnier A. Optimal conditions for prolidase assay by proline colorimetric determination: Application to imminodipeptiduria. Clin Chim Acta. 1982;125:193–205.
  • Iijima T, Suzuki S, Sekizuka K. Follow-up study on urinary type IV collagen in patients with early stage diabetic nephropathy. J Clin Lab Anal. 1998;12(6):378–382.
  • Yagame M, Suzuki D, Jinde K. Significance of urinary type IV collagen in patients with diabetic nephropathy using a highly sensitive one-step sandwich enzyme immunoassay. J Clin Lab Anal. 1997;11(2):110–116.
  • Xu X, Wu Z, Zhou Q. The role of determining the levels of serum kollagen type IV in diagnosing early diabetic nephropathy. Ren Fail. 2002;24:747-753.
  • Matsumoto E, Matsumoto G, Bessho H, Kikuoka H, Nanjo K. Serum concentrations of intact type IV collagen in diabetics. J Diabetic Complication. 1991;5:189-190.
  • Hayashi Y, Makino H, Shikata K, Haramoto T, Yamasaki Y, Kumagai I, et al. Increased concentrations of the basement membrane component type IV collagen in sera and urine pf diabetics. J Diabetic Complication. 1991;5:195-196.
  • Hayashi Y, Makino H, Ota Z. Serum and urinary concentrations of type IV collagen and laminin as a marker of microangiopathy in diabetes. Diabetic Med 1992;9:366-370.
  • Tomono S, Kawazu S, Kato N, Ohno T, Utsugi T, Murata K. Clinical implications of serum levels of basement membrane components in diabetic patients with and without albuminuria. J Diabetic Complication. 1991;5:193-194.
  • Okazaki R, Matsuoka K, Atsumi Y, Maruyama K, Matsuki H, Okazaki I. Serum concentrations of basement membrane proteins in NIDDM as a prognostic marker for nephropathy. Diabetic Res Clin Pract. 1995;27: 39-49.
  • Ishimura E, Nishizawa Y, Shoji S, Mori H. Serum type III, IV collagens and timp in patients with type II diabetes mellitus. Life Sci. 1996;58:1331-133.
  • Ellis D. Forrest K. Erbey J. & Orchard T.J. Urinary measurement of transforming growth factor-b and type IV collagen as new markers of renal injury: application in diabeticnephropathy. Clinical Chemistry. 1998;44,5:950–956.
  • Sabuncu T, Boduroglu O, Eren MA, Torun AN, Aksoy N. The Value of Serum Prolidase Activity in Progression of Microalbuminuria in Patients With Type 2 Diabetes Mellitus. J Clin Lab Anal. 2016;30(5):557-562.
  • Way JM, Kaul K, Chopra M, Kohner EM, Chibber R. Pathophysiology of diabetic retinopathy. ISRN Ophthalmol. 2013;2013:343560.
  • Wayner DD, Burton GW, Ingold KU, Barclay LR, Locke S.J. The relative contributions of vitamin E, urate, ascorbate and proteins to the total peroxyl radical-trapping antioxidant activity of human blood plasma. Biochim. Biophys Acta. 1987;924:408–419.
  • Verma AK, Chandra S, Singh RG, Singh TB, Srivastava S, Srivastava R. Serum prolidase activity and oxidative stress in diabetic nephropathy and end stage renal disease: a correlative study with glucose and creatinine. Biochem Res Int. 2014;2014:291458.
  • Shah S, Iqbal M, Karam J, Salifu M, McFarlane SI. Oxidative stress, glucose metabolism, and the prevention of type 2 diabetes: pathophysiological insights. Antioxidants and Redox Signaling. 2007;9:911–929.
  • Robertson RP, Harmon JS. Diabetes, glucose toxicity, and oxidative stress: a case of double jeopardy for the pancreaticislet 𝛽 cell,Free Radical Biology and Medicine 2006;41(2):177–184.
  • Susztack K, Raff AC, Schiffer M, Böttinger EP. Glucose induced reactive oxygen species cause apoptosis of podocytes and podocyte depletion at the onset of diabetic nephropathy. Diabetes. 2006;55(1):225–233.
  • Monnier L, Mas E, Ginet C. Activation of oxidative stressby acute glucose fluctuations compared with sustained chronichyperglycemia in patients with type 2 diabetes, Journal of theAmerican Medical Association. 2006;295:1681–1687.
  • Surazynski A, LiuY, Miltyk W, Phang JM. Nitric oxide regulates prolidase activity by serine/threonine phosphorylation. J. Cell. Biochem. 2005;96:1086–1094.
  • Aslan M, Sabuncu TA, Kocyigit A, Celik H, Selek S. Relationship between total oxidant status and severity of diabetic nephropathy in type 2 diabetic patients. Nutr Metab Cardiovasc Dis. 2007;17:734–740.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Tuğba Yılmaz 0000-0002-8975-2166

Dilek Tüzün 0000-0002-6693-4928

Murat Şahin 0000-0001-7969-9157

Metin Kılınç 0000-0002-1623-0201

Yayımlanma Tarihi 16 Mart 2023
Gönderilme Tarihi 3 Mart 2022
Kabul Tarihi 5 Mayıs 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 18 Sayı: 1

Kaynak Göster

AMA Yılmaz T, Tüzün D, Şahin M, Kılınç M. Diyabetik Nefropati, Retinopati ve Nöropatili Hastalarda Oksidatif Stres ve Serum Prolidaz Aktivitesi İlişkisi. KSÜ Tıp Fak Der. Mart 2023;18(1):93-101. doi:10.17517/ksutfd.1079948