Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy

Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p

Error Estimates for Calculated Glomerular Filtration Rates

Glomerular filtration rate (GFR) is a measure of kidney function. It is usually estimated from serum concentrations of cystatin C or creatinine although there has been considerable debate in the literature about (i) the best equation to use and (ii) the variability in the correlation between the concentrations of creatinine and cystatin C. The equations for GFR can be written in a general form and from these I calculate the error of the GFR estimates associated with analyte measurement error. These show that the error of the GFR estimates is such that it is not possible to distinguish between the equations over much of the concentration range of either analyte. The general forms of the equations are also used to derive an expression for the concentration of cystatin C as a function of the concentration of creatinine. This equation shows that these analyte concentrations are not linearly related. Clinical reports of cystatin C and creatinine concentration are consistent with the expression derived.