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PubMed1994

[Influence of pancreatic insulin reserve on the metabolic control of type I and II diabetes mellitus].

We have studied 22 diabetic patients, 14 type I and 8 type II, in order to determine if there is a correlation between metabolic control and pancreatic reserve of insulin. All the patients were treated with optimum doses of bolus/basal insulin. They underwent a peptide C test (at baseline and after 3 stimulus with glucagon) and every month, during 3 months, HbA1c and fructosamine were measured, with monthly self control of glycemia. Both HbA1c and fructosamine showed a statistically significant improvement during the study. In all the cases, there was a negative correlation between metabolic control and pancreatic reserve, with statistical significance for type I, especially regarding the response of peptide C to the administration of glucagon. We conclude that the preservation of a good endogenous secretion of insulin benefits the metabolic control of diabetes.

Adult↗
PubMed1993

Comparison of cartridge insulin Penmix 50:50/Isophane with soluble/Isophane in type I diabetic adolescents using a multiple injection regimen.

This study investigated the effect on blood sugar control and weight gain of a multiple injection therapy (MIT) regimen in 22 established adolescent diabetics using a pre-prandial 50:50 mixture of Isophane/soluble insulin with night-time Isophane. This regimen was compared in a cross-over study with MIT using pre-prandial soluble insulin and night-time Isophane. After 4 wk for stabilization, there were 2 periods of 16 wk on each regimen. Throughout the study, blood sugar control was monitored by regular HbA1 and fructosamine measurements. The total daily dose of insulin was unchanged throughout the study, 1.0 +/- 0.3 iu/kg/day for Penmix/Isophane and 1.1 +/- 0.3 iu/kg/day for soluble/Isophane. The mean HbA1 and fructosamine did not alter significantly on either regimen. There was no significant weight gain during the Penmix therapy, despite the increased proportion of longer-acting despite the increased proportion of longer-acting insulin. Lean body mass (LBM) measured by skinfold thickness and electrical impedance only changed marginally on either regimen; the correlation between the 2 measuring techniques for LBM was good. Patient acceptance of the 50:50 Penmix insulin was high, 13 of 19 children preferring it to the conventional regimen.

Adipose Tissue↗
PubMedDate not supplied

Hyperglycemic and lipid parameters in diabetic and nondiabetic patients after acute cerebral stroke.

In 44 patients in acute period of cerebral stroke (35 with a normal glucose tolerance and 9 with non-insulin-dependent diabetes), the concentration of: glycohemoglobin, fructosamine, lipoprotein (a), triglycerides (TG), total cholesterol (TCh), as well as, HDL-cholesterol (HDL-Ch) and LDL-cholesterol (LDL-Ch) were measured and atherogenic factors: TCh/HDL-Ch, LDL-Ch/HDL-Ch, TG/HDL-Ch were calculated. Diabetic patients in acute period of cerebral stroke showed not statistically significant increase of lipids, lipoproteins, glycohemoglobin and fructosamine concentrations, as compared with nondiabetic patients.

Aged↗
PubMed1997

Effect of glucocorticoid treatment on biochemical and hormonal blood parameters in early pregnant gilts.

Twenty Polish Landrace gilts were grouped immediately after mating as follows: Experiment I-- Group 1 (5 gilts), control animals and Group 2 (5 gilts), injected i.m. with dexamethasone (30 mg/kg) at 12-h intervals from day 13 to day 22 of pregnancy; Experiment II--Group 3 (5 gilts), injected i.m. with corn oil from day 13 to day 22 of pregnancy and Group 4 (5 gilts), injected i.m. with hydrocortisone acetate (250 mg) at 12-h intervals from day 11 to day 20 of pregnancy. Gilts were placed in metabolic cages on day 7. On days 34-36 of pregnancy gilts were slaughtered and blood samples were collected. Serum was used for analysis of aspartate aminotransferase (S-ASAT), alanine aminotransferase (S-ALAT), alkaline phosphatase (S-ALP), S-cholesterol, S-triglycerides, S-fructosamine, S-urea, S-total protein, and for electrophoretic fractionation of serum proteins, corticosteroid-binding globulin (CBG), cortisol, progesterone, thyroxine (T4) and free T4. There were no significant differences between groups in embryonic survival or in number of viable fetuses after treatment with glucocorticoids. The activity of S-ALP was lower (p < 0.05) in Group 4 than in Group 3 (0.5 vs 1.2 mukat/l). Group 4 had higher (p < 0.05) levels of S-triglycerides (1.17 vs 0.73 mmol/l), S-cholesterol (5.4 vs 2.7 mmol/l), S-total protein (110.5 vs 93.3 g/l), S-albumin (56.3 vs 43.3 g/l) and alpha 2-globulin concentrations (18.0 vs 14.3 g/l) than Group 3. The hydrocortisone-treated gilts had lower (p < 0.05) CBG (6.8 vs 21.3 nmol/l) and beta 1-globulin (3.25 vs 5.0 g/l) concentrations than the oil-treated ones. Concentrations of T4 were lower (p < 0.05) in Groups 2 (61.3 nmo/l) and 4 (49.0 nmol/l) compared with control Groups 1 and 3 (88.2 and 97.0 nmol/l, respectively). Overall, the treatment of early pregnant gilts with hydrocortisone acetate resulted in decreased levels of S-ALP, CBG, beta 1-globulin and T4, and in increased levels of S-cholesterol, S-triglycerides, S-total protein, S-albumin and alpha 2-globulin. The only effect of dexamethasone was a lowering of T4. There were no differences in free T4, S-fructosamine or S-urea between controls and treatments. Furthermore a negative correlation between triglycerides concentrations and the number of embryos (r = -0.76, p < 0.05) was found in control untreated and oil-treated pregnant gilts.

Animals↗
PubMed1997

Preliminary observation on the metabolism in spontaneous hereditary diabetic Chinese hamster (Shanyi colony).

OBJECTIVE: To observe the changes of tissue lithium content and its relationship with glucose metabolism in spontaneous hereditary diabetic Chinese hamsters (SHDCH). METHODS: Twenty diabetic and ten normal Chinese hamsters were paired and separated randomly into four groups: controls (C), diabetics (D), controls treated with lithium carbonate (CT) and diabetics treated with lithium carbonate (DT). The lithium carbonate treatment was administrated with drinking water containing lithium carbonate (0.2 mg/ml). Blood glucose levels were determined at 0, 1, 3, 5, 6th month, and insulin levels at 1, 3, 6th month. The lithium contents in liver, kidney and muscles were determined at the end of 6th month, using wet digestion assay and ICP-AES. Concentrations of fructosamine, lactic acid, GPT, BUN were also evaluated. RESULTS: The data showed that in Group D the lithium levels in hepatic tissue were lower than in Group C (P < 0.05), and lithium contents in kidney and muscle also decreased. In Group DT, the lithium contents in tissues were higher than in Group D (P < 0.05) and similar to Group C. Blood glucose levels and fructosamine concentrations decreased while insulin and lactic acid levels did not alter significantly. GPT and BUN levels did not change in both Group CT and Group DT. CONCLUSIONS: There is lithium deficiency in hepatic, renal and muscular tissues from diabetic Chinese hamsters. Low-dose and six-month-treatments of lithium carbonate can improve tissue lithium deficiency and glucose metabolism, and do not damage liver and kidney functions.

Animals↗
PubMedDate not supplied

[Prognostic significance of transient hyperglycemia in acute phase of ischemic stroke].

Experimental studies of different stroke models equivocally showed that hyperglycaemia is responsible for the increase of infarct volume and mortality. Similar results were obtained in several, but not all clinical studies. The aim of the study was to assess the occurrence and prognosis of transient hyperglycaemia in non-diabetic, acute ischaemic stroke patients. A consecutive series of 204 patients admitted to the Stroke Unit within 48 hours after the onset of the first-ever hemispheric ischaemic stroke, confirmed by CT and/or autopsy, were included in the study. Blood samples for determination of glucose level were obtained immediately after admission, on the 1-st, 2-nd, 3-rd, 5-th, 7-th and 14-th day of stroke. The fructosamine and HbA1 measurements were used to exclude patients with previous glucose intolerance. The severity of stroke was assessed according to Scandinavian Neurological Stroke Scale on admission, on the first, 7-th, 14-th and 30-th day of stroke. Transient hyperglycaemia, defined as at least one elevated glucose level in the first week of stroke with normal level of HbA1 and fructosamine was found in 65 (31.9%) of patients. Patients with transient hyperglycaemia did not differ from diabetics and normoglycaemic according to age, gender, history of hypertension and other risk factors. 30 day mortality in the group of patients with transient hyperglycaemia was significantly higher than in normoglycaemic ( p. < 0.001) and diabetic patients. Transient hyperglycaemic patients died earlier, mainly on the 7-th day after admission whereas patients with normoglycaemia died mainly on the 18-th day (p < 0.0001). The main reason of death in hyperglycaemic patients were cardiac complications (15/20), in normoglycaemic--the consequences of immobility (8/11) (< 0.01). The results of our study showed that the transient hyperglycaemia occurred in about one third of acute ischaemic stroke patients and resulted in higher 30-day mortality.

Acute Disease↗
PubMed1998

Effect of enteral nutritional products differing in carbohydrate and fat on indices of carbohydrate and lipid metabolism in patients with NIDDM.

Non-insulin dependent diabetes mellitus (NIDDM) is associated with chronic hyperglycemia, which increases the risk of developing microvascular and macrovascular complications. Elevated triglyceride (TG) and VLDL cholesterol levels and low levels of HDL cholesterol have also been frequently reported in NIDDM patients. A diet high in complex carbohydrate and low in fat is typically recommended for management of NIDDM, however, this has recently been challenged by scientific reports of the benefits of dietary intakes high in monounsaturated fat. Thirty-two individuals with NIDDM were randomized to receive either Ensure with Fibre (30% fat) or a high monounsaturated fatty acid product, Glucerna (50% fat). These products were consumed for 28 days at > 80% of daily energy intake. Post-treatment, dietary compliance was verified by a higher plasma TG 18:1 n-9 (p < 0.001) in the Glucerna group and a higher plasma TG 18:2 n-6 (p < 0.001) in the Ensure with Fibre group. The postprandial rise in blood glucose levels, determined by fingerprick samples, was significantly lower (p < 0.01) in the Glucerna group. Trends of clinical interest were greater mean decreases in the Glucerna group compared to the Ensure with Fibre group in: fructosamine, 9.13 umol/L vs 0.14 umol/L; glucose, 1.61 mmol/L vs 0.63 mmol/L; and insulin, 46.0 pmol/L vs 12.6 pmol/L; respectively. However, overall, fasting plasma glucose, fructosamine, TG and cholesterol levels were not significantly different between groups. Thus, in these patients, the high monounsaturated fat diet and the standard diet were similar with regard to usual indicators of carbohydrate and lipid metabolism. A high monounsaturated fat diet appears to pose no risk to lipoprotein metabolism in NIDDM patients.

Adolescent↗
PubMed1996

Relationship of oxidative stress and fibrinolysis in diabetes mellitus.

This study attempted to verify the existence of a relationship between oxidative stress documented by malondialdehyde (MDA) and superoxide dismutase (SOD) and fibrinolysis analysed by tissue plasminogen activator (tPA) and its inhibitor (PAI-1) in diabetes mellitus. Forty-seven patients with Type 1 (n = 27) and Type 2 (n = 20) diabetes were examined together with 20 non-diabetic controls. The following were analysed: plasma MDA concentration, SOD activity in erythrocytes, tPA activity and antigen, PAI-1 activity and antigen, fasting blood glucose, fructosamine, glycated haemoglobin (HbAlc), and urine albumin. SOD activity was decreased in patients with diabetes. This contrasted with an increased plasma MDA concentration especially in Type 2 diabetes as compared with Type 1 or healthy persons (p < 0.001). tPA activity was increased in both groups of patients with diabetes as compared to healthy persons (p < 0.001), PAI-1 activity was higher in Type 2 diabetes with vascular changes than in the remaining subgroups (p < 0.001). Multivariate analysis revealed a significant positive relationship between plasma MDA concentrations and PAI-1 antigen (r = 0.53, p < 0.001) and a negative relationship between SOD and tPA activities (r = -0.53, p < 0.01). We conclude that oxidative stress may modulate fibrinolytic properties in diabetes mellitus.

Adult↗
PubMed1997

Problems in the assessment of glycaemic control in diabetes mellitus.

The measurement of glycated haemoglobin and serum fructosamine to assess the recent glycaemic control of diabetic patients has become well established. Likewise, the monitoring of blood glucose using glucose test strips and meters has become popular in both the community and in the hospital inpatient environment. However, despite improvements in the methods of analysis, clinically inaccurate assessments of glycaemia can still occur. Specific problems such as the lack of standardization in assays are in the process of being resolved, but inherent difficulties associated with these measures remain. Clinicians should be aware that these tests still need to be interpreted in conjunction with clinical prudence.

Aging↗
PubMed1996

Advanced glycation end product (AGE): characterization of the products from the reaction between D-glucose and serum albumin.

We incubated bovine serum albumin (BSA) with glucose in an attempt to study how the advanced glycation end products (AGEs) are formed and what methods can be used for their identification and isolation. The reaction was monitored by boronated affinity gel, size exclusion and ion exchange chromatography, and chromatofocusing. Reaction products were also characterized by fluorescence measurement, fructosamine assay, and polyacrylamide gel electrophoresis (PAGE). Based on the measurement of AGE-associated fluorescence (excitation, 370 nm; emission, 440 nm) we found that the AGEs could be detected as early as after 3 days incubation. The fluorescence was always associated with the larger molecules of cross-linking product resulting from the reaction between BSA and glucose. The overall fluorescence intensity increased with incubation time and fluorescence of the highest intensity was found with the AGE product largest in size. As with the Amadori product, AGEs also bind to the boronated gel column but with an even higher affinity. Compared to the original albumin monomer AGE molecules are not only larger in size but also have lower isoelectric points and carry more negative charges. Both the size and the negative charges of AGEs continue to increase over time during incubation. This results in a group of cross-linking molecules heterogeneous in size and charge. These results will aid in both the isolation and selection of appropriate AGE molecules for the preparation of anti-AGE antibodies, calibrator, and control in the development of an AGE immunoassay.

Animals↗
PubMed2003

Study of degradation pathways of Amadori compounds obtained by glycation of opioid pentapeptide and related smaller fragments: stability, reactions, and spectroscopic properties.

Reactions between biological amines and reducing sugars (the Maillard reaction) are among the most important of the chemical and oxidative changes occurring in biological systems that contribute to the formation of a complex family of rearranged and dehydrated covalent adducts that have been implicated in the pathogenesis of human diseases. In this study, chemistry of the Maillard reactions was studied in four model systems containing fructosamines (Amadori compounds) obtained from the endogenous opioid pentapeptide leucine-enkephalin (Tyr-Gly-Gly-Phe-Leu), leucine-enkephalin methyl ester, structurally related tripeptide (Tyr-Gly-Gly), or from amino acid (Tyr). The degradation of model compounds as well as their ability to develop Maillard fluorescence was investigated under oxidative conditions in methanol and phosphate buffer pH 7.4 at two different temperatures (37 and 70 degrees C). At 37 degrees C, glycated leucine-enkephalin degraded slowly in methanol (t(1/2) approximately 13 days) and phosphate buffer (t(1/2) approximately 9 days), producing a parent peptide compound as a major product throughout a three-week incubation period. Whereas fluorescence slowly increased over time at 37 degrees C, incubations off all studied Amadori compounds at 70 degrees C resulted in a rapid appearance of a brown color and sharp increase in AGE (advanced glycation end products)-associated fluorescence (excitation 320 nm/emmision 420 nm) as well as in distinctly higher amounts of fragmentation products. The obtained data indicated that the shorter the peptide chain the more degradation products were formed. These studies have also helped to identify a new chemical transformation of the peptide backbone in the Maillard reaction that lead to beta-scission of N-terminal tyrosine side chain and p-hydroxybenzaldehyde formation under both aqueous and nonaqueous conditions.

Fructosamine↗
PubMed1994

Inhibition with N-acetylcysteine of enhanced production of tumor necrosis factor in streptozotocin-induced diabetic rats.

We previously reported that the in vivo production of the tumor necrosis factor alpha (TNF) was significantly enhanced after the onset of diabetes in spontaneous type 1 and 2 diabetic animals. In this report we confirmed the enhanced production of TNF in streptozotocin (STZ)-induced diabetes and then attempted to suppress the enhanced TNF production with N-acetylcysteine (NAC), a precursor of glutathione synthesis. The lipopolysaccharide-induced serum TNF activities were significantly enhanced in STZ-induced diabetic rats (6-18 weeks of age) compared with those of nondiabetic rats throughout the 12-week experiment. A single, oral administration of NAC (200 or 1000 mg/kg body wt) significantly suppressed the enhanced TNF production in the diabetic rats compared with that in untreated rats in a dose-dependent manner. On the other hand, in the long-term (6 or 12 weeks) administrations, smaller doses of NAC (50 or 200 mg/kg/day) also significantly inhibited the enhanced production of TNF regardless of the dose of NAC. NAC administration, however, did not suppress the TNF production of nondiabetic rats. The long-term NAC administration affected neither body weight nor levels of serum glucose, fructosamine, albumin, and triglyceride. These results show that NAC administration significantly suppressed the enhanced TNF production in diabetic rats and indicate that NAC might be useful in preventing TNF-mediated pathological conditions in diabetes.

Acetylcysteine↗
PubMed1999

Economic evaluation of alternative indicators for screening for diabetes mellitus.

BACKGROUND: the optimal indicator for screening for diabetes mellitus without relying on fasting conditions was clarified. METHODS: the subjects were 891 men ages 26 through 80 years (48.5 +/- 8.5). The objectives of this study were (1) to elucidate the efficacy of 1,5-anhydroglucitol (1,5-AG), glycosylated hemoglobin, and fructosamine (FRA) as screening tests for non-insulin-dependent diabetes mellitus (NIDDM) or for impaired glucose tolerance (IGT) and (2) to perform an economic evaluation for each indicator. The efficacy of each indicator was evaluated by drawing the receiver operating characteristic curves and calculating the areas under these curves (AUCs). An original model was developed for the pur pose of cost-effectiveness analysis. RESULTS: each indicator was evaluated as a screening test for NIDDM alone and for both IGT and NIDDM. The AUCs of 1,5-AG and fasting plasma glucose were the largest in the case of the detection of NIDDM alone and the detection of both IGT and NIDDM, respectively. FRA was, however, the most cost-effective in Japan. CONCLUSION: using equations, we indicated the equi librium points at which the cost-effectiveness ratios of each indicator intersected in order to generalize the results. By calculating the appropriate-actual ratios of costs for each indicator, we could ascertain the optimal indicator for each country.

Adult↗
PubMed1992

Increased platelet sodium-proton exchange rates in insulin-dependent (type 1) diabetic patients with nephropathy and hypertension.

In order to assess the potential role of the plasma membrane sodium-proton (Na+/H+) exchanger in the pathogenesis of diabetic nephropathy, we investigated 32 insulin dependent (type 1) diabetic patients and 21 control subjects. We tested the Na+/H+ exchange as the rate of amiloride sensitive and sodium dependent volume gain of platelets suspended in sodium propionate. Patients with diabetic nephropathy had significantly increased rates of Na+/H+ exchange (0.31 +/- 0.06 s-1 x 10(-2)) when compared to those without nephropathy (0.24 +/- 0.07, p less than 0.05) or to a control group (0.23 +/- 05, p less than 0.05). Nine patients who were classified as hypertensive had a highly significant increase in the Na+/H+ exchange rates when compared to 23 non-hypertensive diabetic patients: 0.33 +/- 0.04 versus 0.24 +/- 0.06 (p less than 0.001). There was no significant correlation between the Na+/H+ exchange rates and age, diabetes duration, glycated hemoglobin or fructosamine levels on the day of the test. In summary, the data presented here demonstrate an increase in the Na+/H+ exchange rate in insulin-dependent diabetic patients with nephropathy and hypertension.

Adolescent↗
PubMed1988

Reduction of protein intake decreases glomerular filtration rate in young type 1 (insulin-dependent) diabetic patients mainly in hyperfiltering patients.

The influence of different protein intake on renal function was studied in 16 Type 1 (insulin-dependent) diabetic patients, aged 15-23 years, with onset of diabetes before puberty and with a duration of diabetes between 5 and 20 years. The glomerular filtration rate, renal plasma flow, albumin excretion rate, and blood pressure were examined in a cross-over randomised order after 10 days on isocaloric diets with either 10% (i.e. 0.9 +/- 0.06 g.kg-1.day-1) or 20% (1.9 +/- 0.1 g.kg-1.day-1) of the calories as protein, the latter being equal to the recommended diet. Dietary compliance was evaluated using fractional phosphate excretion and overnight urea excretion. Glomerular filtration rate was lower after the low-protein diet compared to the usual protein diet (p less than 0.001). Patients with glomerular filtration rate above +2 SD of the normal mean on the usual protein diet (n = 6) exhibited the steepest fall in glomerular filtration rate with a mean decrease of 20 ml/min compared to 7 ml/min in those with initially normal glomerular filtration (p = 0.01). Filtration fraction tended to decrease on low protein diet, more so in initially hyperfiltering patients (p = 0.09). Renal plasma flow remained unchanged. In patients with elevated glomerular filtration rate on usual protein diet, albumin excretion rate and systolic, but not diastolic blood pressure, were decreased on low protein diet (p = 0.03 and p = 0.01, respectively) but not in initially normal-filtering patients. Mean blood glucose and serum fructosamine were unchanged on both diets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Effects of a new oral hypoglycaemic agent, repaglinide, on metabolic control in sulphonylurea-treated patients with NIDDM.

We have evaluated the effects of repaglinide, a new non-sulphonylurea oral hypoglycaemic agent that has a stimulatory effect on insulin secretion. Forty-four patients with NIDDM, already treated with a sulphonylurea, took part in an open, randomised, group comparison study of 12 weeks duration, during which they received either repaglinide or glibenclamide twice daily. While glibenclamide had a greater effect on fasting blood glucose (10.4 to 8.6 mmol.l-1), repaglinide significantly lowered postprandial blood glucose (13.8 to 12.2 mmol.l-1). Glycosylated haemoglobin remained unchanged in both groups, and serum fructosamine showed a tendency to fall. With both treatments total cholesterol was significantly decreased after 12 weeks, while HDL-cholesterol and triglycerides did not change. Fasting plasma insulin in the repaglinide group decreased from 80 (median value) to 67 pmol.l-1; it did not change in the glibenclamide group. Two patients in the repaglinide group did not complete the study, one for personal reasons, and one because of a rise in blood glucose. No abnormal findings attributable to repaglinide were observed in clinical and laboratory examinations, and no hypoglycaemic symptoms caused by it were observed.

Aged↗
PubMed1993

Insulin autoantibodies and high titre islet cell antibodies are preferentially associated with the HLA DQA1*0301-DQB1*0302 haplotype at clinical type 1 (insulin-dependent) diabetes mellitus before age 10 years, but not at onset between age 10 and 40 years. The Belgian Diabetes Registry.

Demographic and biological data were collected from all Caucasian Type 1 diabetic patients (n = 279) who were recruited at clinical onset by the Belgian Diabetes Registry over 34 months. The male/female ratio was significantly higher for onset between age 20 and 40 years (2.4) than before age 20 years (1.0); no age-or sex-differences were noticed in serum fructosamine concentration. Total and high concentrations of insulin autoantibodies and islet cell antibodies were preferentially associated with the HLA DQA1*0301-DQB1*0302 susceptibility haplotype. The occurrence of both types of antibodies was also correlated, irrespective of haplotype. At onset before age 10 years, the high risk genotype DQA1*0301-DQB1*0302/DQA1*0501-DQB1*0201 was more prevalent than all other DQA1-DQB1 genotypes taken together, leading to a higher prevalence of the DQA1*0301-DQB1*0302 haplotype in this age group (75%) than in the 10-39 years age group (54%). Under age 10 years, the presence of DQA1*0301-DQB1*0302 was strongly associated with insulin autoantibodies (90%) and islet cell autoantibodies (92% with 85% of high titre), whereas patients without this haplotype were less frequently positive for insulin autoantibodies (31%) or islet cell autoantibodies (38% high titre). In the group with onset at age 10-39 years, the DQA1*0301-DQB1*0302 haplotype presented a lower association with insulin autoantibodies (approximately 40%) and islet cell autoantibodies (50 to 65% high titre), prevalences which no longer differed from those in subjects lacking this haplotype.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Elevated plasma endothelin in patients with diabetes mellitus.

Plasma concentrations of endothelin, a vasoconstrictor peptide released from vascular endothelial cells, have been measured by radioimmunoassay in 100 patients with diabetes mellitus and 19 healthy subjects. The plasma immunoreactive-endothelin concentrations were found to be greatly raised in the patients with diabetes (1,880 +/- 120 fmol/l, mean +/- SEM) compared with the healthy subjects (540 +/- 50 fmol/l, p less than 0.005). The elevation of immunoreactive-endothelin could not be explained by secondary changes in blood pressure or renal disease and did not correlate with the presence of diabetic retinopathy, duration of diabetes mellitus, fasting blood glucose or serum fructosamine. Fast protein liquid chromatographic analysis of the diabetic plasma immunoreactive-endothelin showed three forms, one in a very big molecular weight position, one intermediate and one in the position of endothelin-1 itself. No material appeared in the positions of endothelin-2 and 3. Chromatographic analysis of normal plasma showed only the big molecular weight peak while material in the endothelin-1, 2 or 3 positions was below detection. The elevation of endothelin in diabetic patients may be a marker of, and further exacerbate, their vascular disease.

Adult↗