20Jan 2017

EFFECT OF SERUM COPPER LEVELS IN TYPE 2 DIABETES MELLITUS WITH NEPHROPATHY: A CASE CONTROL STUDY IN NORTH INDIAN POPULATION.

  • Senior Resident, Department of Accident and Emergency Medicine, Lady Hardinge Medical College (LHMC), New Delhi. Senior Resident, Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi. Address of correspondence- – Room no. 3013, Department of Biochemistry, Third Floor, Teaching Block, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi-110027. Junior Resident, Department of Pathology, Lady Hardinge Medical College (LHMC), New Delhi. Senior Resident, Department of Gastroenterology, Max Super Specialty Hospital, Saket, New Delhi. Senior Resident, Department of Chest and TB, PGIMS, Rohtak, Haryana. Senior Resident, Department of Pulmonary and Critical care.PGIMS, Rohtak, Haryana. Assistant Professor, Department of Biochemistry, LN Medical College and JK Hospital, Bhopal, MP Professor, Department of Biochemistry, Lady Hardinge Medical College (LHMC), New Delhi. Professor, Department of Medicine, Lady Hardinge Medical College (LHMC), New Delhi.
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Introduction-Diabetes mellitus is chronic metabolic disease, associated with various complications such as diabetic nephropathy. It is most common cause of End Stage Renal Disease (ESRD) in diabetic individual. In various studies, altered levels of serum copper levels are associated with diabetic complications such as diabetic nephropathy. We studied serum copper levels in type 2 diabetic individual with and without nephropathy. Materials and Methods- The study population consisted of 100 type 2 diabetic individual which was further divided into two groups, first group consisted of 50 diabetic individual with nephropathy and second group consisted of 50 diabetic individual without nephropathy. Diabetic nephropathy status was assessed by spot urinary albumin creatinine ratio and GFR. Serum copper levels were measured by colorimetric method. Result- Mean serum copper levels were significantly higher in diabetic patient with nephropathy (111.8 ± 13.9 mg/dl) as compare to diabetic patient without nephropathy (102.3 ± 16.2 mg/dl), (p = 0.002). Serum copper was also positively correlated with weight of subject (r = 0.263, p = 0.009), and negatively correlate with serum zinc (r = -0.263, p = 0.009). Conclusion- Diabetic nephropathy is the leading cause of death in diabetic individual. Our study points toward the increased serum copper levels are associated with diabetic nephropathy. Thus we could use copper chelator in an attempt to decrease serum copper, so that diabetic nephropathy could be prevented and thus improve overall management of diabetic individual.

  1. Ceriello A, Motz E. Is oxidative stress the pathogenic mechanism underlying insulin resistance, diabetes, and cardiovascular disease? The common soil hypothesis revisted. Arterioscler Thromb Vasc Biol.2004;24(5):816-23.
  2. King GL, Brownlee M. The cellular and molecular mechanisms of diabetic complications. Endocrinol Metab Clin North Am.1996;25(2):255-7.
  3. Wild S, Roglic G, Green, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5):1047-53.
  4. World Healh Organisation. Prevalence of diabetes. In: Diabetes Action now, editor. WHO; 2004.
  5. Elina EL, Jerums G, Skene A, Grammer P, Power D, Cheong KY, Panagiotopoulos S, McNeil K, Baker ST, Fioretto P et al. Renal structure in normalbuminuric and albuminuric patient with type 2 diabetes and impaired renal function. Diabetes Care. 2013.Nov;36(II):3620-6.
  6. Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. The Review of Diabetic Studies?: RDS. 2012;9 (1):6-22.
  7. Zargar AH, Shah NA, Massodi SR, Laway BA, Dar FA, Khan AR, Sofi FA, Wani AI. Copper, zinc and magnesium levels in non-insulin-dependent diabetes mellitus. Postgrad Med J. 1998(Nov); 74(877): 665-8.
  8. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and New CKD-EPI Formulas in Relation to GFR, Age, and Body Size. Clinical Journal of the American Society of Nephrology?: CJASN. 2010;5(6):1003-1009
  9. Burtis C A, Ashwood E R, Bruns E D. Tietz Textbook of Clinical Chemistry And molecular diagnostic. 1Vth ed: Saunders. Philadelphia. 2008.
  10. Mohanty SS, Pinnelli VB, Murgod R, Raghavendra DS. Evaluation of serum copper, magnesium and glycated haemoglobin in type 2 diabetes mellitus. Asian J Pharm Clin Res.2013;6(2):188-190.
  11. Viktorinova A, Toserova E, Krizko M, Durackova Z. Altered metabolism of copper, zinc, and magnesium is associated with increased levels of glycated hemoglobin in patients with diabetes mellitus. Metabolism 2009; 58:1477-1482.
  12. Bremner I. Manifestation of copper excess. Am J Clin Nutr. 1998; 67(5):1069S-1073S.
  13. Quilliot D, Dousset B., Guerci B, Dubois F, Drouin P, Ziegler O. Evidence that diabetes mellitus favors impaired metabolism of zinc, copper, and selenium in chronic pancreatitis. Pancreas 2001; 22: 299-306.
  14. Rusu ML, Marunoiu C, Rusu LD, Olivia FMN, Cristina HN, Laura P. Testing of Magnesium, Zinc and Copper Blood Levels in Diabetes Mellitus Patients. Acta Universitatis Cibiniensis.Seria F Chemia. 2005; 8:61-63.
  15. Noto R, Alicata R, Sfogliano L, Neri S, Bifarella M. A study of cupremia in a group of elderly diabetics. Acta Diabetol Lat.1984; 21(1):79-85.
  16. Prabodh S, Prakash DS, Sudhakar G, Chowdary NV, Desai V, Shekhar R. Status of copper and magnesium levels in diabetic nephropathy cases: a case-control study from South India. Biological trace element research. 2011;142(1): 29-35.
  17. Hazzim H Edan. Serum copper level in non insulin diabetes mellitus, Al-Mustansyriah University .Mustansiriya Med J. 2006; 6(1):36-41.
  18. Cooper GC. Selective divalent copper chelation for the treatment of diabetes mellitus. Current Medicinal Chemistry.2012;19(17):2828–2860.
  19. Cooper GJ, Chan YK, Dissanayake AM, Leahy FE, Keogh GF, Frampton CM, Gamble GD, Brunton DH, Baker JR, Poppitt SD. Demonstration of a hyperglycemia-driven pathogenic abnormality of copper homeostasis in diabetes and its reversibility by selective chelation: quantitative comparisons between the biology of copper and eight other nutritionally essential elements in normal and diabetic individuals. Diabetes.2005;54(5):1468–1476.
  20. Lu J, Gong D, Choong SY, Xu H, Chan YK, Chen X, Fitzpatrick S, Glyn-Jones S, Zhang S, Nakamura T et al. Copper(II)-selective chelation improves function and antioxidant defences in cardiovascular tissues of rats as a model of diabetes: comparisons between triethylenetetramine and three less copper-selective transition-metal-targeted treatments. Diabetologia.2010;53(6):1217–1226.
  21. Bakker SJL, Navis G, Gans ROB. Copper chelation as a potential treatment for left-ventricular hypertrophy in type 2 diabetes. Diabetologia.2009;52(10)2244.
  22. Cooper GJ, Phillips AR, Choong SY, Leonard BL, Crossman DJ, Brunton DH, Saafi 'L, Dissanayake AM, Cowan BR, Young AA et al. Regeneration of the heart in diabetes by selective copper chelation. Diabetes 2004;53(9) 2501–2508.

[Sonny Bherwani, Ashok Kumar Ahirwar, A S Saumya, Sitendu Kumar Patel, A S Sandhya, Brijesh Prajapat, Srushtee Bipin Jibhkate, Ritu Singh and LH Ghotekar. (2017); EFFECT OF SERUM COPPER LEVELS IN TYPE 2 DIABETES MELLITUS WITH NEPHROPATHY: A CASE CONTROL STUDY IN NORTH INDIAN POPULATION. Int. J. of Adv. Res. 5 (Jan). 420-424] (ISSN 2320-5407). www.journalijar.com

Dr Ashok Kumar Ahirwar
Senior Resident, Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi.

DOI:

Article DOI: 10.21474/IJAR01/2762      
DOI URL: http://dx.doi.org/10.21474/IJAR01/2762

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