Role of Elevated Serum Sialic Acid in the Progression of both Diabetic Retinopathy and Diabetic Nephropathy

Title: Role of Elevated Serum Sialic Acid in the Progression of both Diabetic Retinopathy and Diabetic Nephropathy

Authors: Soher A.Mohammed Ismail, Hadeer Bakeer, Mustafa Abdel Aziz M., Iman A. Fahmy, Mohamed El Hefni, Shimaa Nabil, Safyea Mohamed Hussien, Leqaa A. Moemen, Mona A. Abdel Hamid, Margeret A. Aziz

DOI: http://dx.doi.org/10.18535/jmscr/v3i11.49

Abstract

Purpose: The purpose of this study was mainly to determine the relationship between total serum sialic acid and occurrence and progression of diabetic retinopathy and diabetic nephropathy in diabetic patients.

Materials and Methods: The study included 60 subjects, their ages ranged between 45-60 year;most of diabetic patients had controlled blood pressure. These subjects were divided into the following groups:

Control group: involved 15 healthy subjects. Clinical and laboratory investigation were performed for each to exclude the presence of diabetes mellitus or any associated disease.

Group (1): involved15 diabetic patients without retinopathy

Group (2): involved 15 diabetic patients with non-proliferative diabetic retinopathy (NPDR).

Group (3): involved 15 diabetic patients with proliferative diabetic retinopathy (PDR).

Urine and fasting blood samples were collected. Patients with DR were clinically examined by a specialist. The standard curve of sialic acid was drawn using Echrlich method. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c%), serum total cholesterol, serum HDL-cholesterol, serum triglycerides (STG), serum creatinine, serum urea, microalbuminuria, urine creatinine and serum c-reactive protein were estimated using LABOMED, Inc (spectro uv-vis Double Beam Pc with 8 scanning autocell uv D-3200). Serum LDL-cholesterol and urine albumin/creatinine ratiowere calculated.

Results: The study showed statistical significant increase in total serum sialic acid in all diabetic patients but the increase was more prominent in patients with proliferative DR. There were increase in fasting glucose level, glycosylated HB%, total cholesterol, triglycerides, LDL-C, serum urea, serum creatinine and urinary albumin/creatinine ratio with decrease in HDL-C in diabetic retinopathy patients ( mainly with proliferative retinopathy ), the increase was statistically significant. This increase in these parameters was parallel to this increase in total serum sialic acid but not reach to significant correlation. The statistically significant correlation was found between total serum sialic acid and both age of the patients and duration of diabetes.

Conclusion: Serum sialic acid concentrations were increased in type 2 diabetics with and without complications and this increase was strongly related to the progression of retinopathy and occurrence of nephropathy

Keywords: sialic acid, diabetic retinopathy, diabetic nephropathy

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Corresponding Author

Soher Abdel Wahab

Medical Biochemistry

Department Research Institute of Ophthalmology