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Manouchehr Nakhjavani, Fatemeh Esfahanian, Mahsa Safavi, Mana Kalbasi Anaraki, Pantea Zohrevand,
Volume 4, Issue 2 (17 2004)
Abstract

Background: Diabetic nephropathy is a leading cause of end-stage renal disease (ESRD) in developed countries. This study was designed to determine the proportion of the diabetic patients among under-hemodialysis patients in ten hemodialysis centers of Tehran. Methods: This descriptive, cross-sectional study was done on all under-hemodialysis patients of ten hemodialysis centers (620 patients) during 2001-2002. Data were collected by taking history of the patients and reviewing their medical records. The data were analyzed to find out the frequency of the diabetes and the risk factors associated with diabetic nephropathy such as age, sex, type and duration of diabetes, smoking, hypertension, dyslipidemia, ischemic heart disease and the family history of diabetes and hypertension. Results: Diabetes was the cause of ESRD in 25% of patients aged 32 to 89 years old. The most frequent age group was 7th decade. 9% of diabetic patients suffered from type 1 and 91% of them suffered from type 2 diabetes. Patients with the diabetes duration of 15-19 years had the most frequency. 40% of patients were female and 60% of them were male. History of hyperglycemia, hypertension, dyslipidemia, ischemic heart diseases and smoking were positive in 48%, 82.5%, 46%, 41%, and 21% of patients, respectively. Conclusion: The results of this study are in agreement with other studies in this field. Diabetic patients compose a remarkable percentage of under-hemodialysis-patients. High frequency of risk factors in these patients should promote controlling them to prevention ESRD.
Mitra Neiafar, Fatemeh Esfahanian, Alireza Esteghamati, Ramin Heshmat, Mehdi Hedayati, Masoumeh Karami, Mehrshad Abbasi, Manochehr Nakhjavani,
Volume 4, Issue 4 (17 2005)
Abstract

Background: Oxidized low-density lipoprotein (Ox-LDL), a key factor in the development of atherosclerosis, can cause endothelial dysfunction and augment lipid accumulation within the arterial wall. Increased oxidative stress in diabetes contributes to this process. Ox-LDL is a highly immunogenic molecule and it is not clear whether anti oxidized LDL antibodies (OLAB) are pathogenic or protective in atherosclerosis? The aim of this study was to evaluate Ox-LDL and its antibody in type 2 diabetes and healthy subjects.
Methods: As a case-control study we evaluated 81 type 2 diabetic patients and 69 non-diabetic healthy persons aged 40 to 65 years. Controls were sex and BMI matched with diabetic patients. Patients with history of cigarette smoking, antioxidant or antihyperlipidemic drugs consumption, coronary heart disease, hypertension , and renal impairment were excluded. We measured serum level of Ox-LDL(two monoclonal antibody of Mercodia co.) and OLAB by ELISA. Lipid profile, serum electrolytes, and HbA1c (HPLC) were also determined. Ox-LDL and its antibody were compared between diabetic patients and controls and the correlation with lipid profile, HbA1c and BMI were assessed.
Results: Serum Ox-LDL concentration and Ox-LDL to LDL ratio were distinctively higher in controls (15.7+-6.9 vs. 11.8+-5.6, P < 0.005). Ox-LDL concentrations were correlated with LDL-C (rs=0.36, P<0.0005) and total cholesterol (rs=0.31, P<0.0005) in both groups but not with age and HbA1c. In diabetic patients, Ox-LDL and its antibody were positively correlated (rs=0.26, P<0.05). Obese diabetic patients (BMI > 30) had higher Ox-LDL concentrations in comparison with diabetic patients with BMI less than 30.
Conclusion: In diabetic patients Ox-LDL level is lower than non-diabetics and is correlated with its antibodies. Based on previous findings, we suppose that the pattern of LDL oxidation enhances Ox-LDL recognition by macrophage via specific legends. This results in low serum Ox-LDL concentrations in diabetes.

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