Reenu Sharma - Academia.edu (original) (raw)

Papers by Reenu Sharma

Research paper thumbnail of Glucose Fluctuations and Activation of Oxidative Stress in Patients with Type II Diabetes Mellitus

Indian journal of Medical Biochemistry, 2017

Introduction: In recent years, the oxidative stress (OS)-induced free radicals have been implicat... more Introduction: In recent years, the oxidative stress (OS)-induced free radicals have been implicated in the pathology of diabetes mellitus (DM). Persistently high glucose levels can lead to the generation of higher amounts of free radicals. The purpose of the present study was to evaluate the role of hyperglycemia [by measuring variables: Glycated hemoglobin (HbA1c), fasting plasma glucose (FPG)] in the induction of OS [(by analyzing the OS marker: Malondialdehyde (MDA)] in type II DM. Materials and methods: This observational study was conducted among 50 type II DM patients without complications and 50 type II DM patients with complications in S.B.K.S. Medical Institute and Research Centre, Waghodiya, Gujarat, India. Correlations between variables were tested using the Pearson rho correlation test. Chi-squared (χ 2) analysis was used for comparison of groups. Results: The MDA values correlated significantly with HbA1c and FPG values in type II diabetic subjects with complications (r = +0.29, p = 0.04; r = +0.47, p = 0.0006). Conclusion: Glucose fluctuations may activate OS in DM. Assessment of glycemic control marker HbA1c and lipid peroxidation marker MDA is useful in DM patients for detection of risk of diabetic complications at an early stage of the disease.

Research paper thumbnail of Effect of Obesity on Antioxidant enzymes and Type 2 Diabetes Mellitus

Obesity refers to body mass index (BMI) greater than 30kg/m. The present study aims to assess fir... more Obesity refers to body mass index (BMI) greater than 30kg/m. The present study aims to assess firstly, obesity as an independent risk factor for decreased activity of antioxidant enzymes in humans and secondly, its role in complicating glucose and lipid metabolism in type 2 diabetic subjects. The study was conducted on two groups; Group 1 had 50 obese subjects with two subgroups: (a) including 25 type 2 diabetic subjects and (b) 25 obese with different grades of obesity (30-50 kg/m) with no history of type 2 diabetes, hypertension, and hyperlipidemia. Group 2 included 25 non-obese type 2 diabetic subjects. Results were compared with 25 age matched healthy controls. Parameters assessed were BMI (weight in kg/height in metres), lipid profile, erythrocyte Superoxide dismutase (SOD) and

Research paper thumbnail of Effects of Serum Iron Status on the Relationship between Manganese and Iron transport proteins in Iron Foundry Workers

Iron foundries deal with the tapping and transport of molten iron and charging of furnaces. This ... more Iron foundries deal with the tapping and transport of molten iron and charging of furnaces. This creates exposure to iron oxide and other metal oxide fumes. The aim of this study was to evaluate the alterations in biochemical parameters related to iron metabolism in iron foundry workers. In the study 50 iron foundry workers engaged in daily foundry work were randomly selected from an iron foundry in Narol, Ahmedabad. The results were compared with age, sex matched employees of the foundry engaged in other work and not exposed to fumes. Results showed higher manganese and iron levels in subjects engaged in foundry work compared to controls. The proteins ferritin and transferrin, associated with iron metabolism were significantly altered compared to controls.

Research paper thumbnail of Association between gamma glutamyl transferase and insulin resistance markers in healthy obese children

The Journal of the Association of Physicians of India, 2009

OBJECTIVE To study the relationship of gamma glutamyl transferase (GGT) with insulin resistance m... more OBJECTIVE To study the relationship of gamma glutamyl transferase (GGT) with insulin resistance markers [fasting insulin and Homeostasis Model Assessment of-insulin resistance (HOMA-IR)] and to assess the role of GGT as a determinant of insulin resistance in healthy obese children. MATERIAL AND METHODS Fifty healthy obese children (boys and girls with mean age 9.2 +/- 0.73 and 8.8 +/- 0.74 years) born to diabetic mothers were studied. In all the subjects, anthropometric measurements viz, BMI and body weight were studied. The biochemical parameters analysed in fasting samples of subjects were plasma glucose, plasma insulin, serum GGT and calculation of HOMA-IR. RESULTS The fifty studied subjects belonged to age group 8 to12 years. The difference in mean age of boys and girls was not significant (p = 0.09). Body weight values in all subjects ranged from 20 to 78 kgs and BMI values ranged from 14.5 to 42.1 Kg/m2. No significant difference was observed between body weight and BMI values...

Research paper thumbnail of Subclinical hypothyroidism and its association with cardiovascular risk factors

Clinical laboratory, 2011

BACKGROUND Subclinical hypothyroidism (SH) represents the mildest form of thyroid hormone deficie... more BACKGROUND Subclinical hypothyroidism (SH) represents the mildest form of thyroid hormone deficiency and may be associated with adverse consequences [Subclinical hypothyroidism was defined as a TSH level > 4.0 mIU/L and a normal free thyroxine level 0.6-1.8 ng/dL]. The identification of patients with subclinical hypothyroidism having an increased cardiovascular risk (CVR) is important. The aim of the study was to evaluate atherosclerotic risk factors in patients with subclinical hypothyroidism. METHODS Forty patients with subclinical hypothyroidism and forty healthy euthyroid controls, age and gender matched were included in the study. Serum total triiodothyronine (T3), thyroxine (T4), TSH, free T3 (FT3) and free T4 (FT4) were measured by enzyme linked immunosorbent assay (ELISA). Atherosclerotic risk factors measured were high sensitivity-CRP (hs-CRP), Lipoprotein (a) [Lp (a)] and lipid parameters. Lipid parameters (triglycerides, total cholesterol and high density lipoprotein c...

Research paper thumbnail of Study of impairment in collaboration between ceruloplasmin and transferrin in development of complications in type 2 diabetes mellitus

International Journal of Research in Medical Sciences, 2016

Background: Hyperglycemia in diabetic patients can increase the levels of free radicals through v... more Background: Hyperglycemia in diabetic patients can increase the levels of free radicals through various metabolic alterations. One of the most reactive pro-oxidants in peroxidation reactions is free, redox-active iron and generates highly reactive hydroxyl radicals that initiate lipid peroxidation. The purpose of the study was to elucidate the role of CP and TRF in type 2 DM and analyse the effect of disturbance in collaboration between these parameters in pathogenesis of type 2 diabetic complications. Methods: We included 100 Type 2 DM subjects (with and without complications) and 100 healthy controls. The duration of type 2 DM in study subjects ranged from 5 to 16 years. Blood samples in fasting condition were collected for analysis of serum malondialdehyde (MDA), CP and TRF. Results: In the study serum CP levels were higher in Type 2 diabetic subjects with complications compared to diabetic subjects without complications (P=0.01). However, significantly low transferrin values were obtained in diabetic subjects with complications compared to diabetic subjects without complications (P=0.007). Significantly high MDA levels were observed (P=0.002) in type 2 diabetic subjects with complications compared to type 2 diabetic subjects without complications. Conclusions: The results of the present study indicate oxidative stress plays a role in precipitating complications in Type 2 DM reflecting in disturbance of CP and TRF collaboration.

Research paper thumbnail of Assessment of Oxidative Stress and Lipid Status in Patients of Type 2 Diabetes Mellitus with and without Complications

International Journal of Biochemistry Research & Review, 2016

Research paper thumbnail of Effect of meals with varying glycemic index on blood glucose response in type 2 diabetes mellitus

International Journal of Research in Medical Sciences, 2016

Background: In diabetes mellitus (DM) glucose is underused, producing hyperglycaemia. Dietary int... more Background: In diabetes mellitus (DM) glucose is underused, producing hyperglycaemia. Dietary interventions would be effective in management of glycemic control in DM. The glycemic index (GI) and glycemic load (GL) takes into account the glycemic response. Foods with contrasting GI when incorporated into a meal are able to differentially modify glycemia. Currently there is no universal approach to the optimal dietary strategy for DM. Also, little is known about whether this is dependent on the size and composition of the meal. The purpose of the study was to evaluate the blood glucose response to mixed meals (with varying GI and GL) served to Type 2 DM subjects and to determine the relationship between GI, GL and Postprandial Plasma glucose levels (PPG) in Type 2 DM. Methods: This study included 30 Type 2 DM subjects and 30 Non Diabetic Subjects. The subjects were served Hospital based and Home based diet. The FPG (Fasting Plasma Glucose) and PPG values were analysed for comparing the effect of both the diets on plasma glucose levels. Results: After analysis of study data we found that plasma glucose response (FPG-126±6.1 mg/dl, PPG-144.3±4.5 mg/dl) for hospital based low GI meals is significantly lower (p <0.0001) than after one week follow up home based mixed GI meals, (FPG-135±4.5 mg/dl, PPG 158.3±4.5 mg/dl). Conclusions: It was concluded in the study that Plasma Glucose shows a positive response to high GI foods and this may aggravate the hyperglycemia already present in Type 2 DM. Low GI diets may be helpful in reducing risks related to Type 2 DM.

Research paper thumbnail of Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes

Diabetologia, 2007

Aims/hypothesis Glucose fluctuations may help predict diabetic complications. We evaluated the re... more Aims/hypothesis Glucose fluctuations may help predict diabetic complications. We evaluated the relation between glucose variability and oxidative stress in patients with type 1 diabetes. Methods Continuous glucose monitors were inserted subcutaneously in 25 patients. During the measurement, patients collected two 24 h urine samples, while 24 healthy controls collected one 24 h urine sample for determination of 15(S)-8-iso-prostaglandin F 2a PGF 2a ð Þ using HPLC tandem mass spectrometry. Mean of the daily differences (MODD), mean amplitude of glycaemic excursions (MAGE) and continuous overlapping net glycaemic action calculated with n hour time-intervals (CONGA-n) were calculated as markers for glucose variability and correlation with 15 S ð Þ-8-iso-PGF 2α excretion was calculated. Results Median [interquartile range (IQR)] urinary 15 S ð Þ-8-iso-PGF 2α was higher in patients than healthy controls: 161 (140-217) pg/mg creatinine vs 118 (101-146) pg/mg creatinine (p=0.001). Median (IQR) MODD was 3.7 (3.2-5.0) mmol/l, MAGE 7.6 (6.4-9.0) mmol/l and CONGA-1 2.3 (2.1-2.8) mmol/l. Univariate regression did not reveal an association for MODD (r 2 =0.01), MAGE (0.08) or CONGA-1 (0.07) with 15 S ð Þ-8-iso-PGF 2α excretion, nor was an association revealed when corrected for HbA 1c , age, sex and smoking. Spearman correlation coefficients (r) between 15 S ð Þ-8-iso-PGF 2α excretion and MODD, MAGE and CONGA-1 were non-significant: −0.112, −0.381 and −0.177. Conclusions/interpretation We report that there is no relationship between glucose variability and urinary 15 S ð Þ-8-iso-PGF 2α. We also confirm that patients with type 1 diabetes have higher levels of urinary 15 S ð Þ-8-iso-PGF 2α than healthy controls, suggesting that in addition to glucose variability, other factors favouring oxidative stress may exist. We did not see a relation between high glucose variability and elevated levels of oxidative stress in patients with type 1 diabetes.

Research paper thumbnail of Glucose Fluctuations and Activation of Oxidative Stress in Patients with Type II Diabetes Mellitus

Indian journal of Medical Biochemistry, 2017

Introduction: In recent years, the oxidative stress (OS)-induced free radicals have been implicat... more Introduction: In recent years, the oxidative stress (OS)-induced free radicals have been implicated in the pathology of diabetes mellitus (DM). Persistently high glucose levels can lead to the generation of higher amounts of free radicals. The purpose of the present study was to evaluate the role of hyperglycemia [by measuring variables: Glycated hemoglobin (HbA1c), fasting plasma glucose (FPG)] in the induction of OS [(by analyzing the OS marker: Malondialdehyde (MDA)] in type II DM. Materials and methods: This observational study was conducted among 50 type II DM patients without complications and 50 type II DM patients with complications in S.B.K.S. Medical Institute and Research Centre, Waghodiya, Gujarat, India. Correlations between variables were tested using the Pearson rho correlation test. Chi-squared (χ 2) analysis was used for comparison of groups. Results: The MDA values correlated significantly with HbA1c and FPG values in type II diabetic subjects with complications (r = +0.29, p = 0.04; r = +0.47, p = 0.0006). Conclusion: Glucose fluctuations may activate OS in DM. Assessment of glycemic control marker HbA1c and lipid peroxidation marker MDA is useful in DM patients for detection of risk of diabetic complications at an early stage of the disease.

Research paper thumbnail of Effect of Obesity on Antioxidant enzymes and Type 2 Diabetes Mellitus

Obesity refers to body mass index (BMI) greater than 30kg/m. The present study aims to assess fir... more Obesity refers to body mass index (BMI) greater than 30kg/m. The present study aims to assess firstly, obesity as an independent risk factor for decreased activity of antioxidant enzymes in humans and secondly, its role in complicating glucose and lipid metabolism in type 2 diabetic subjects. The study was conducted on two groups; Group 1 had 50 obese subjects with two subgroups: (a) including 25 type 2 diabetic subjects and (b) 25 obese with different grades of obesity (30-50 kg/m) with no history of type 2 diabetes, hypertension, and hyperlipidemia. Group 2 included 25 non-obese type 2 diabetic subjects. Results were compared with 25 age matched healthy controls. Parameters assessed were BMI (weight in kg/height in metres), lipid profile, erythrocyte Superoxide dismutase (SOD) and

Research paper thumbnail of Effects of Serum Iron Status on the Relationship between Manganese and Iron transport proteins in Iron Foundry Workers

Iron foundries deal with the tapping and transport of molten iron and charging of furnaces. This ... more Iron foundries deal with the tapping and transport of molten iron and charging of furnaces. This creates exposure to iron oxide and other metal oxide fumes. The aim of this study was to evaluate the alterations in biochemical parameters related to iron metabolism in iron foundry workers. In the study 50 iron foundry workers engaged in daily foundry work were randomly selected from an iron foundry in Narol, Ahmedabad. The results were compared with age, sex matched employees of the foundry engaged in other work and not exposed to fumes. Results showed higher manganese and iron levels in subjects engaged in foundry work compared to controls. The proteins ferritin and transferrin, associated with iron metabolism were significantly altered compared to controls.

Research paper thumbnail of Association between gamma glutamyl transferase and insulin resistance markers in healthy obese children

The Journal of the Association of Physicians of India, 2009

OBJECTIVE To study the relationship of gamma glutamyl transferase (GGT) with insulin resistance m... more OBJECTIVE To study the relationship of gamma glutamyl transferase (GGT) with insulin resistance markers [fasting insulin and Homeostasis Model Assessment of-insulin resistance (HOMA-IR)] and to assess the role of GGT as a determinant of insulin resistance in healthy obese children. MATERIAL AND METHODS Fifty healthy obese children (boys and girls with mean age 9.2 +/- 0.73 and 8.8 +/- 0.74 years) born to diabetic mothers were studied. In all the subjects, anthropometric measurements viz, BMI and body weight were studied. The biochemical parameters analysed in fasting samples of subjects were plasma glucose, plasma insulin, serum GGT and calculation of HOMA-IR. RESULTS The fifty studied subjects belonged to age group 8 to12 years. The difference in mean age of boys and girls was not significant (p = 0.09). Body weight values in all subjects ranged from 20 to 78 kgs and BMI values ranged from 14.5 to 42.1 Kg/m2. No significant difference was observed between body weight and BMI values...

Research paper thumbnail of Subclinical hypothyroidism and its association with cardiovascular risk factors

Clinical laboratory, 2011

BACKGROUND Subclinical hypothyroidism (SH) represents the mildest form of thyroid hormone deficie... more BACKGROUND Subclinical hypothyroidism (SH) represents the mildest form of thyroid hormone deficiency and may be associated with adverse consequences [Subclinical hypothyroidism was defined as a TSH level > 4.0 mIU/L and a normal free thyroxine level 0.6-1.8 ng/dL]. The identification of patients with subclinical hypothyroidism having an increased cardiovascular risk (CVR) is important. The aim of the study was to evaluate atherosclerotic risk factors in patients with subclinical hypothyroidism. METHODS Forty patients with subclinical hypothyroidism and forty healthy euthyroid controls, age and gender matched were included in the study. Serum total triiodothyronine (T3), thyroxine (T4), TSH, free T3 (FT3) and free T4 (FT4) were measured by enzyme linked immunosorbent assay (ELISA). Atherosclerotic risk factors measured were high sensitivity-CRP (hs-CRP), Lipoprotein (a) [Lp (a)] and lipid parameters. Lipid parameters (triglycerides, total cholesterol and high density lipoprotein c...

Research paper thumbnail of Study of impairment in collaboration between ceruloplasmin and transferrin in development of complications in type 2 diabetes mellitus

International Journal of Research in Medical Sciences, 2016

Background: Hyperglycemia in diabetic patients can increase the levels of free radicals through v... more Background: Hyperglycemia in diabetic patients can increase the levels of free radicals through various metabolic alterations. One of the most reactive pro-oxidants in peroxidation reactions is free, redox-active iron and generates highly reactive hydroxyl radicals that initiate lipid peroxidation. The purpose of the study was to elucidate the role of CP and TRF in type 2 DM and analyse the effect of disturbance in collaboration between these parameters in pathogenesis of type 2 diabetic complications. Methods: We included 100 Type 2 DM subjects (with and without complications) and 100 healthy controls. The duration of type 2 DM in study subjects ranged from 5 to 16 years. Blood samples in fasting condition were collected for analysis of serum malondialdehyde (MDA), CP and TRF. Results: In the study serum CP levels were higher in Type 2 diabetic subjects with complications compared to diabetic subjects without complications (P=0.01). However, significantly low transferrin values were obtained in diabetic subjects with complications compared to diabetic subjects without complications (P=0.007). Significantly high MDA levels were observed (P=0.002) in type 2 diabetic subjects with complications compared to type 2 diabetic subjects without complications. Conclusions: The results of the present study indicate oxidative stress plays a role in precipitating complications in Type 2 DM reflecting in disturbance of CP and TRF collaboration.

Research paper thumbnail of Assessment of Oxidative Stress and Lipid Status in Patients of Type 2 Diabetes Mellitus with and without Complications

International Journal of Biochemistry Research & Review, 2016

Research paper thumbnail of Effect of meals with varying glycemic index on blood glucose response in type 2 diabetes mellitus

International Journal of Research in Medical Sciences, 2016

Background: In diabetes mellitus (DM) glucose is underused, producing hyperglycaemia. Dietary int... more Background: In diabetes mellitus (DM) glucose is underused, producing hyperglycaemia. Dietary interventions would be effective in management of glycemic control in DM. The glycemic index (GI) and glycemic load (GL) takes into account the glycemic response. Foods with contrasting GI when incorporated into a meal are able to differentially modify glycemia. Currently there is no universal approach to the optimal dietary strategy for DM. Also, little is known about whether this is dependent on the size and composition of the meal. The purpose of the study was to evaluate the blood glucose response to mixed meals (with varying GI and GL) served to Type 2 DM subjects and to determine the relationship between GI, GL and Postprandial Plasma glucose levels (PPG) in Type 2 DM. Methods: This study included 30 Type 2 DM subjects and 30 Non Diabetic Subjects. The subjects were served Hospital based and Home based diet. The FPG (Fasting Plasma Glucose) and PPG values were analysed for comparing the effect of both the diets on plasma glucose levels. Results: After analysis of study data we found that plasma glucose response (FPG-126±6.1 mg/dl, PPG-144.3±4.5 mg/dl) for hospital based low GI meals is significantly lower (p <0.0001) than after one week follow up home based mixed GI meals, (FPG-135±4.5 mg/dl, PPG 158.3±4.5 mg/dl). Conclusions: It was concluded in the study that Plasma Glucose shows a positive response to high GI foods and this may aggravate the hyperglycemia already present in Type 2 DM. Low GI diets may be helpful in reducing risks related to Type 2 DM.

Research paper thumbnail of Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes

Diabetologia, 2007

Aims/hypothesis Glucose fluctuations may help predict diabetic complications. We evaluated the re... more Aims/hypothesis Glucose fluctuations may help predict diabetic complications. We evaluated the relation between glucose variability and oxidative stress in patients with type 1 diabetes. Methods Continuous glucose monitors were inserted subcutaneously in 25 patients. During the measurement, patients collected two 24 h urine samples, while 24 healthy controls collected one 24 h urine sample for determination of 15(S)-8-iso-prostaglandin F 2a PGF 2a ð Þ using HPLC tandem mass spectrometry. Mean of the daily differences (MODD), mean amplitude of glycaemic excursions (MAGE) and continuous overlapping net glycaemic action calculated with n hour time-intervals (CONGA-n) were calculated as markers for glucose variability and correlation with 15 S ð Þ-8-iso-PGF 2α excretion was calculated. Results Median [interquartile range (IQR)] urinary 15 S ð Þ-8-iso-PGF 2α was higher in patients than healthy controls: 161 (140-217) pg/mg creatinine vs 118 (101-146) pg/mg creatinine (p=0.001). Median (IQR) MODD was 3.7 (3.2-5.0) mmol/l, MAGE 7.6 (6.4-9.0) mmol/l and CONGA-1 2.3 (2.1-2.8) mmol/l. Univariate regression did not reveal an association for MODD (r 2 =0.01), MAGE (0.08) or CONGA-1 (0.07) with 15 S ð Þ-8-iso-PGF 2α excretion, nor was an association revealed when corrected for HbA 1c , age, sex and smoking. Spearman correlation coefficients (r) between 15 S ð Þ-8-iso-PGF 2α excretion and MODD, MAGE and CONGA-1 were non-significant: −0.112, −0.381 and −0.177. Conclusions/interpretation We report that there is no relationship between glucose variability and urinary 15 S ð Þ-8-iso-PGF 2α. We also confirm that patients with type 1 diabetes have higher levels of urinary 15 S ð Þ-8-iso-PGF 2α than healthy controls, suggesting that in addition to glucose variability, other factors favouring oxidative stress may exist. We did not see a relation between high glucose variability and elevated levels of oxidative stress in patients with type 1 diabetes.