Stuti Gupta | Universidade Federal do Rio Grande do Sul (original) (raw)

Papers by Stuti Gupta

Research paper thumbnail of Association of Plasma Uric Acid with Inflammatory and Oxidative Stress Markers in Diabetic Nephropathy in North Indian Population: A Case Control Study

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

Introduction: Uric acid (UA), despite being a major antioxidant in human plasma, is also associat... more Introduction: Uric acid (UA), despite being a major antioxidant in human plasma, is also associated with development of diseases associated with oxidative stress. There have been few studies exploring the relationship of Plasma Uric Acid (PUA) with oxidative stress and inflammation. Aim: To analyse the association between UA and markers of oxidative stress and inflammation in diabetic nephropathy. Materials and Methods: The present case control study enrolled 100 participants and were categorized into two Groups (50 each) i.e., Type 2 Diabetes Mellitus without complication (T2DM) and Type 2 Diabetes Mellitus with Nephropathy (DN). Markers of oxidative stress like reduced Glutathione (GSH), Ferric Reducing Ability of Plasma (FRAP), Glutathione-S-Transferase (GST) and Malondialdehyde (MDA) were measured spectrophotometrically. Plasma TNF-α, hsCRP, urinary MCP-1 as markers of inflammation were estimated by ELISA. PUA was measured by uricase-PAP method. Student's t-test, pearson correlation and, linear regression were used for statistical analysis. results: Plasma TNF-α, hsCRP, urinary MCP-1 were significantly (p<0.001) higher in DN as compared to patients with T2DM. GSH, FRAP and GST were lower (p<0.001) in DN as compared to T2DM group. However, plasma MDA was significantly higher in DN group as compared to T2DM. PUA significantly correlated negatively with GSH(r=-0.937, p<0.001), FRAP (r=-0.649, p<0.01), GST (r=-0.905, p<0.01) and positively with MDA (r=0.931, p<0.01), TNF-α (r=0.552, p<0.01), hsCRP (r=0.815, p<0.01), uMCP-1 (r=0.811, p< 0.001). In multivariate analysis, PUA was associated negatively with FRAP (Model 3:p=0.045) and GST (Model 3:p=0.44) but lost significance with GSH (Model 3:p=0.741), MDA (Model 3:p=0.884). However, PUA was associated with positively with TNF-α (Model 3:p=0.038), hsCRP (Model 3:p=0.036) and uMCP-1 (Model 3:p=0.040). conclusion: PUA was associated negatively with FRAP, GST and positively with TNF-α, hsCRP, uMCP-1 in diabetic patients. These results suggest that UA contributes to oxidative stress and systemic inflammation. Stuti Gupta et al., Uric acid, as an Agent of Oxidative Stress and Inflammation www.jcdr.net

Research paper thumbnail of Pre-analytical phase in clinical chemistry laboratory

Journal of Clinical and Scientific Research, 2016

The laboratory testing process is divided into the pre-analytical, analytical and post-analytical... more The laboratory testing process is divided into the pre-analytical, analytical and post-analytical phases. For obtaining reliable test results, the prevention and detection of errors at all steps is required. While analytical standards have been developed by recognized quality control criteria, there is a scarcity in the development of standards for the preanalytical phase. This phase is most prone to errors as the steps involved are directly dependent on humans and are out of direct control of the laboratory. Such errors in preanalytical stage often only become apparent in the analytical or post-analytical phase. The development of a pre-analytical quality manual is essential in achieving total quality control. Correct practices and strategies of error prevention can reduce preanalytical errors. This review focuses on prevention of pre-analytical errors that occur while collecting a specimen of blood, urine and cerebrospinal fluid. Most of these can be easily prevented with understanding and education of the personnel involved in and responsible for executing this crucial pre-analytical phase.

Research paper thumbnail of Effect of iron deficiency anemia and iron supplementation on HbA1c levels - Implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians

Clinica Chimica Acta, 2017

Background: We investigated the effect of iron deficiency anemia (IDA) on levels of glycated hemo... more Background: We investigated the effect of iron deficiency anemia (IDA) on levels of glycated hemoglobin (HbA1c) and to compare its levels before and after iron supplementations. Methods: Age and sex matched subjects were enrolled and clustered in 2 groups: IDA (n=62) and healthy controls (HC; n=60). HbA1c levels were estimated by HPLC. Hemogram were estimated by hematology analyser. Serum ferritin (ELISA) and other parameters of iron profile were measured by standard guidelines of ICSH. HbA1c values and iron studies were repeated after 3 months of iron supplementation to determine the effect of iron therapy on HbA1c levels. Results: Significantly higher HbA1c levels were observed in IDA subjects compared to HC (5.51 ± 0.696 v/s 4.85 ± 0.461 %, p < 0.001). A significant negative correlation was observed between HbA1c and hemoglobin, hematocrit, RBC count, MCH, MCHC and serum ferritin in IDA subjects (r=-0.632,-0.652,-0.384,-0.236,-0.192 and-0.441). Significant decline was noticed in HbA1c levels in IDA subjects after iron supplementation (5.51 ± 0.696 before treatment v/s 5.044 ± 0.603 posttreatment; p< 0.001). Post treatment, 70% subjects (14/20) with HbA1c in prediabetes range normalised to normal glucose tolerance (NGT) range and out of 6 patients with pre-treatment HbA1c in diabetes range, 5 reverted to pre-diabetes range while 1 of them reverted to the NGT range. Conclusions: Caution must be exercised in interpreting the results of HbA1c in patients of IDA and iron deficiency must be corrected before diagnosing diabetes and pre-diabetes solely on the basis of HbA1c criteria.

Research paper thumbnail of Association of glutathione-S-transferase with patients of type 2 diabetes mellitus with and without nephropathy

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016

Hyperglycemia induced oxidative stress is implicated as a contributor to the onset and progressio... more Hyperglycemia induced oxidative stress is implicated as a contributor to the onset and progression of type 2 diabetes mellitus (T2DM) and its complications like diabetic nephropathy (DN). Glutathione-S-transferase (GST) is primarily involved in the neutralization of reactive oxygen species (ROS) by enzymatic conjugation with the scavenger peptide glutathione (GSH). Therefore, present study was aimed to evaluate the role of GST along with oxidative stress markers and their correlation in patients with Type 2 diabetes mellitus with and without nephropathy. This study comprised of 300 participants divided into three groups of 100 each: healthy controls (HC), T2DM without complications and DN. Plasma GST, malondialdehyde (MDA), reduced GSH levels and ferric reducing ability of plasma (FRAP) were estimated spectrophotometrically. Highest GST levels was observed in T2DM which was significantly higher (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) as compared to DN and HC. However, GSH and FRAP levels were found to be significantly lowest whereas MDA levels were significantly highest in DN as compared to T2DM and HC. GST showed a significant negative correlation with GSH, FRAP and positive correlation with MDA in both patients groups. Highest activity of GST in T2DM might be as a compensatory mechanism in response to oxidative stress. GST is found to have significant negative association with decreased GSH. Altered redox milieu in DN collectively conspire to increase the risk of renal damage in T2DM.

Research paper thumbnail of Effect of obesity and glycated hemoglobin on oxygen saturation in ambulatory type 2 diabetic individuals: A pilot study

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016

Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. The worldw... more Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. The worldwide prevalence of diabetes among adults (aged 20-79) was about 285 million in 2010 and is predicted to become 439 million by 2030 and this increase will be most notable in the developing countries [1]. Diabetes is strongly associated with both microvascular and macrovascular complications, including retinopathy, nephropathy, and neuropathy (microvascular) and ischemic heart disease, peripheral vascular disease, and cerebrovascular disease (macrovascular), resulting in tissue and organ hypoxia and damage in approximately one third to one half of people with diabetes [2]. Of these Myocardial infraction (MI) is the leading cause ($70%) of death in diabetic patients [3]. Hemoglobin is the principal carrier of oxygen in the body. HbA1c measures the percentage of HbA that has been irreversibly glycated at the N-terminal amino group of the b-chain. The value is determined by the level of plasma glucose and the life span of red blood cells. Thus HbA1c is commonly used as an indicator to assess the glycemic control over the preceding 2-3 months [4]. Previous studies have shown that glycation alters the structure and function of hemoglobin [5,6] and tends to shift the oxygen dissociation Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2016) xxx-xxx

Research paper thumbnail of Association of Tumor Necrosis Factor (TNF) promoter polymorphisms with plasma TNF-α levels and susceptibility to diabetic nephropathy in North Indian population

Journal of diabetes and its complications, 2015

The concept of diabetic nephropathy (DN) as a metabolic disease is now being replaced by chronic ... more The concept of diabetic nephropathy (DN) as a metabolic disease is now being replaced by chronic low-grade inflammatory disease. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine which plays an important role in the pathogenesis and clinical outcome of DN. Therefore, this work was planned to evaluate the association of -863C/A (rs1800630) and -1031T/C (rs1799964) polymorphisms in TNF gene with plasma TNF-α levels and DN among subjects with type 2 diabetes (T2DM) in a population from North India. Age and sex matched 100 healthy controls (HC), 100 T2DM subjects without nephropathy (DM) and 100 subjects with DN were screened for above polymorphisms using the PCR-RFLP methods. Plasma TNF-α levels were measured by ELISA. Analysis of variance and logistic regression were used to associate individual polymorphisms with plasma TNF-α levels and DN. The allelic frequencies of -863C/A were 0.86/0.14 in HC, 0.72/0.23 in DM and 0.84/0.16 in DN, and that of -1031T/C were 0.89/0.11...

Research paper thumbnail of Association of NFKB1 gene polymorphism (rs28362491) with levels of inflammatory biomarkers and susceptibility to diabetic nephropathy in Asian Indians

World journal of diabetes, Jan 15, 2017

To investigate the association of NFKB1 gene -94 ATTG insertion/deletion (rs28362491) polymorphis... more To investigate the association of NFKB1 gene -94 ATTG insertion/deletion (rs28362491) polymorphism with inflammatory markers and risk of diabetic nephropathy in Asian Indians. A total of 300 subjects were recruited (100 each), normoglycemic, (NG); type 2 diabetes mellitus (T2DM) without any complications (DM) and T2DM with diabetic nephropathy [DM-chronic renal disease (CRD)]. Analysis was carried out by polymerase chain reaction-restriction fragment length polymorphism and ELISA. Pearson's correlation, analysis of variance and logistic regression were used for statistical analysis. The allelic frequencies of -94 ATTG insertion/deletion were 0.655/0.345 (NG), 0.62/0.38 (DM) and 0.775/0.225 (DM-CRD). The -94 ATTG ins allele was associated with significantly increased levels of urinary monocyte chemoattractant protein-1 (uMCP-1); uMCP-1 (P = 0.026) and plasma tumor necrosis factor-alpha (TNF-α); TNF-α (P = 0.030) and almost doubled the risk of diabetic nephropathy (OR = 1.91, 95%C...

Research paper thumbnail of Association of Plasma Uric Acid with Inflammatory and Oxidative Stress Markers in Diabetic Nephropathy in North Indian Population: A Case Control Study

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

Introduction: Uric acid (UA), despite being a major antioxidant in human plasma, is also associat... more Introduction: Uric acid (UA), despite being a major antioxidant in human plasma, is also associated with development of diseases associated with oxidative stress. There have been few studies exploring the relationship of Plasma Uric Acid (PUA) with oxidative stress and inflammation. Aim: To analyse the association between UA and markers of oxidative stress and inflammation in diabetic nephropathy. Materials and Methods: The present case control study enrolled 100 participants and were categorized into two Groups (50 each) i.e., Type 2 Diabetes Mellitus without complication (T2DM) and Type 2 Diabetes Mellitus with Nephropathy (DN). Markers of oxidative stress like reduced Glutathione (GSH), Ferric Reducing Ability of Plasma (FRAP), Glutathione-S-Transferase (GST) and Malondialdehyde (MDA) were measured spectrophotometrically. Plasma TNF-α, hsCRP, urinary MCP-1 as markers of inflammation were estimated by ELISA. PUA was measured by uricase-PAP method. Student's t-test, pearson correlation and, linear regression were used for statistical analysis. results: Plasma TNF-α, hsCRP, urinary MCP-1 were significantly (p<0.001) higher in DN as compared to patients with T2DM. GSH, FRAP and GST were lower (p<0.001) in DN as compared to T2DM group. However, plasma MDA was significantly higher in DN group as compared to T2DM. PUA significantly correlated negatively with GSH(r=-0.937, p<0.001), FRAP (r=-0.649, p<0.01), GST (r=-0.905, p<0.01) and positively with MDA (r=0.931, p<0.01), TNF-α (r=0.552, p<0.01), hsCRP (r=0.815, p<0.01), uMCP-1 (r=0.811, p< 0.001). In multivariate analysis, PUA was associated negatively with FRAP (Model 3:p=0.045) and GST (Model 3:p=0.44) but lost significance with GSH (Model 3:p=0.741), MDA (Model 3:p=0.884). However, PUA was associated with positively with TNF-α (Model 3:p=0.038), hsCRP (Model 3:p=0.036) and uMCP-1 (Model 3:p=0.040). conclusion: PUA was associated negatively with FRAP, GST and positively with TNF-α, hsCRP, uMCP-1 in diabetic patients. These results suggest that UA contributes to oxidative stress and systemic inflammation. Stuti Gupta et al., Uric acid, as an Agent of Oxidative Stress and Inflammation www.jcdr.net

Research paper thumbnail of Pre-analytical phase in clinical chemistry laboratory

Journal of Clinical and Scientific Research, 2016

The laboratory testing process is divided into the pre-analytical, analytical and post-analytical... more The laboratory testing process is divided into the pre-analytical, analytical and post-analytical phases. For obtaining reliable test results, the prevention and detection of errors at all steps is required. While analytical standards have been developed by recognized quality control criteria, there is a scarcity in the development of standards for the preanalytical phase. This phase is most prone to errors as the steps involved are directly dependent on humans and are out of direct control of the laboratory. Such errors in preanalytical stage often only become apparent in the analytical or post-analytical phase. The development of a pre-analytical quality manual is essential in achieving total quality control. Correct practices and strategies of error prevention can reduce preanalytical errors. This review focuses on prevention of pre-analytical errors that occur while collecting a specimen of blood, urine and cerebrospinal fluid. Most of these can be easily prevented with understanding and education of the personnel involved in and responsible for executing this crucial pre-analytical phase.

Research paper thumbnail of Effect of iron deficiency anemia and iron supplementation on HbA1c levels - Implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians

Clinica Chimica Acta, 2017

Background: We investigated the effect of iron deficiency anemia (IDA) on levels of glycated hemo... more Background: We investigated the effect of iron deficiency anemia (IDA) on levels of glycated hemoglobin (HbA1c) and to compare its levels before and after iron supplementations. Methods: Age and sex matched subjects were enrolled and clustered in 2 groups: IDA (n=62) and healthy controls (HC; n=60). HbA1c levels were estimated by HPLC. Hemogram were estimated by hematology analyser. Serum ferritin (ELISA) and other parameters of iron profile were measured by standard guidelines of ICSH. HbA1c values and iron studies were repeated after 3 months of iron supplementation to determine the effect of iron therapy on HbA1c levels. Results: Significantly higher HbA1c levels were observed in IDA subjects compared to HC (5.51 ± 0.696 v/s 4.85 ± 0.461 %, p < 0.001). A significant negative correlation was observed between HbA1c and hemoglobin, hematocrit, RBC count, MCH, MCHC and serum ferritin in IDA subjects (r=-0.632,-0.652,-0.384,-0.236,-0.192 and-0.441). Significant decline was noticed in HbA1c levels in IDA subjects after iron supplementation (5.51 ± 0.696 before treatment v/s 5.044 ± 0.603 posttreatment; p< 0.001). Post treatment, 70% subjects (14/20) with HbA1c in prediabetes range normalised to normal glucose tolerance (NGT) range and out of 6 patients with pre-treatment HbA1c in diabetes range, 5 reverted to pre-diabetes range while 1 of them reverted to the NGT range. Conclusions: Caution must be exercised in interpreting the results of HbA1c in patients of IDA and iron deficiency must be corrected before diagnosing diabetes and pre-diabetes solely on the basis of HbA1c criteria.

Research paper thumbnail of Association of glutathione-S-transferase with patients of type 2 diabetes mellitus with and without nephropathy

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016

Hyperglycemia induced oxidative stress is implicated as a contributor to the onset and progressio... more Hyperglycemia induced oxidative stress is implicated as a contributor to the onset and progression of type 2 diabetes mellitus (T2DM) and its complications like diabetic nephropathy (DN). Glutathione-S-transferase (GST) is primarily involved in the neutralization of reactive oxygen species (ROS) by enzymatic conjugation with the scavenger peptide glutathione (GSH). Therefore, present study was aimed to evaluate the role of GST along with oxidative stress markers and their correlation in patients with Type 2 diabetes mellitus with and without nephropathy. This study comprised of 300 participants divided into three groups of 100 each: healthy controls (HC), T2DM without complications and DN. Plasma GST, malondialdehyde (MDA), reduced GSH levels and ferric reducing ability of plasma (FRAP) were estimated spectrophotometrically. Highest GST levels was observed in T2DM which was significantly higher (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) as compared to DN and HC. However, GSH and FRAP levels were found to be significantly lowest whereas MDA levels were significantly highest in DN as compared to T2DM and HC. GST showed a significant negative correlation with GSH, FRAP and positive correlation with MDA in both patients groups. Highest activity of GST in T2DM might be as a compensatory mechanism in response to oxidative stress. GST is found to have significant negative association with decreased GSH. Altered redox milieu in DN collectively conspire to increase the risk of renal damage in T2DM.

Research paper thumbnail of Effect of obesity and glycated hemoglobin on oxygen saturation in ambulatory type 2 diabetic individuals: A pilot study

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016

Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. The worldw... more Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. The worldwide prevalence of diabetes among adults (aged 20-79) was about 285 million in 2010 and is predicted to become 439 million by 2030 and this increase will be most notable in the developing countries [1]. Diabetes is strongly associated with both microvascular and macrovascular complications, including retinopathy, nephropathy, and neuropathy (microvascular) and ischemic heart disease, peripheral vascular disease, and cerebrovascular disease (macrovascular), resulting in tissue and organ hypoxia and damage in approximately one third to one half of people with diabetes [2]. Of these Myocardial infraction (MI) is the leading cause ($70%) of death in diabetic patients [3]. Hemoglobin is the principal carrier of oxygen in the body. HbA1c measures the percentage of HbA that has been irreversibly glycated at the N-terminal amino group of the b-chain. The value is determined by the level of plasma glucose and the life span of red blood cells. Thus HbA1c is commonly used as an indicator to assess the glycemic control over the preceding 2-3 months [4]. Previous studies have shown that glycation alters the structure and function of hemoglobin [5,6] and tends to shift the oxygen dissociation Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2016) xxx-xxx

Research paper thumbnail of Association of Tumor Necrosis Factor (TNF) promoter polymorphisms with plasma TNF-α levels and susceptibility to diabetic nephropathy in North Indian population

Journal of diabetes and its complications, 2015

The concept of diabetic nephropathy (DN) as a metabolic disease is now being replaced by chronic ... more The concept of diabetic nephropathy (DN) as a metabolic disease is now being replaced by chronic low-grade inflammatory disease. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine which plays an important role in the pathogenesis and clinical outcome of DN. Therefore, this work was planned to evaluate the association of -863C/A (rs1800630) and -1031T/C (rs1799964) polymorphisms in TNF gene with plasma TNF-α levels and DN among subjects with type 2 diabetes (T2DM) in a population from North India. Age and sex matched 100 healthy controls (HC), 100 T2DM subjects without nephropathy (DM) and 100 subjects with DN were screened for above polymorphisms using the PCR-RFLP methods. Plasma TNF-α levels were measured by ELISA. Analysis of variance and logistic regression were used to associate individual polymorphisms with plasma TNF-α levels and DN. The allelic frequencies of -863C/A were 0.86/0.14 in HC, 0.72/0.23 in DM and 0.84/0.16 in DN, and that of -1031T/C were 0.89/0.11...

Research paper thumbnail of Association of NFKB1 gene polymorphism (rs28362491) with levels of inflammatory biomarkers and susceptibility to diabetic nephropathy in Asian Indians

World journal of diabetes, Jan 15, 2017

To investigate the association of NFKB1 gene -94 ATTG insertion/deletion (rs28362491) polymorphis... more To investigate the association of NFKB1 gene -94 ATTG insertion/deletion (rs28362491) polymorphism with inflammatory markers and risk of diabetic nephropathy in Asian Indians. A total of 300 subjects were recruited (100 each), normoglycemic, (NG); type 2 diabetes mellitus (T2DM) without any complications (DM) and T2DM with diabetic nephropathy [DM-chronic renal disease (CRD)]. Analysis was carried out by polymerase chain reaction-restriction fragment length polymorphism and ELISA. Pearson's correlation, analysis of variance and logistic regression were used for statistical analysis. The allelic frequencies of -94 ATTG insertion/deletion were 0.655/0.345 (NG), 0.62/0.38 (DM) and 0.775/0.225 (DM-CRD). The -94 ATTG ins allele was associated with significantly increased levels of urinary monocyte chemoattractant protein-1 (uMCP-1); uMCP-1 (P = 0.026) and plasma tumor necrosis factor-alpha (TNF-α); TNF-α (P = 0.030) and almost doubled the risk of diabetic nephropathy (OR = 1.91, 95%C...