Abstract
Sialic acid (SA) is responsible for the composition of different isoforms of transferrin and is reported to be a marker of microvascular complications in type 2 diabetes mellitus. Therefore, we explored the serum concentration of SA, and the less sialylated isoforms of transferrin, termed carbohydrate‐deficient transferrin (CDT), in relation to the presence of microvascular complications in type 2 diabetes mellitus. We studied 21 patients with type 2 diabetes with microangiopathy and 22 patients without complications who were hospitalized at a diabetic clinic. The prevalence of microvascular complications was based on clinical history, fundoscopy, and laboratory tests. Blood samples were taken for measurements of SA, CDT, total transferrin, glucose, HbA1c, fibrinogen, C‐reactive protein (CRP), and indicators of renal dysfunction (i.e., creatinine, urea, albumin excretion rate (AER), and glomerular filtration rate (GFR)). A rise in serum SA and a decrease in CDT concentrations were observed in both diabetic groups with and without complications, and there were no differences between the two groups of patients. There was a statistically significant correlation between serum SA and CDT in diabetic subjects with microvascular complications, but not in patients without such complications. This proves that the serum changes in CDT and SA levels in the course of type 2 diabetes mellitus are associated with each other in the presence of microangiopathy. J. Clin. Lab. Anal. 20:68–73, 2006. © 2006 Wiley‐Liss, Inc.
Keywords: carbohydrate‐deficient transferrin, sialic acid, diabetes mellitus
REFERENCES
- 1. Wu JT. Review of diabetes: identification of markers for early detection, glycemic control, and monitoring clinical complications. J Clin Lab Anal 1993;7:293–300. [DOI] [PubMed] [Google Scholar]
- 2. Schauer R, Kamerling JP. Chemistry, biochemistry and biology of sialic acids In: Montreuil J, Visegenthart JFG, Schahter H, editors. Glycoproteins. Amsterdam: Elsevier; 1997. p 243–402. [Google Scholar]
- 3. Rahman MA, Zafar G, Shera AS. Changes in glycosylated proteins in long‐term complications of diabetes mellitus. Biomed Pharmacother 1990;44:229–234. [DOI] [PubMed] [Google Scholar]
- 4. Rehman J, Raman MA. Studies on glycosylated plasma proteins in diabetic patients. J Pak Med Assoc 1991;41:16–18. [PubMed] [Google Scholar]
- 5. Stibler H, Borg S, Allgulander C. Clinical significance of abnormal heterogeneity of transferrin in relation to alcohol consumption. Acta Med Scand 1979;206:275–281. [DOI] [PubMed] [Google Scholar]
- 6. Arndt T. Carbohydrate‐deficient transferrin as a marker of chronic alcohol abuse: a critical review of preanalysis, analysis and interpretation. Clin Chem 2000;47:13–27. [PubMed] [Google Scholar]
- 7. Crook M, Haq M, Haq S, Tutt P. Plasma sialic acid and acute‐phase proteins in patients with myocardial infarction. Angiology 1994;45:709–715. [DOI] [PubMed] [Google Scholar]
- 8. Crook MA, Couchman S, Tutt P. Plasma fibrinogen and its relationship to plasma sialic acid in non‐insulin‐dependent diabetes mellitus. Blood Coagul Fibrinolysis 1996;7:586–589. [DOI] [PubMed] [Google Scholar]
- 9. Romppanen J, Eskelinen M, Tikanoja S, Mononen I. Total and lipid bound serum sialic acid in benign and malignant breast disease. Anticancer Res 1997;17:1249–1254. [PubMed] [Google Scholar]
- 10. Sillanaukee P, Ponnio M, Jaaskelainen IP. Occurrence of sialic acids in healthy humans and different disorders. Eur J Clin Invest 1999;29:413–425. [DOI] [PubMed] [Google Scholar]
- 11. Sillanaukee P, Ponnio M, Seppa K. Sialic acid–new potential marker of alcohol abuse. Alcohol Clin Exp Res 1999;23:1039–1043. [DOI] [PubMed] [Google Scholar]
- 12. Crook MA, Earle K, Morocutti A, Yip J, Viberti G, Pickup JC. Serum sialic acid, a risk factor for cardiovascular diseases, is increased in IDDM patients with microalbuminuria and clinical proteinuria. Diabetes Care 1994;17:305–310. [DOI] [PubMed] [Google Scholar]
- 13. Yokoyama H, Jensen JS, Jensen T, Deckert T. Serum sialic acid concentration is elevated in IDDM especially in early diabetic nephropathy. J Intern Med 1995;237:519–523. [DOI] [PubMed] [Google Scholar]
- 14. Chen J, Gall MA, Yokoyama H, Jensen JS, Deckert M, Parving HH. Raised serum sialic acid concentration in NIDDM patients with and without diabetic nephropathy. Diabetes Care 1996;19:130–134. [DOI] [PubMed] [Google Scholar]
- 15. Ozben T, Nacitarhan S, Tuncer N. Plasma and urine sialic acid in non‐insulin dependent diabetes mellitus. Ann Clin Biochem 1995;32:303–306. [DOI] [PubMed] [Google Scholar]
- 16. Yokoyama H, Jensen JS, Myrup B, Mathiesen ER, Ronn B, Deckert T. Raised serum sialic acid concentration precedes onset of microalbuminuria in IDDM. A 10‐year follow‐up study. Diabetes Care 1996;19:435–440. [DOI] [PubMed] [Google Scholar]
- 17. Crook M. Type 2 diabetes mellitus: a disease of the innate immune system? An update. Diabet Med 2004;21:203–207. [DOI] [PubMed] [Google Scholar]
- 18.Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183–1197. [DOI] [PubMed] [Google Scholar]
- 19. Snowden C, Houlston R, Laker MF, Kesteven P, Alberti KG, Humphries S. Plasma fibrinogen levels and fibrinogen genotype in non‐insulin dependent diabetics. Dis Markers 1992;10:159–167. [PubMed] [Google Scholar]
- 20. Wakabayashi I, Masuda H. Relation of serum sialic acid to blood coagulation activity in type 2 diabetes. Blood Coagul Fibrinolysis 2002;13:691–696. [DOI] [PubMed] [Google Scholar]
- 21. Crook MA, Tutt P, Simpson H, Pickup JC. Serum sialic acid and acute phase proteins in type 1 and type 2 diabetes mellitus. Clin Chim Acta 1993;219:131–138. [DOI] [PubMed] [Google Scholar]
- 22. Flahaut C, Michalski JC, Danel T, Humbert MH, Klein A. The effects of ethanol on the glycosylation of human transferrin. Glycobiology 2003;13:191–198. [DOI] [PubMed] [Google Scholar]
- 23. Mesaric M, Decker K. Sialyltransferase activities in cultured rat hepatocytes. Biochem Biophys Res Commun 1990;171:132–137. [DOI] [PubMed] [Google Scholar]
- 24. Tepperman HM, DeWitt J, Tepperman J. The effects of streptozotocin diabetes on the activities of rat liver glycosyltransferases. Diabetes 1983;32:412–415. [DOI] [PubMed] [Google Scholar]
- 25. Rellier N, Ruggiero‐Lopez D, Lecomte M, Lagarde M, Wiernsperger N. In vitro and in vivo alternations of enzymatic glycosylation in diabetes. Life Sci 1999;64:1571–1583. [DOI] [PubMed] [Google Scholar]
