Differences in Gamma-Glutamyl Transferase and High-Sensitivity C-Reactive Protein Levels Between Type 2 Diabetes Mellitus with and without Vascular Complications
DOI:
https://doi.org/10.56294/saludcyt2024.1358Keywords:
Diabetes mellitus type 2, Vascular Complications, Gamma-glutamyl transferase, high-sensitivity C-reactive proteinAbstract
Introduction: Type 2 diabetes mellitus (T2DM) is a metabolic disease that causes microvascular and macrovascular complications and increases mortality. Oxidative stress and inflammation play a role in the pathogenesis of (T2DM). Gamma-glutamyl transferase (GGT) and high-sensitivity C-Reactive Protein (hs-CRP) levels as oxidative stress and inflammation markers help detect the high risk of developing T2DM complications. Objectives: Analyzing the differences in GGT and hs-CRP levels between T2DM with and without vascular complications predicts the sensitivity and specificity for the detection of T2DM vascular complications.
Methods: The cross-sectional study involved 19 patients with vascular complications of T2DM and 19 patients with T2DM without complications. Using patient serum samples, GGT and hs-CRP levels were measured using the TMS24i device. Results: The T2DM vascular complications group increased GGT and hs-CRP values. GGT and hs-CRP levels between T2DM with and without vascular complications were significant. The macrovascular (CHD) group had a higher GGT value than the microvascular group, there was a substantial difference in GGT between the two research subjects. On the other hand, there was no significant difference in hs-CRP. Logistic regression analysis found that the duration of T2DM and GGT influenced the risk of T2DM vascular complications. Analysis (ROC) showed GGT had (AUC=0.691) and hs-CRP (AUC=0.706). Conclusions: GGT plays a role in risk detection (CHD) compared to microvasculature. Significant differences in GGT and hs-CRP between T2DM with and without vascular complications and vascular complications of T2DM increase the values of GGT and hs-CRP
References
1. PERKENI. Guidelines for managing and preventing Type 2 Diabetes Mellitus in Indonesia 2021. PB PERKENI; 2021.
2. ADA. Classification and diagnosis of diabetes. Diabetes Care. 2015;38:8–16. https://doi.org/10.2337/dc15-S005
3. Bi Y, Yang S, Liu Y, Cao L. To explore the association between gamma-glutamyl transferase and type 2 diabetes using a real-world study and Mendelian randomization analysis. Front Endocrinol (Lausanne). 2022;13:1–10. https://doi.org/10.3389/fendo.2022.899008
4. Rafaqat S, Sattar A, Khalid A, Rafaqat S. Role of liver parameters in diabetes mellitus – a narrative review. Endocr Regul. 2023;57:200–220. https://doi.org/10.2478/enr-2023-0024
5. Gasecka A, Siwik D, Gajewska M, et al. Early biomarkers of neurodegenerative and neurovascular disorders in diabetes. J Clin Med. 2020;9(9):1–22. https://doi.org/10.3390/jcm9092807
6. Brownlee M. The pathobiology of diabetic complications: A unifying mechanism. J Diabetes. 2005;54(June):1615–25.
7. Ebrahimi M, Heidari-bakavoli AR, Shoeibi S, et al. Association of serum hs-CRP levels with the presence of obesity, diabetes mellitus, and other cardiovascular risk factors. J Clin Lab Anal. 2016;30(5):672–6. https://doi.org/10.1002/jcla.21920
8. Babu LE, Joshi A. Correlation of high-sensitivity C-reactive protein with blood sugar levels in patients with type 2 diabetes. Natl J Physiol Pharm Pharmacol. 2018;8(1):37–41. https://doi.org/10.5455/njppp.2018.8.0726805082017
9. Xie W, Liu B, Tang Y. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence. Endocrinol. 2022;13(1026791):1–10. https://doi.org/10.3389/fendo.2022.1026791
10. Cheema S, Maisonneuve P, Zirie M, et al. Risk factors for microvascular complications of diabetes in a high-risk Middle East population. J Diabetes Res. 2018;1–7. https://doi.org/10.1155/2018/8964027
11. Shiferaw K, Id K, Degemu N, et al. Determinants of hypertension among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa: A case-control study. PLoS One. 2021;16(8):1–16. https://doi.org/10.1371/journal.pone.0256399
12. El-Khawaga G, Abdel-Wahab F. European Journal of Research in Medical Sciences. Eur J Res Med Sci. 2015;3(1):40–53.
13. Ali SS, Oni ET, Blaha MJ, et al. Elevated gamma-glutamyl transferase is associated with subclinical inflammation independent of cardiometabolic risk factors in an asymptomatic population: A cross-sectional study. Nutr Metab. 2016;13(37):1–7. https://doi.org/10.1186/s12986-016-0097-7
14. Gohel MG, Chacko AN. Serum GGT activity and hs-CRP levels in patients with type 2 diabetes mellitus with good and poor glycemic control. J Diabetes Metab Disord. 2013;12(56):1–8. https://doi.org/10.1186/2251-6581-12-56
15. Simmons RK, Griffin SJ. Screening for type 2 diabetes: An update of the evidence. Diabetes Obes Metab. 2010;12(10):838–44. https://doi.org/10.1111/j.1463-1326.2010.01244.x
16. Kunutsor SK, Abbasi A, Adler AI. Gamma-glutamyl transferase and risk of type II diabetes: An updated systematic review and dose-response meta-analysis. Ann Epidemiol. 2014;24(11):809–16. https://doi.org/10.1016/j.annepidem.2014.09.001
17. Chuengsamarn S, Rattanamongkolgul S, Sittithumcharee G, et al. Association of serum high-sensitivity C-reactive protein with metabolic control and diabetic chronic vascular complications in patients with type 2 diabetes. Diabetes Metab Syndr Clin Res Rev. 2017;11(2):103–8. https://doi.org/10.1016/j.dsx.2016.08.012
18. Lainampetch J, Panprathip P, Phosat C, et al. Association of tumor necrosis factor alpha, interleukin 6, and C-reactive protein with the risk of developing type 2 diabetes: A retrospective cohort study of rural Thailand. J Diabetes Res. 2019;2:1–9. https://doi.org/10.1155/2019/9051929
19. Kalyan V, Reddy K, Shiddapur G, Jagdale N, Kondapalli MP. Investigating interleukin-6 levels in type 2 diabetes mellitus patients with and without diabetic nephropathy. Cureus. 2024;16(8):1–7. https://doi.org/10.7759/cureus.67014
20. Guan H, Liu K, Fan X, et al. Association of gamma-glutamyl transferase concentrations with all-cause and cause-specific mortality in Chinese adults with type 2 diabetes. J Diabetes. 2023;15(8):674–84. https://doi.org/10.1111/1753-0407.13399
21. Chung GE, Kim YJ, Cho Y, et al. Gamma-glutamyl transferase and the risk of all-cause and disease-specific mortality in patients with diabetes: A nationwide cohort study. Diabetes J. 2024;16(5):1–14. https://doi.org/10.1111/1753-0407.13551
22. Haydinger CD, Oliver GF, Ashander LM, Smith JR. Oxidative stress and its regulation in diabetic retinopathy. Antioxidants. 2023;12(1649):1–25.
23. Dai H, Zhu L, Pan B, et al. The relationship between serum γ glutamyltransferase (GGT) and diabetic nephropathy in patients with type 2 diabetes mellitus: A cross-sectional study. Clin Exp Med. 2023;23(7):3619–30. https://doi.org/10.1007/s10238-023-00991-9
24. Lin CC, Li CI, Liu CS, et al. Association of high-sensitivity C-reactive protein and diabetic nephropathy in patients with type 2 diabetes: A Mendelian randomization study. BMJ Open Diabetes Res Care. 2023;11(1):1–10. https://doi.org/10.1136/bmjdrc-2022-003197
25. Miranda Sánchez AB, Moina Veloz AP. Emerging biomarkers in gestational diabetes: Perspectives for improving diagnosis and prognoses. Salud, Ciencia y Tecnología. 2024;4:733.
26. Ménégaut L, Laubriet A, Crespy V, et al. Inflammation and oxidative stress markers in type 2 diabetes patients with advanced carotid atherosclerosis. Clin Exp Med. 2023;22(248):1–10.
27. Tisalema-Panimboza MA, Galárraga-Pérez EA. Cystatin C as an early marker of cardiovascular risk in patients with diabetes. Salud, Ciencia y Tecnología. 2024;4:684.
28. Aryan Z, Faghihi-Kashani S, Afarideh M. Baseline high-sensitivity C-reactive protein predicts macrovascular and microvascular complications of type 2 diabetes: A population-based study. Diabetes Res. 2018;72(4):287–95. https://doi.org/10.1159/000488537
29. Sharma S, Sharma H. Interrelationship among high sensitivity C-reactive protein (Hs-CRP). J Med Sci Clin Res. 2020;8(7):484–90
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