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Panminerva Medica 1998 December;40(4):304-8


lingua: Inglese

Nitrite plasma levels in type 1 and 2 diabetics with and without complications

Ferlito S., Gallina M.

From the Institute of Medical Clinic I Chair of Semeiology and Medical Methodology University of Catania, Catania, Italy


Background. The ­authors ­thought it inter­esting to ­examine the inter­re­la­tion­ship ­between ­nitric ­oxide and dia­betes mel­litus by the deter­mi­na­tion of the ­nitrite ­plasma ­levels, ­stable end-prod­ucts of ­nitric ­oxide, in var­ious clin­ical pat­terns of dia­betes mel­litus.
Methods. Our ­series con­sisted of 161 ­female sub­jects (­mean age 54±7 years, dis­ease dura­tion 5±3 ­months) sub­di­vided ­into: a) 13 ­patients suf­fering ­from ­insulin-depen­dent dia­betes (­IDDM) ­without clin­ical and instru­mental ­signs of ­micro- and mac­ro­an­gio­pathy; b) 148 suf­fering ­from non ­insulin-depen­dent dia­betes mel­litus (­NIDDM) of ­whom: 1) 52 ­without vas­cular com­pli­ca­tions (28 ­normal ­weight, BMI <25, and 24 ­obese, BMI >30); 2) 40 ­with clin­ical and instru­mental ­signs of non hyper­ten­sive cor­o­nary ­heart dis­ease (CHD); 3) 25 ­with CHD and hyper­ten­sion (arte­rial ­blood pres­sure ­over 160/95 mmHg); 4) 31 ­with hyper­cho­les­ter­o­lemia (­values ­over 250 mg/dl). All ­patients ­were exam­ined in ­good gly­co­met­a­bolic con­di­tions ­reached by ­oral hypo­gly­cem­iant (12 ­cases) or ­insulin (149 ­cases) treat­ment. As ­normal con­trol 37 ­female sub­jects (­mean age 48±7) ­without inter­nistic dis­eases ­were con­sid­ered. For ­each ­sample we deter­mined the ­plasma ­levels of ­nitrites by the Gutman and Hollywood ­method.
Results. Almost sim­ilar ­nitrite ­plasma ­levels in ­IDDM (17±0.5 ­mumol/L) and ­normal con­trols (17±0.2 ­mumol/L) ­were ­found; in non com­pli­cated non ­obese ­NIDDM a not sig­nif­i­cantly ele­vated ­value (21±0.8 mumol/L) as com­pared ­with the ­IDDM and con­trol ­group was ­found; the ­obese ­NIDDM ­patients ­showed a ­value (18±0.4 mumol/L) not sig­nif­i­cantly dif­ferent in com­par­ison ­with the non ­obese ­NIDDM ­group. In the ­NIDDM ­group ­with non hyper­ten­sive CHD) the ­nitrite ­value was ­almost sim­ilar (20±0.5 ­mumol/L) to the cor­re­sponding ­group ­without vas­cular com­pli­ca­tions. In the ­patients ­with CHD and hyper­ten­sion the ­nitrite ­level was super­im­pos­able (20±0.7 ­mumol/L) on the one ­recorded in ­NIDDM ­patients ­without vas­cular com­pli­ca­tions and in ­those ­with CHD ­without hyper­ten­sion. In ­NIDDM ­patients ­with hyper­cho­les­ter­o­lemia the ­mean ­nitrite ­value was ­sharply ele­vated (24±0.8 mumoI/L); the dif­fer­ence ­between ­this ­group and ­those of non hyper­chol­es­ter­o­lemic, non ­obese, ­obese and CHD (­with or ­without hyper­ten­sion) ­patients was sig­nifl­cant (p<0.05).
Conclusions. It is con­ceiv­able ­that dia­betes mel­litus per se ­causes a ten­den­tial not sig­nif­i­cant ­increase of NO pro­duc­tion in com­par­ison ­with ­normal con­trols; ­some fac­tors ­such as ­blood pres­sure, over­weight, dis­ease dura­tion, ther­a­peutic treat­ment and cor­o­nary com­pli­ca­tions ­appear not to influ­ence NO pro­duc­tion. In hyper­chol­es­ter­o­lemic dia­betic ­patients the ­nitrite ­enhanced ­level in ­plasma ­might ­mean a com­pen­sa­tory ­response to a con­tin­uous inac­ti­va­tion of NO ­involved in a pro­tec­tive com­pe­ti­tion ­towards dam­aging fac­tors and ­chiefly ­against oxid­ised LDL.

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