Ibrahim, Hanim Afzan
(2015)
Paraoxonase activity in type 2 diabetes mellitus malay patients in Hospital Universiti Sains Malaysia (HUSM).
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Paraoxonase (PON) is an enzyme associated with high-density lipoprotein
(HDL). PON is involved in the detoxification of lipid peroxides and play a role in
decreasing oxidative stress which are related with the risk for complication in diabetes
mellitus type 2(T2 DM) patients that is strongly associated with their diabetic control. The
ability of PON to protect low density lipoprotein (LDL) against oxidation has been shown
to vary between the three polymorphic forms (A, AB, B). PON with phenotype B is less
efficient in protecting LDL against oxidation. Objectives: The purpose of this study was to
determine the PON1 activities, PON1 phenotypic polymorphism, lipid profile and oxidized
LDL (oxLDL) in T2 DM among Malay population and healthy control group, their relation
with diabetic complications and the correlation between PON activities and lipid profile.
Methods: A total of 99 subjects were chosen for three groups (healthy control, good
control diabetes mellitus (HbA1c ≤ 6.5%) and poor control diabetes mellitus(HbA1c >
6.5%) (each group n=33). Fasting serum were analysed for PON, salt stimulated PON,
arylesterase (AREase) activities, lipid profile and oxLDL. The phenotypes assesment for
PON can be A, B, AB based on the ratio of salt stimulated PON to the AREase activity.
Results: The basal PON and salt stimulated PON activities were not statistically significant
among the three groups. AREase activity was lower in T2 DM patients compared to healthy
control.Majority of subjects were AB phenotype and none of the healthy control subjects
with B phenotype. Diabetic patients with chronic kidney disease (CKD) showed
significantly lower salt stimulated PON activity when compared to those without CKD.
Lipid profile analyses for poor control diabetic group showed significantly lower in total
cholesterol (TC), HDL and LDL level and higher in triglyceride (TG) level compared to
healthy control. A positive correlation between the HDL levels and basal PON activity in
poor control diabetic and a positive correlation between the TC and HDL with salt
stimulated PON activity in poor control group. OxLDL level was not statistically
significant among the three groups however the PON to oxLDL ratio (PON/oxLDL) shows
significantly higher in healthy control compared to poor control diabetic group.
Conclusion: AREase activity was lower in T2 DM patients compared to healthy control
and majority of subjects (Malay population) were AB phenotype. Poor control T2 DM
group had lesser PON/oxLDL ratio when compared with healthy control and good control
T2DM although PON and oxLDL levels not significant. Thus it could relate with the risk of
complications in poor control T2 DM.
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