Assessment of Renal Erythropoietic Status of the Newly Diagnosed Diabetic Patients without Renal Impairment in Benin City, Nigeria — Oak Academic Publishing
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Assessment of Renal Erythropoietic Status of the Newly Diagnosed Diabetic Patients without Renal Impairment in Benin City, Nigeria
Department of Physiology, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Department of Medical Laboratory Science, University of Benin, Benin City, Benin
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Department of Medical Laboratory Science, College of Health Technology, Akure, Ondo State, Nigeria
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Department of Medical Laboratory Science, Federal University, Lafia, Nasarawa State, Nigeria
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Department of Medical Laboratory Science, University of Benin, Benin City, Benin
,
Department of Medical Laboratory Science, College of Allied Health Sciences, McPherson University, Ogun State, Nigeria
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Department of Chemical Pathology, National Hospital, Abuja, Nigeria
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Department of Medical Laboratory Science, University of Medical Sciences, Ondo, Ondo State, Nigeria
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Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Benson Idahosa University, Benin City, Edo State, Nigeria
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Department of Physiology, College of Health Sciences, Joseph Ayo Babalola University, Ikeji-Arakeji, Osun State, Nigeria
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Department of Natural Science, Faculty of Science and Technology, Middlesex University, London, UK
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Department of Anatomy, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Benson Idahosa University, Benin City, Edo State, Nigeria
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Department of Medical Laboratory Science, International Institute for Oncology and Cancer Research, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
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Department of Medical Laboratory Science, University of Benin, Benin City, Benin
1 Department of Physiology, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
2 Department of Medical Laboratory Science, University of Benin, Benin City, Benin
3 Department of Medical Laboratory Science, College of Health Technology, Akure, Ondo State, Nigeria
4 Department of Medical Laboratory Science, Federal University, Lafia, Nasarawa State, Nigeria
5 Department of Medical Laboratory Science, University of Benin, Benin City, Benin
6 Department of Medical Laboratory Science, College of Allied Health Sciences, McPherson University, Ogun State, Nigeria
7 Department of Chemical Pathology, National Hospital, Abuja, Nigeria
8 Department of Medical Laboratory Science, University of Medical Sciences, Ondo, Ondo State, Nigeria
9 Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Benson Idahosa University, Benin City, Edo State, Nigeria
10 Department of Physiology, College of Health Sciences, Joseph Ayo Babalola University, Ikeji-Arakeji, Osun State, Nigeria
11 Department of Natural Science, Faculty of Science and Technology, Middlesex University, London, UK
12 Department of Anatomy, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
13 Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Benson Idahosa University, Benin City, Edo State, Nigeria
14 Department of Medical Laboratory Science, International Institute for Oncology and Cancer Research, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
15 Department of Medical Laboratory Science, University of Benin, Benin City, Benin
Diabetes mellitus is a carbohydrate metabolism disorder which is caused due to impairment in insulin secretion and/or the activity of insulin, leading to chronic hyperglycemia with defective carbohydrate, fat and protein metabolism. This study aimed at assessing the erythropoietin (EPO), hemoglobin and renal parameters levels among the newly diagnosed diabetic patients and providing valuable insights into the management and progression of the disease. A case-control study was conducted on samples of 60 consenting participants including newly diagnosed diabetic patients (n − 30), and healthy controls (n − 30) of age ranging between 20 - 50 years. EPO level was measured using enzyme-linked immunosorbent assay (ELISA), the renal parameters (electrolytes) were measured using Ion-Selective Electrodes. Hemoglobin, urea and creatinine were measured using cyanmethemoglobin and colorimetric methods respectively under standard protocols. Demographic and clinical data, including age, gender, diabetes duration, iron rich diet consumption, medication history and family history were collected via questionnaires. Independent sample t-test indicated significantly higher mean hemoglobin (p < 0.05), packed cell volume (p = 0.05) and fasting blood glucose (p < 0.001) in newly diagnosed diabetic patients compared with their healthy control. No significant differences were observed in EPO, creatinine, urea, potassium, bicarbonate, sodium, and chloride between the two groups. In this study, the values of haemoglobin, packed cell volume, EPO and all renal biomarkers were normal, this may be due to the early diagnosis of the disease. It also suggests the extensive capacity of the kidney which is able to withstand metabolic disturbances in the newly diagnosed diabetes mellitus condition. Routine medical check and lifestyle modification are recommended to a newly diagnosed diabetic patients. Also further research is warranted to explore the clinical implications of these assessments in predicting diabetes complications, disease progression and guiding therapeutic interventions.
American Diabetes Association (2009) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care , 32, S62-S67. https://doi.org/10.2337/dc09-s062
Atkinson, M.A., Eisenbarth, G.S. and Michels, A.W. (2014) Type 1 Diabetes. The Lancet , 383, 69-82. https://doi.org/10.1016/s0140-6736(13)60591-7
Hu, F.B. (2011) Globalization of Diabetes. Diabetes Care , 34, 1249-1257. https://doi.org/10.2337/dc11-0442
DeFronzo, R.A. (2009) From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus. Diabetes , 58, 773-795. https://doi.org/10.2337/db09-9028
International Diabetes Federation (2019) IDF Diabetes Atlas. 9th Edition, International Diabetes Federation.
Unnikrishnan, R., Pradeepa, R., Joshi, S.R. and Mohan, V. (2020) Type 2 Diabetes: Demystifying the Global Epidemic. Journal of Diabetes , 69, 1054-1066.
Mikolás, E., Cseh, J., Pap, M., Szijárto, I., Balogh, A., Laczy, B., et al . (2012) Effects of Erythropoietin on Glucose Metabolism. Hormone and Metabolic Research , 44, 279-285. https://doi.org/10.1055/s-0032-1301901
Jelkmann, W. (2013) Physiology and Pharmacology of Erythropoietin. Transfusion Medicine and Hemotherapy , 40, 302-309. https://doi.org/10.1159/000356193
Alicic, R.Z., Rooney, M.T. and Tuttle, K.R. (2017) Diabetic Kidney Disease. Clinical Journal of the American Society of Nephrology , 12, 2032-2045. https://doi.org/10.2215/cjn.11491116
Mehdi, U. and Toto, R.D. (2009) Anemia, Diabetes, and Chronic Kidney Disease. Diabetes Care , 32, 1320-1326. https://doi.org/10.2337/dc08-0779
Gluba-Brzózka, A., Franczyk, B., Olszewski, R. and Rysz, J. (2020) The Influence of Inflammation on Anemia in CKD Patients. International Journal of Molecular Sciences , 21, Article 725. https://doi.org/10.3390/ijms21030725
Maiese, K., Chong, Z., Hou, J. and Shang, Y. (2008) Erythropoietin and Oxidative Stress. Current Neurovascular Research , 5, 125-142. https://doi.org/10.2174/156720208784310231
Thomas, M.C. (2006) The Role of Anemia in Progression of Diabetic Kidney Disease. Journal of the American Society of Nephrology , 17, S19-S21.
Williams, A., Bissinger, R., Shamaa, H., Patel, S., Bourne, L., Artunc, F., et al . (2023) Pathophysiology of Red Blood Cell Dysfunction in Diabetes and Its Complications. Pathophysiology , 30, 327-345. https://doi.org/10.3390/pathophysiology30030026
Gallagher, H. and Suckling, R.J. (2016) Diabetic Nephropathy: Where Are We on the Journey from Pathophysiology to Treatment? Diabetes , Obesity and Metabolism , 18, 641-647. https://doi.org/10.1111/dom.12630
Tsevi, Y., Amekoudi, E.Y.M. and Sabi, T.S.E.V.I. (2021) Déclin rapide de la fonction rénale chez les patients diabétiques à Lomé (Togo). Néphrologie & Thérapeutique , 17, 310-311. https://doi.org/10.1016/j.nephro.2021.07.166
Kossi, K., Mawufemo, T.Y., Badomta, D., Georges, T.K., Abago, B., Hubert, Y.K., et al . (2022) Renal Risk among Diabetic Patients in Togo. Open Journal of Nephrology , 12, 249-261. https://doi.org/10.4236/ojneph.2022.123026
Mohamud, A.M., Xu, N., Liu, G., Odilov, B., Jiang, B. and Hu, Z. (2022) The Spectrum of Kidney Disease in Type Two Diabetic Patients: A Single-Center Study. Open Journal of Nephrology , 12, 1-14. https://doi.org/10.4236/ojneph.2022.121001
Liamis, G. (2014) Diabetes Mellitus and Electrolyte Disorders. World Journal of Clinical Cases , 2, 488-496. https://doi.org/10.12998/wjcc.v2.i10.488
Zhong, J., Yao, Y., Zeng, G., Zhang, Y., Ye, B., Dou, X., et al . (2023) A Closer Association between Blood Urea Nitrogen and the Probability of Diabetic Retinopathy in Patients with Shorter Type 2 Diabetes Duration. Scientific Reports , 13, Article No. 9881. https://doi.org/10.1038/s41598-023-35653-z
Huang, Y., Liu, W., Liu, J., Guo, D., Zhang, P., Liu, D., et al . (2021) Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Frontiers in Endocrinology , 12, Article 772073. https://doi.org/10.3389/fendo.2021.772073
Nkrumah, B., Nguah, S.B., Sarpong, N., Dekker, D., Idriss, A., May, J., et al . (2011) Hemoglobin Estimation by the Hemocue Portable Hemoglobin Photometer in a Resource Poor Setting. BMC Clinical Pathology , 11, Article No. 5. https://doi.org/10.1186/1472-6890-11-5
Farooq, U., Idris, M., Sajjad, N., Lashari, M.H., Ahmad, S., Rehman, Z.U., et al . (2023) Investigating the Potential of Packed Cell Volume for Deducing Hemoglobin: Cholistani Camels in Perspective. PLOS ONE , 18, e0280659. https://doi.org/10.1371/journal.pone.0280659
Kumar, V. and Gill, K.D. (2018) Estimation of Blood Glucose Levels by Glucose Oxidase Method. In: Kumar, V. and Gill, K.D., Eds., Basic Concepts in Clinical Biochemistry : A Practical Guide , Springer, 57-60. https://doi.org/10.1007/978-981-10-8186-6_13
Langenfeld, N.J., Payne, L.E. and Bugbee, B. (2021) Colorimetric Determination of Urea Using Diacetyl Monoxime with Strong Acids. PLOS ONE , 16, e0259760. https://doi.org/10.1371/journal.pone.0259760
Toora, B.D. and Rajagopal, G. (2002) Measurement of Creatinine by Jaffe’s Reaction-Determination of Concentration of Sodium Hydroxide Required for Maximum Color Development in Standard, Urine and Protein Free Filtrate of Serum. Indian Journal of Experimental Biology , 40, 352-354.
Rayana, M.C.B., Burnett, R.W., Covington, A.K., D'Orazio, P., Fogh-Andersen, N., Jacobs, E., et al . (2006) Recommendation for Measuring and Reporting Chloride by Ises in Undiluted Serum, Plasma or Blood: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division, Committee on Point of Care Testing and Working Group on Selective Electrodes. Clinical Chemistry and Laboratory Medicine , 44, 346-352. https://doi.org/10.1515/cclm.2006.060
Prabhakar, S.P. and Ganesan, M. (2015) Development of a High Sensitive Sandwich ELISA for Measuring Erythropoietin in Human Serum. Applied Biological Research , 17, 105-112. https://doi.org/10.5958/0974-4517.2015.00018.x
Schoener, B. and Borger, J. (2024) Erythropoietin Stimulating Agents. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK536997/
Haase, V.H. (2010) Hypoxic Regulation of Erythropoiesis and Iron Metabolism. American Journal of Physiology - Renal Physiology , 299, F1-F13. https://doi.org/10.1152/ajprenal.00174.2010
Galicia-Garcia, U., Jebari, S., Larrea-Sebal, A., Uribe, K.B., Siddiqi, H., Ostolaza, H., et al . (2020) Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights. International Journal of Molecular Sciences , 21, Article 4725. https://doi.org/10.3390/ijms21134725
Yadav, U.N., Ghimire, S., Mistry, S.K., Shanmuganathan, S., Rawal, L.B. and Harris, M. (2021) Prevalence of Non-Communicable Chronic Conditions, Multimorbidity and Its Correlates among Older Adults in Rural Nepal: A Cross-Sectional Study. BMJ Open , 11, e041728. https://doi.org/10.1136/bmjopen-2020-041728
Bai, A., Tao, J., Tao, L. and Liu, J. (2021) Prevalence and Risk Factors of Diabetes among Adults Aged 45 Years or Older in China: A National Cross-Sectional Study. Endocri nology , Diabetes & Metabolism , 4, e00265. https://doi.org/10.1002/edm2.265
Sosale, A., Prasanna Kumar, K., Sadikot, S., Nigam, A., Bajaj, S., Zargar, A., et al . (2014) Chronic Complications in Newly Diagnosed Patients with Type 2 Diabetes Mellitus in India. Indian Journal of Endocrinology and Metabolism , 18, 355-360. https://doi.org/10.4103/2230-8210.131184
Zhang, J., Yang, Z., Xiao, J., Xing, X., Lu, J. and Chen, L. (2017) Association between Insulin Resistance and Gestational Diabetes Mellitus and Risk of Preeclampsia: A Meta-Analysis. Medicine , 96, e7041.
Annis, A.M., Caulder, M.S., Cook, M.L. and Duquette, D. (2005) Family History, Diabetes, and Other Demographic and Risk Factors Among Participants of the National Health and Nutrition Examination Survey 1999–2002 . Prevalence of Chronic Disease , 2, A19.
Volker, V. and Radko, K. (2018) Pathophysiology of the Diabetic Kidney. Journal of Comprehensive Physiology , 1, 1175-1232.
Nahar, S., Rahman, M., Ullah, M., Debnath, B., Sultana, N. and Farhad, C. (1970) Prevalence of Metabolic Syndrome in Newly Diagnosed Type 2 Diabetes Mellitus. Cardiovascular Journal , 4, 17-25. https://doi.org/10.3329/cardio.v4i1.9385
Lee, M., Han, K., Lee, J., Sohn, S., Jeong, J., Kim, M., et al . (2018) High Hemoglobin Levels Are Associated with Decreased Risk of Diabetic Retinopathy in Korean Type 2 Diabetes. Scientific Reports , 8, Article No. 5538. https://doi.org/10.1038/s41598-018-23905-2
Meier, C., Schneider, C., Jick, S. and Coll, B. (2016) Doubling of Serum Creatinine and the Risk of Cardiovascular Outcomes in Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus: A Cohort Study. Clinical Epidemiology , 8, 177-184. https://doi.org/10.2147/clep.s107060