DETERMINATION OF HEMOGLOBIN A1c, LIPID PROFILES, HOMOCYSTEINE, OXIDATIVE STRESS AND PHYSICAL ACTIVITY LEVELS IN DIABETIC AND/OR NON-DIABETIC COVID-19 PATIENTS

Year 2023, Volume: 4 Issue: 2, 85 - 91, 31.08.2023

Kadirhan Özdemir , Ercan Saruhan , Gözde Kaya , Tuba Kaya Benli , Orhan Meral , Hümeyra Bozoğlan , Halit Demir , Canan Demir , Servet Kavak

https://doi.org/10.52831/kjhs.1254353

Cited By: 1

Abstract

Objective: The coronavirus disease 2019 (Covid-19) pandemic results in higher morbidity and mortality rates. This study aims to compare hemoglobin A1c (HbA1c), lipid profiles, homocysteine, oxidative stress, and physical activity levels between diabetic Covid-19 patients (group I), non-diabetic Covid-19 patients (group II), and healthy controls (group III).
Method: HbA1c, lipid profiles, homocysteine, oxidative stress, oxidant, and antioxidant status were analyzed from the venous blood samples and physical activity levels were measured with International Physical Activity Questionnaire. All the parameters were compared between the groups (n=16 for each group).
Results: HbA1c and fasting blood glucose levels in group I were higher than group II and III (p<0.001). There were significant differences in serum levels of total cholesterol, triglyceride, high density lipoprotein cholesterol and low-density lipoprotein cholesterol between the groups (p<0.001). There was lower superoxide dismutase (p<0.001) and total antioxidant status (TAS) (p<0.001), and higher malondialdehyde (p<0.001), total oxidant status (TOS) (p<0.001), oxidative stress index (p<0.001), C-reactive protein level (p=0.001), and neutrophil/lymphocyte ratio (p<0.001) in group I and II compared with group III. Although the patients in group I and II had lower physical activity levels than group III, only the patients in group II had significantly lower physical activity levels than group III (p=0.006).
Conclusion: Diabetic Covid-19 patients had higher blood glucose markers than non-diabetic Covid-19 patients and healthy controls in our study. Diabetic and non-diabetic patients had higher oxidant, lower antioxidant, and higher oxidative stress levels than healthy controls. In addition, the physical activity levels of non-diabetic Covid-19 patients were lower than diabetic Covid-19 patients and healthy controls.

Keywords

Covid-19, Lipid Markers, Homocysteine, Oxidative Stress Level, Physical Activity

TİP II DİYABET VE/VEYA COVID-19 TANILI HASTALARDAKİ HEMOGLOBİN A1c, LİPİT PROFİLLERİ, HOMOSİSTEİN, OKSİDATİF STRES VE FİZİKSEL AKTİVİTE DÜZEYLERİNİN BELİRLENMESİ

Abstract

Amaç: Koronavirüs 2019 (Covid-19) pandemisi, yüksek morbidite ve mortalite oranlarına neden olmaktadır. Bu çalışma, diyabetik Covid-19 hastaları (grup I), diyabetik olmayan Covid-19 hastaları (grup II) ve sağlıklı kontroller (Grup III) arasındaki hemoglobin A1c (HbA1c), lipid profilleri, homosistein, oksidatif stres ve fiziksel aktivite düzeylerini karşılaştırmayı amaçlamaktadır.
Yöntem: Katılımcıların venöz kan örneklerinden HbA1c, lipid profilleri, homosistein, oksidatif stres, oksidan ve antioksidan seviyesi analiz edildi ve Uluslararası Fiziksel Aktivite Anketi ile fiziksel aktivite seviyeleri ölçüldü. Tüm parametreler gruplar arasında karşılaştırıldı (her grup için n=16).
Bulgular: Grup I'de HbA1c ve açlık kan şekeri düzeyleri grup II ve III'e göre yüksekti (p<0.001). Gruplar arasında serum total kolesterol, trigliserit, yüksek yoğunluklu lipoprotein kolesterol ve düşük yoğunluklu lipoprotein kolesterol düzeyleri arasında anlamlı fark vardı (p<0.001). Grup III ile karşılaştırıldığında grup I ve grup II'de daha düşük süperoksit dismutaz (p<0.001) ve toplam antioksidan seviyesi (TAS) (p<0.001), daha yüksek malondialdehit, total oksidan seviyesi (TOS) (p<0.001), oksidatif stres indeksi (p<0.001), C-reaktif protein seviyesi (p=0.001) ve nötrofil/lenfosit oranı (p<0.001) vardı. Grup I ve II'deki hastaların fiziksel aktivite düzeyleri grup III'e göre daha düşük olmasına rağmen, yalnızca grup II'deki hastaların fiziksel aktivite düzeyleri grup III'e göre anlamlı olarak daha düşüktü (p=0.006).
Sonuç: Çalışmamızdaki diyabetik Covid-19 hastalarının kan şekeri belirteçleri, diyabetik olmayan Covid-19 hastalarına ve sağlıklı kontrollere göre daha yüksekti. Diyabetik ve diyabetik olmayan Covid-19 hastaları sağlıklı kontrollere göre daha yüksek oksidan, daha düşük antioksidan ve daha yüksek oksidatif stres düzeyine sahipti. Ayrıca diyabetik olmayan Covid-19 hastalarının fiziksel aktivite düzeyleri diyabetik Covid-19 hastalarına ve sağlıklı kontrollere göre daha düşüktü.

Keywords

Covid-19, Lipit Profilleri, Homosistein, Oksidatif Stres Seviyesi, Fiziksel Aktivite

References

• Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-95.
• Katulanda P, Dissanayake HA, Ranathunga I, et al. Prevention and management of COVID-19 among patients with diabetes: An appraisal of the literature. Diabetologia. 2020;63:1440-1452.
• Nathan DM. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-1334.
• Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab. 2009;5:150-159.
• Sun JT, Chen Z, Nie P, et al. Lipid profile features and their associations with disease severity and mortality in patients with COVID-19. Front Cardiovasc Med. 2020;7:584987.
• Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis. 2020;95:304-307.
• Ponti G, Ruini C, Tomasi A. Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19. Med Hypotheses. 2020;143:109859.
• Lobo V, Patil A, Phatak A, et al. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4:118-126.
• Aviram M. Malondialdehyde affects the physico-chemical and biological characteristics of oxidized low density lipoprotein. Atherosclerosis. 1990;84:141-143.
• Yasui K, Baba A. Therapeutic potential of superoxide dismutase (SOD) for resolution of inflammation. Inflamm Res. 2006;55:359-363.
• Landis GN, Tower J. Superoxide dismutase evolution and life span regulation. Mech Ageing Dev. 2005;126:365-379.
• Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38:1103-1111.
• Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004;37:112-119.
• Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;63:386-388.
• American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44:S15-S33.
• Mihara M, Uchiyama M. Determination of malonaldehyde precursor in tissues by thiobarbituric acid test. Anal Biochem. 1978;86:271-278.
• Popov B, Gadjeva V, Valkanov P, et al. Lipid peroxidation, superoxide dismutase and catalase activities in brain tumor tissues. Arch Physiol Biochem. 2003;111:455-459.
• Craig CL, Marshall AL, Sjöström M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381-1395.
• Shimodaira M, Okaniwa S, Hanyu N, et al. Optimal hemoglobin A1c levels for screening of diabetes and prediabetes in the Japanese population. J Diabetes Res. 2015;2015:932057.
• Buse JB, Tan MH, Prince MJ, et al. The effects of oral anti-hyperglycaemic medications on serum lipid profiles in patients with type 2 diabetes. Diabetes Obes Metab. 2004;6:133-156.
• Hayakawa M, Maekawa K, Kushimoto S, et al. High d-dimer levels predict a poor outcome in patients with severe trauma, even with high fibrinogen levels on arrival: A multicenter retrospective study. Shock. 2016;45:308-314.
• Zhang Y, Li H, Zhang J, et al. The clinical characteristics and outcomes of patients with diabetes and secondary hyperglycaemia with coronavirus disease 2019: A single-centre, retrospective, observational study in Wuhan. Diabetes Obes Metab. 2020;22:1443-1454.
• Patel AJ, Klek SP, Peragallo-Dittko V, et al. Correlation of hemoglobin A1C and outcomes in patients hospitalized with COVID-19. Endocr Pract. 2021;27:1046-1051.
• Yuan S, Li H, Chen C, et al. Association of glycosylated haemoglobin HbA1c levels with outcome in patients with COVID-19: A retrospective study. J Cell Mol Med. 2021;25:3484-3497.
• Bar-Or D, Rael LT, Madayag RM, et al. Stress Hyperglycemia in Critically Ill Patients: Insight into Possible Molecular Pathways. Front Med (Lausanne). 2019;6:54.
• Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14:395-403.
• Sardu C, D'Onofrio N, Balestrieri ML, et al. Outcomes in patients with hyperglycemia affected by COVID-19: Can we do more on glycemic control? Diabetes Care. 2020;43:1408-1415.
• Baynes JW. Role of oxidative stress in development of complications in diabetes. Diabetes. 1991;40:405-412.
• Maddux BA, See W, Lawrence JC, Jr., et al. Protection against oxidative stress-induced insulin resistance in rat L6 muscle cells by mircomolar concentrations of alpha-lipoic acid. Diabetes. 2001;50:404-410.
• Maritim AC, Sanders RA, Watkins JB. Diabetes, oxidative stress, and antioxidants: A review. J Biochem Mol Toxicol. 2003;17:24-38.
• Suhail S, Zajac J, Fossum C, et al. Role of oxidative stress on SARS-CoV (SARS) and SARS-CoV-2 (COVID-19) infection: A review. Protein J. 2020;39:644-656.
• Schieber M, Chandel NS. ROS function in redox signaling and oxidative stress. Curr Biol. 2014;24:R453-R462.
• Muhammad Y, Kani YA, Iliya S, et al. Deficiency of antioxidants and increased oxidative stress in COVID-19 patients: A cross-sectional comparative study in Jigawa, Northwestern Nigeria. SAGE Open Med. 2021;9:2050312121991246.
• Kumar DS, Hanumanram G, Suthakaran PK, et al. Extracellular oxidative stress markers in COVID-19 patients with diabetes as co-morbidity. Clin Pract. 2022;12:168-176.
• Laddu DR, Lavie CJ, Phillips SA, et al. Physical activity for immunity protection: Inoculating populations with healthy living medicine in preparation for the next pandemic. Prog Cardiovasc Dis. 2021;64:102-104.
• Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: A statement from the council on clinical cardiology (subcommittee on exercise, rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). Circulation. 2003;107:3109-3116.
• Venkatasamy VV, Pericherla S, Manthuruthil S, et al. Effect of physical activity on insulin resistance, inflammation and oxidative stress in diabetes mellitus. J Clin Diagn Res. 2013;7:1764-1766.
• Boulé NG, Haddad E, Kenny GP, et al. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: A meta-analysis of controlled clinical trials. Jama. 2001;286:1218-1227.
• Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388:1302-1310.
• Riebe D, Ehrman JK, Liguori G, et al. Medicine ACoS. ACSM's guidelines for exercise testing and prescription: Wolters Kluwer; 2018.
• Hamer M, Kivimäki M, Gale CR, Batty GD. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK. Brain Behav Immun. 2020;87:184-187.
• Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet. 2012;380:219-229.
• Ammar A, Brach M, Trabelsi K, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: Results of the ECLB-COVID19 international online survey. Nutrients. 2020;12:1583.