Association of Serum Gamma-Glutamyl Transferase and C-Reactive Protein as a Biomarkers of Oxidative Stress in Patients of Type 2 Diabetes Mellitus

Abstract

Objective: To compare Serum gamma-glutamyl transferase and serum C-reactive protein as biomarker of oxidative stress in patients of type 2 Diabetes Mellitus. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Pathology, department of Chemical Pathology and Endocrinology Rawalpindi. The duration of study was 6 months i.e., 17 Nov 2021 – 17 May 2022 after approval from Institutional Review Board FC-CHP21-12/Read-IRB/22/846. Materials and Methods: An analytical, cross-sectional research was carried out at Armed Forces Institute of Pathology Rawalpindi. An overall 300 diabetic patients were included between ages of 45 – 65 years. Group I had 100 nondiabetic individuals of 45 – 65 years of age with HbA1c < 5.7 %. Group II and III included 100 patients each of DM of matched age with HbA1c 6.5 – 7 % and greater than 7 % respectively, without any other chronic disease. Serum gamma-glutamyl transferase, HbA1c, Serum C-Reactive Protein were analyzed. Moreover, some more biochemical investigations such as serum liver enzymes were measured to rule out any liver disease. One-way ANOVA was followed up by post-hoc Tukey analysis for intergroup comparison. Results: Mean serum gamma-glutamyl transferase levels were markedly increased in group III patients followed by group II and normal in group I. The mean of serum gamma-glutamyl transferase in group I was (9.38+4.05U/l), group II (34.27+15.07 U/l) and group III (47.08+20.56 U/l). The mean of Serum C-Reactive Protein in group I was (11+6.02 mg/l), group II (62.07+ 26.94 mg/l) and group III (107.73+57.03 mg/l). Pearson correlation revealed prominent positive correlation between HbA1c, serum gamma-glutamyl transferase and Serum C-Reactive Protein with r value of serum gamma-glutamyl transferase (0.838367) and Serum C-Reactive Protein (0.684722). One-way ANOVA and post-hoc Tukey analysis had p value of < 0.05 which was statistically significant. Conclusion: Serum gamma-glutamyl transferase is better marker of oxidative stress in patients of type 2 diabetes mellitus as compared to Serum C-Reactive Protein. The r value of serum gamma-glutamyl transferase is (0.838367) and Serum C-Reactive Protein is (0.684722) indicating strong positive correlation of serum gamma-glutamyl transferase with HbA1c. Therefore, Serum gamma-glutamyl transferase can be used for the prevention and monitoring of complications of type 2 Diabetes Mellitus.

Keywords

• armed forces institute of pathology (afip)
• c reactive protein (crp)
• diabetes mellitus (dm)
• gamma glutamyl transferase (ggt)