Association of diabetic autonomic neuropathy with red blood cell aldose reductase activity.
OBJECTIVE
Activation of polyol pathway based on increased activity of aldose reductase (AR) has been implicated in the development of diabetic complications including diabetic autonomic neuropathy (DAN). The relationship between DAN and hyperglycemia-induced activation of polyol pathway is still uncertain. In the present study, we investigate the association between aldose reductase activity and diabetic autonomic neuropathy by measuring AR level in red blood cells (RBC).


METHODS
In this study, 145 subjects with diabetes with or without DAN and 32 subjects without diabetes have been included. All subjects have been investigated for autonomic function tests and RBC aldose reductase activity. DAN was defined if results of any 2 of the tests of parasympathetic function were abnormal. RBC aldose reductase level was determined spectrophotometrically and expressed as unit/g of hemoglobin. The values were expressed as mean ± standard deviation, and ANOVA test has been applied for comparison between groups.


RESULTS
RBC aldose reductase activity was found to be significantly higher in people with diabetes with autonomic neuropathy in comparison to people with diabetes without autonomic neuropathy and healthy individuals without diabetes. Aldose reductase (AR) level ranges from 0.8 units/g Hb to 14.2 units/g Hb. The mean AR level was 8.6±2.95 units in subjects of DM with autonomic neuropathy, while mean AR level was 4.1±1.78 units and 2.0±0.89 units in people with diabetes without neuropathy and normal healthy individuals, respectively (p<0.001).


CONCLUSIONS
High aldose reductase activity is associated with the presence of autonomic neuropathy in subjects of type 2 DM.
Department of Physiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Pawan
P
Gupta
Department of Physiology, King George Medical University, Lucknow, Uttar Pradesh, India. Electronic address: drnsvermakgmu@gmail.com.
Narsingh
N
Verma
Department of Physiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Sandeep
S
Bhattacharya
Department of Biochemistry, King George Medical University, Lucknow, Uttar Pradesh, India.
Abbas A
AA
Mahdi
Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.
Kauser
K
Usman
Department of Physiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Sunita
S
Tiwari
Department of Physiology, King George Medical University, Lucknow, Uttar Pradesh, India.
Kshitij
K
Bhardwaj
D000328:Adult; D000449:Aldehyde Reductase / Q000097:blood*; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D003929:Diabetic Neuropathies / Q000097:blood / Q000201:enzymology* / Q000503:physiopathology; D004912:Erythrocytes / Q000201:enzymology* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D000449:Aldehyde Reductase
aldose reductase; aldose réductase; autonomic function tests; diabetic autonomic neuropathy; explorations fonctionnelles du système nerveux autonome; neuropathie diabétique autonome; polyol pathway; voie des polyols