title: Biochemical changes in blood of type 2 diabetes with and without metabolic syndrome and their association with metabolic syndrome components.
abstract: BACKGROUND
  Multiple factors are involved in the development and progression of type 2 diabetes mellitus (DMII) to DMII with metabolic syndrome (MetS) and cardiovascular complications. To identify some of these factors, we aim to investigate the changes in erythrocyte membrane Na(+)/K(+)-ATPase activity, serum glucose, insulin, lipid profile, hemoglobin A1C (HbA1c), high-sensitivity C-reactive protein (hs-CRP), anthropometric measurements, and blood pressure in DMII with and without MetS.
  
  
  METHODS
  This cross-sectional study comprised 155 male subjects distributed into three groups as healthy controls (50 non-DMII volunteers), Group I (50 DMII without MetS), and Group II (55 DMII with MetS). Fasting blood samples were taken for the measurement of glucose, insulin, HbA1c, hs-CRP and lipid profile. Na(+)/K(+)-ATPase activity was determined in erythrocyte ghost.
  
  
  RESULTS
  Na(+)/K(+)-ATPase activity was significantly decreased in DMII groups compared with controls. No significant difference was shown in Na(+)/K(+)-ATPase activity between DMII groups. Total ATPase activity, total cholesterol and low-density lipoprotein-cholesterol levels were similar in the three groups. Levels of insulin, hs-CRP, triacylglycerols, systolic blood pressure, weight, waist and hip circumference, waist/hip ratio, and body mass index were significantly elevated and high-density lipoprotein-cholesterol significantly decreased only in Group II. Significant differences in serum glucose and hip circumference were seen between the groups. No significant differences in HbA1c levels were observed between DMII groups.
  
  
  CONCLUSIONS
  Changes in many of the measured risk factors that occurred only in Group II compared with controls and Group I may provide an explanation of how DMII progresses to DMII with MetS and future cardiovascular complications.
authors.affiliation: Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fouzieh
authors.initials: F
authors.lastname: Zadhoush
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran ; Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Pourfarzam
keywords: Lipid profile; Na+/K+-ATPase activity; metabolic syndrome; type 2 diabetes