Roma Rattan1, Andrew Abel Lamare2, Sudeep Jena3, Nirmal Sahoo4, Manmath Kumar Mandal5
BACKGROUND
Telomerase is an enzyme which helps in maintaining the length of the telomeres.
Various studies have associated the telomere length and serum telomerase activity
with ageing, insulin resistance and obesity. The metabolic disease type 2 diabetes
mellitus is also associated with premature ageing, obesity, insulin resistance. Urine
microalbuminuria is one of the frequently used markers to assess renal
involvement in non-insulin dependent type 2 diabetes patients. Hence, this study
was conducted to estimate the association of serum telomerase activity, a marker
of aging and its association with urine microalbuminuria in non-insulin dependent
type 2 diabetes patients with or without renal involvement.
METHODS
The study included 180 non-insulin dependent type 2 diabetes patients divided
into two groups – Group I without microalbuminuria; Group II with
microalbuminuria and 90 age and sex matched healthy volunteers as control
population of the study. The sample size was determined at conveniences. Fasting
blood sugar, lipid profile, serum urea, creatinine was estimated by autoanalyser,
glycated haemoglobin by high performance liquid chromatography (HPLC) and
serum telomerase activity were measured by enzyme-linked immunosorbent assay
(ELISA) method. Urinary microalbuminuria was measured by immunoturbidimetry.
The data was compared by one-way analysis of variance (ANOVA) and post hoc
Tukey’s honestly significant difference (HSD) test, linear regression analysis and
Pearson correlation analysis.
RESULTS
Non-insulin dependent type 2 diabetes patients with microalbuminuria had
significantly lower telomerase activity and higher glycated haemoglobin,
dyslipidaemia, increased serum urea and creatinine levels as compared to the
group I diabetes mellitus patients and healthy volunteers. The serum telomerase
level exhibited a negative correlation with urinary microalbuminuria, glycated
hemoglobin and serum triglyceride and BMI.
CONCLUSIONS
Low Serum Telomerase is associated with microalbuminuria, obesity and poor
glycaemic control in non-insulin dependent type 2 diabetes mellitus patients,
indicating the possible existence of a common clinical profile and premature aging
among diabetic patients with chronic kidney disease. Early screening for
microalbuminuria and serum telomerase level may assist management of positive
cases and reduce the load of chronic renal disease and coronary artery disease in
type 2 diabetes patients. Validation of our observations may be done by extending
the study in larger population thereby facilitating the understanding of T2DM
pathophysiology and its complications.
