Vol. 8, No 1, 2001 pp. 59 - 62
UC 616.379
PLASMA AND URINE PC-1 ACTIVITY IN TYPE
2 DIABETICS
TREATED WITH METFORMIN
Vladisav Stefanović, Maja Milojković, Marina Mitić-Zlatković, Slobodan
Antić, Mileva Ivić, Predrag Vlahović
Institute of Nephrology and Hemodialysis, Faculty of Medicine, Niš
Institute of Pathophysiology, Faculty of Medicine, Niš
Faculty of Occupational Safety, University of Niš
Clinic of Endocrinology, Diabetes and Metabolic Disorders, Faculty
of Medicine, Niš, Yugoslavia
Summary. The plasma cell differentiation antigen (PC-1) is an inhibitor
of insulin receptor tyrosine kinase activity and is a major factor of insulin
resistance in patients with type 2 diabetes mellitus. We have studied lymphocyte
PC-1 (ecto-alkaline phosphodiesterase I, APD I) in obese type 2 diabetics,
as well as plasma level and urinary excretion of PC-1. Fifteen patients
(8 female, 7 male) with a BMI 34.11+3.37 kg/m2, were studied
before and after 3 months of metformin (1000 mg b.i.d.) treatment. Lymphocyte
PC-1 in patients with type 2 diabetes was markedly increased, and metformin
treatment brought it to the level slightly over control. Plasma PC-1 was
significantly reduced after metformin treatment, from 37 to 14 mU/L. However,
urinary excretion of PC-1 was not changed by metformin treatment. A highly
significant correlation between lymphocyte and plasma PC-1 was obtained
(r = 0.909 and 0.529, before and after metformin treatment, respectively).
Glucoregulation was found improved by metformin treatment as the mean glycosylated
hemoglobin was found decreased from 8.15 before to 7.07% after therapy
with metformin. In conclusion, an increased lymphocyte PC-1 activity and
its reversal by metformin treatment were demonstrated in obese type 2 diabetics.
Plasma PC-1 activity was found also decreased after metformin treatment
and correlated significantly with lymphocyte PC-1 activity. Urine PC-1
was not found to correlate with lymphocyte PC-1. A high correlation of
plasma and lymphocyte PC-1 before metformin treatment should be evaluated
for using plasma PC-1 in demonstration of insulin resistance in type 2
diabetics. Plasma but not urine PC-1 correlates with insulin resistance
in obese type 2 diabetes mellitus.
Key words: PC-1, Type 2 diabetes, insulin resistance, metformin
AKTIVNOST PC-1 U PLAZMI I URINU PACIJENATA
SA TIPOM 2
DIJABETES MELITUSA TRETIRANIH METFORMINOM
Kratak sadržaj: Plazma-ćelijski antigen (PC-1) je inhibitor tirozin-kinazne
aktivnosti insulinskog receptora i jedan od važnih faktora u nastanku insulinske
rezistencije u pacijenata sa tipom 2 dijabetes melitusa. Predmet ovog istraživanja
bilo je određivanje aktivnosti limfocitnog PC-1, kao i nivoa PC-1 u plazmi
i urinu gojaznih tip 2 dijabetičara. Ispitivano je 15 pacijenata (8 žena
i 7 muškaraca) pre i posle tromesečne terapije metforminom (1000 mg dnevno
podeljeno u dve doze per os). U studiju su uključeni gojazni tip 2 dijabetičari
čiji je indeks mase tela na početku ispitivanja bio 34,11+3,37 kg/m2.
Limfocitni PC-1 u pacijenata sa tipom 2 dijabetesa bio je značajno povišen,
da bi nakon terapije metfominom došlo do njegovog smanjenja na vrednosti
bliske normalnim. Tretman metforminom signifikantno je smanjio nivo PC-1
u plazmi, sa 37 na 14 mU/L. Vrednosti PC-1 u urinu, međutim, nisu se značajno
promenile tokom terapije. Utvrđena je visoko signifikantna korelacija između
vrednosti PC-1 u plazmi i limfocitima (r = 0,909 pre terapije, a r = 0,529
posle terapije metforminom). Efekat metformina na stanje glikoregulacije
bio je povoljan (srednja vrednost glikoziliranog hemoglobina smanjila se
sa 8,15 pre na 7,07% posle terapije). Rezultati dobijeni ispitivanjem gojaznih
tip 2 dijabetičara uključenih u studiju pokazuju značajno povišene početne
vrednosti limfocitnog PC-1, kao i njihovo smanjenje na vrednosti bliske
normalnim nakon terapije metforminom. Tromesečna terapija metforminom dovela
je, takođe, do sniženja vrednosti PC-1 u plazmi, dok promene PC-1 u urinu
nisu bile značajne. Nađena je visoko signifikantna korelacija vrednosti
PC-1 u plazmi i limfocitima, a nema značajne korelacije između urinarnog
i limfocitnog PC-1. Visoku korelaciju vrednosti PC-1 u plazmi i limfocitima
pre lečenja metforminom treba dalje ispitivati da bi se PC-1 u plazmi mogao
koristiti pri identifikaciji insulin-rezistentnih tip 2 dijabetičara. Zaključeno
je da u gojaznih bolesnika sa tipom 2 dijabetesa nivo PC-1 u plazmi a ne
PC-1 u urinu korelira sa prisustvom insulinske rezistencije.
Ključne reči: PC-1, tip 2 dijabetes melitusa, insulinska rezistencija,
metformin
