Diagnostic value of Adenosine deaminase and its isoenzymaticactivity in Nepalese patients with type 2 Diabetes Mellitus

Abstract

Background

Adenosine deaminase, an enzyme of purine metabolism is suggested to play an important role in cell mediated immunity and modulation of insulin activity, but its clinical and diagnostic significance in Nepalese type 2 diabetes mellitus is not yet characterized.

Methods

This is a hospital based case control study including 80 type 2 DM patients and same number of age and sex matched healthy controls aged between 30-70 years attending Manipal Teaching Hospital (MTH), Pokhara, Nepal. All the demographic and anthropometric data were collected using a preformed set of questionnaire and biochemical data were obtained from the laboratory analysis of the patients’ blood samples. Statistical analysis was done with SPSS version 20.

Results

A significantly higher (p<0.001) mean values of BMI, FBS, PPBS, HbA1c and lipid profiles were found in type 2  diabetic cases compared to the controls. Similarly, the cases were also found to have significantly higher (p<0.001) serum ADA (35.55 + 7.53U/L), ADA1 (14.16 + 4.74 U/L) and ADA2 (21.48 + 4.60 U/L) activities  compared  to controls (ADA- 20.46 + 3.27 U/L, ADA1-8.3 + 2.21 U/Land ADA2-12.2 + 2.17 U/L). Highest diagnostic accuracy and agreement with blood glucose test was observed with ADA2 followed by total ADA and ADA1.

Conclusion

Based on their higher serum activities, diagnostic sensitivity, specificity and substantial agreement with plasma glucose estimation, serum total ADA and its isoenzymes could be utilized as biomarkers for identifying the immunological origin of the uncomplicated type 2 DM.