Diyabetik Anne Bebeklerinde Serum Paraoksonaz Aktivitesi ve Total Oksidan ve Antioksidan Kapasitenin Değerlendirilmesi

Yıl 2025, Cilt: 22 Sayı: 4

Süleyman Geter , Mehmet Kılıç , Alpay Çakmak

Öz

Amaç: Bu çalışmada diyabetik anne bebeklerinde (DAB), ateroskleroz oluşma riskini gösteren Paraoksonaz (PON) aktivitesi ile total oksidan (TOS) ve antioksidan kapasitelerinin (TAS) değerlendirilmesi amaçlanmaktadır.
Materyal ve metod: Çalışmaya, prospektif olarak 01.03.2012-25.09.2012 tarihleri arasında, pregestasyonel veya gestasyonel diyabet nedeniyle izlenen 58 anneden doğan ve postnatal ilk 3 gün içinde olan yenidoğan bebekler dahil edilmiştir. Maternal risk faktörü olmayan sağlıklı bebekler kontrol grubu olarak alınmıştır. Hastaların PON, TOS ve TAS düzeyleri karşılaştırılmıştır.
Bulgular: DAB’de PON1 aktivitesi, TOS seviyeleri ve oksidatif stres indeksi kontrol grubuna göre anlamlı derecede yüksek bulunmuştur (sırasıyla; p<0,01, p<0,01, p<0,01). Serum TAS seviyelerinde ise kontrol grubuna göre anlamlı fark saptanmamıştır (p=0,446).
Sonuç: İntrauterin programlama ile diyabetik annelerin glisemik kontrolünün sağlanması, DAB’nin daha az hiperglisemiye maruz kalması durumunda oksidatif stresin azalabileceği düşündürmektedir.

Anahtar Kelimeler

Diyabetik anne bebeği , Serum paraoksonaz aktivitesi , Oksidan-antioksidan sistem

Evaluation of Serum Paraoxonase Activity and Total Oxidant and Antioxidant Capacity in Infants of Diabetic Mothers

Öz

Background: This study aims to evaluate the paraoxonase (PON) activity, total oxidant (TOS) levels, and antioxidant capacities (TAS) in infants of diabetic mothers (IDM), to assess the risk of atherosclerosis formation.
Materials and Methods: A total of 58 infants born to mothers with pregestational or gestational diabetes who were followed up prospectively between 01.03.2012 and 25.09.2012 and were within the first 3 postnatal days were included in the study. Healthy infants without maternal risk factors were selected as the control group. The levels of PON, TOS, and TAS were compared between the groups.
Results: PON1 activity, TOS levels, and oxidative stress index were found to be significantly higher in IDM compared to the control group (p<0.01, p<0.01, p<0.01, respectively). However, no significant difference was found in serum TAS levels between the IDM and the control group (p=0.446).
Conclusions: Achieving glycemic control in diabetic mothers through intrauterine programming may reduce oxidative stress and the risk of atherosclerosis development by reducing the exposure of infants to hyperglycemia..

Anahtar Kelimeler

Infant of diabetic mother , Serum paraoxonase activity , Oxidant-antioxidant system

Etik Beyan

This study was approved by the Ethics Committee of Harran University Faculty of Medicine (approval no: 12/03/20, date: May 18, 2012).

Kaynakça

• 1. Combs CA, Gunderson E, Kitzmiller JL, Gavin LA, Main EK. Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care. 1992;15:1251-1257.
• 2. Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı ve Çocuk Sağlığı Enstitüsü Yayını. Katkı Pediatri Dergisi. 1997;18(2-3):92-108.
• 3. Kızıltan M. Diyabet ve periferik nöropati. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitim Etkinlikleri, Diabetes Mellitus Sempozyumu. 1997:69-77.
• 4. Caughey AB, Turrentine MA. ACOG practice bulletin no. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49-e64.
• 5. Tam WH, Ma RCW, Ozaki R, Li AM, Chan MHM, Yuen LY, et al. In Utero Exposure to Maternal Hyperglycemia Increases Childhood Cardiometabolic Risk in Offspring. Diabetes Care. 2017;40(5):679-686.
• 6. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773-1779.
• 7. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG. 2015;122(5):643-651.
• 8. Zhang C, Bao W, Rong Y, Yang H, Bowers K, Yeung E, et al. Genetic variants and the risk of gestational diabetes mellitus: a systematic review. Hum Reprod Update. 2013;19(4):376-390.
• 9. López-Tinoco C, Roca M, García-Valero A, Murri M, Tinahones FJ, Segundo C, et al. Oxidative stress and antioxidant status in patients with late-onset gestational diabetes mellitus. Acta Diabetol. 2013;50(2):201-208.
• 10. Mackness B, Durrington PN, Mackness MI. Human serum paraoxonase. Gen Pharmacol. 1998;3:329-336.
• 11. Parthasarathy S, Barnett J, Fonfara S. High-density lipoprotein inhibits the oxidative modification of low density lipoprotein. Biochim Biophys Acta. 1990;1044:275-283.
• 12. Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL. Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med. 1989;320(14):915-924.
• 13. Klimov AN, Kozhemiakin LA, Pleskov VM, Andreeva LI. Antioxidant effect of high-density lipoproteins in the peroxidation of low-density lipoproteins. Biull Eksp Biol Med. 1987;103(5):550-552.
• 14. Mackness MI, Durrington PN. High density lipoprotein, its enzymes and its potential to influence lipid peroxidation. Atherosclerosis. 1995;115:243-253.
• 15. Mackness MI, Mackness B, Durrington PN, Connelly PW, Hegele RA. Paraoxonase: biochemistry, genetics and relationship to plasma lipoproteins. Curr Opin Lipidol. 1996;7(2):69-76.
• 16. Balcı Ekmekçi Ö, Donma O, Ekmekçi H. Paraoxonase. Cerrahpaşa J Med. 2004;35:78-82.
• 17. Aviram M, Hardak E, Vaya J, Mahmood S, Milo S, Hoffman A, et al. Human serum paraoxonases (PON1) Q and R selectively decrease lipid peroxides in human coronary and carotid atherosclerotic lesions: PON1 esterase and peroxidase-like activities. Circulation. 2000;101(21):2510-2517.
• 18. MacKness B, Mackness MI, Durrington PN, Arrol S, Evans AE, McMaster D, et al. Paraoxonase activity in two healthy populations with differing rates of coronary heart disease. Eur J Clin Invest. 2000;30(1):4-10.
• 19. Cross CE, Halliwell B, Borish ET, Pryor WA, Ames BN, Saul RL, et al. Oxygen radicals and human disease. Ann Intern Med. 1987;107(4):526-545.
• 20. Stefanović A, Kotur-Stevuljević J, Vujović A, Spasić S, Spasojević-Kalimanovska V, Jelic-Ivanović Z, et al. Association of the atherogenic index of plasma and oxidative stress status with weight gain during non-complicated pregnancy. Clin Chem Lab Med. 2012;50(11):2019-2025.
• 21. Shang M, Zhao J, Yang L, Lin L. Oxidative stress and antioxidant status in women with gestational diabetes mellitus diagnosed by IADPSG criteria. Diabetes Res Clin Pract. 2015;109(2):404-410.
• 22. Gutteridge JMC, Halliwell B. Antioxidants in nutrition, health and disease. 1st ed. New York: Oxford University Press; 1994:290-293.
• 23. Medici F, Puder D, Williams CL. Cholesterol screening in the pediatric office. Ann NY Acad Sci. 1991;(623):200-204.
• 24. Stocker R, Keaney JF Jr. Role of oxidative modifications in atherosclerosis. Physiol Rev. 2004;84:1381-1478.
• 25. Cyrus T, Yao Y, Rokach J, Tang LX, Praticò D. Vitamin E reduces progression of atherosclerosis in low-density lipoprotein receptor-deficient mice with established vascular lesions. Circulation. 2003;107(4):521-523.
• 26. Durrington PN, Mackness B, Mackness MI. Paraoxonase and atherosclerosis. Arterioscler Thromb Vasc Biol. 2001;21:473-480.
• 27. Mackness M, Durrington P, Mackness B. Paraoxonase 1 activity, concentration and genotype in cardiovascular disease. Curr Opin Lipidol. 2004;15:399-404.
• 28. Reardon CA. Paraoxonase, a cardioprotective enzyme: continuing issues. Curr Opin Lipidol. 2004;15:261-267.
• 29. Ng CJ, Shih DM, Hama SY, Villa N, Navab M, Reddy ST. The paraoxonase gene family and atherosclerosis. Free Radic Biol Med. 2005;38(2):153-163.
• 30. Mackness B, Durrington PN, Boulton AJM, Hine D. Serum paraoxonase activity in patients with type 1 diabetes compared to healthy controls. Eur Clin Invest. 2002;32(4):259-264.
• 31. Parmaksız İ, Atak PG, Yavuz DG, Şirikçi Ö. Serum paraoxonase activity in patients with type 1 diabetes compared to healthy controls. Turk J Biochem. 2011;36(4):329-333.
• 32. McElveen J, Mackness MI, Colley CM, Peard T, Warner S, Walker CH. Distribution of paraoxon hydrolytic activity in the serum of patients after myocardial infarction. Clin Chem. 1986;(32):671-673.
• 33. Packard CJ, Shepherd J. Trigliseridler ile koroner kalp hastalığı arasındaki bağlantının metabolik temeli. In: Born GVR, Schwartz CJ, eds. Atherogenesis. 1995;(4):1-2.
• 34. Rhoads GG, Gulbrandsen CL, Kagan A. Serum lipoproteins and coronary heart disease in a population study of Hawaii Japanese men. N Engl J Med. 1976;294(6):293-298.
• 35. Thomas-Moya E, Gianotti M, Liadino I, Proenza AM. Effects of caloric restriction and gender on rat paraoxonase 1 activity. J Biochem. 2006;17:197-203.
• 36. Cakmak A, Soker M, Koc A, Erel O. Paraoxonase and arylesterase activity with oxidative status in children with thalassemia major. J Pediatr Hematol Oncol. 2009;31(8):583-587.