A STUDY OF SERUM ADA ISOENZYMES AND MDA LEVELS IN TUBERCULOSIS WITH AND WITHOUT TYPE 2 DIABETES MELLITUS

Dr. G. Murugan and *Dr. A. Sangeetha

ABSTRACT

Tuberculosis and type 2 diabetes mellitus are a major cause of morbidity and mortality in India. Diagnosis of sputum negative TB has been a challenge to the clinicians and search for reliable markers for early diagnosis has been an ongoing effort. Type 2 DM has also been diagnosed most often accidentally during routine checkup or during investigation of other disorders. Serum adenosine deaminase(ADA) levels have shown promising results as a marker for diagnosis of sputum –ve TB. Serum ADA levels have also been reported to be elevated in DM. ADA exist as two isoforms ADA1 & ADA2. The extent of elevation in ADA when both TB & DM are coexisting are not known. The isoenzyme pattern of the elevated serum ADA is not also known. Both TB & DM are associated with increased lipid peroxidation. MDA levels have been shown to be elevated in TB as well as DM. However the extent of elevation when TB & DM are coexisting has not been studied. Aims & Objectives: The present study was conducted to study the relevance of serum ADA levels in diagnosis of TB when type 2 DM is coexisting and alteration in isoenzyme patterns both in TB and type 2 DM. Methods & Materials: The study subjects included 20 patients each with confirmed diagnosis of TB, DM and coexisting DM & TB and age matched controls. To study serum MDA levels in TB, DM and coexisting DM & TB. Results: The serum ADA isoenzyme fractions and MDA levels were increased in TB, DM patients, but the levels were significantly higher when both TB & DM were coexisting(<0.05) compared to control groups. Conclusion: Serum ADA as well as its isoenzyme levels are equally elevated in patients with TB as well as DM. In patients with coexisting TB & DM, the elevations both in TADA as well as ADA2 as much higher as compared to TB or DM alone. Oxidative damage reflected as MDA levels is correlated with the extent of ADA elevation in all the three groups of patients.

Keywords: ADA isoenzymes, Tuberculosis, Type II Diabetes Mellitus, erythro-9-(2-hydroxy-3- nonyl) adenine (EHNA), south indian population, MDA.