Association patterns of volatile metabolites in urinary excretions among Type-2 Non-Insulin dependent diabetes patients

Muhammad Saqib Shahzad, Javed Iqbal Bajwa, Javed Iqbal Wattoo, Mushtaq A Saleem

Abstract


Background: Patterns of volatile metabolites in urine are important to detect abnormalities associated with diabetes. Present study was conducted to find out the excretion patterns of endogenously produced alcohols in urine for type 2 (Non-Insulin Dependent) diabetes mellitus. A cross sectional analytical study was conducted with duration extended from Jan to Mar 2015.

Methods: The current study included 40 patients with chronic type 2 diabetes mellitus. In total, 10 sex and age matched subjects with no history of any disease were considered as controls. Blood sugar was estimated by autoanalyzer using standard kit of Merck following manufacturer`s instructions. Urine sugar was quantitatively detected by biuret reagent using titration technique. Urinary alcohol was identified and estimated by gas chromatography.  Urinary ketone bodies were estimated by urinary strip.

Results: It was observed that level of fasting blood sugar was significantly increased (P<0.001) in patients as compared to their controls. The blood sugar and urinary alcohol in patients were 3.0% and 6.0% respectively. Urinary ketone bodies were found to be 2+. On the other hand urine sugar, alcohol and ketone bodies were not detected in the negative control subjects.

Conclusions: It is concluded that urinary alcohol is endogenously produced in patients with type 2 diabetes due to uncontrolled hyperglycemia. However further work is needed to find out the ratio of urinary and blood alcohol which may confirm the present findings.


Full Text:

PDF

References


Zlatkis A, Brazell RS, Poole CF. The role of organic volatile profiles in clinical diagnosis. Clinical Chemistry, (1981); 27(6): 789-97.

Rhodes G, Miller M, McConnell ML, Novotny M. Metabolic abnormalities associated with diabetes mellitus, as investigated by gas chromatography and pattern-recognition analysis of profiles of volatile metabolites. Clinical Chemistry, (1981); 27 (4): 580-5.

Patel HP. The Abnormal Urinalysis. Pediatric Clinics of North America, (2006); 53(3): 325-337.

Jones AW, Kugelberg FC. Relationship between blood and urine alcohol concentrations in apprehended drivers who claimed consumption of alcohol after driving with and without supporting evidence. Forensic Science International, (2010); (1-3): 97-102.

Liebich HM, Al-Babbili O, Zlatkis A, Kim K. Gas-chromatographic and mass-spectrometric detection of low-molecular-weight aliphatic alcohols in urine of normal individuals and patients with diabetes mellitus. Clinical Chemistry, (1975); 21(9): 1294-6.

Lewis GD, Laufman AK, McAnalley BH, Garriott JC. Metabolism of Acetone to Isopropyl Alcohol in Rats and Humans. Journal of Forensic Sciences, (1984); 29(2): 541-549.

Krönert K, Künzel M, Reutter B, Zimmermann C, Liebich HM, et al. Urinary excretion patterns of endogenously produced alcohols in type 1 (IDDM) and type 2 (NIDDM) diabetes mellitus compared with healthy control subjects. Diabetes Research and Clinical Practice, (1990); 10(2): 161-5.

Muoio DM, Newgard CB. Fatty Acid Oxidation and Insulin Action When Less Is More. Diabetes, (2008); 57(6): 1455-1456.

Høiseth G, Kristoffersen L, Larssen B, Arnestad M, Hermansen NO, et al. In vitro formation of ethanol in autopsy samples containing fluoride ions. International Journal of Legal Medicine, (2008); 122(1): 63-6.

Yajima D, Motani H, Kamei K, Sato Y, Hayakawa M, et al. Ethanol production by Candida albicans in postmortem human blood samples: effects of blood glucose level and dilution. Forensic Science International, (2006); 164(2-3): 116-21.

Alexander WD, Wills PD, Eldred N. Urinary Ethanol and Diabetes Mellitus. Diabetic Medicine, (1988); 5(5): 463-64.

Petrovska B, Winkelhausen E, Kuzmanova S. Ethanol and Polyol production from glucose by Candida boidinii NRRL Y-17213. Bulletin of the Chemists and Technologists of Macedonia, (2000); 19(1): 57-63.

Helander A, Olsson I, Dahl H. Post collection synthesis of ethyl glucuronide by bacteria in urine may cause false identification of alcohol consumption. Clinical Chemistry, (2007); 53(10): 1855-7.

Winek CL, Esposito FM. Blood alcohol concentrations: factors affecting predictions. Legal Medicine, (1985): 34-61.

Dentin R, Liu Y, Koo S, Hedrick S. Insulin modulates gluconeogenesis by inhibition of the coactivator TORC2. Nature, (2007); 449(7160): 366-369.

Plougmann S, Hejlesen O, Turner B, Kerr D, Cavan D. The effect of alcohol on blood glucose in type 1 diabetes—metabolic modelling and integration in a decision support system. International Journal of Medical Information, (2003); 70(2-3): 337-344.

Edenberg HJ. The genetic of alcohol metabolism. Role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Research and Health, (2007); 30(1): 5-13.

Honey D, Caylor C, Luthi R, Kerrigan S. Comparative alcohol concentrations in blood and vitreous fluid with illustrative case studies. Journal of Analytical Toxicology, (2005); 29(5): 365-9.

Lidén H, Vijayakumar AR, Gorton L, Marko-Varga G. Rapid alcohol determination in plasma and urine by column liquid chromatography with biosensor detection. Journal of Pharmacy and Biomedical Analysis, (1998); 17(6-7): 1111-28.

Sulkowski HA, Wu AH, McCarter YS. In-vitro production of ethanol in urine by fermentation. Journal of Forensic Science, (1995); 40(6): 990-3.

Passariello N, Sepe J, Marrazzo G, De Cicco A, Peluso A, et al. Effect of Aldose Reductase Inhibitor (Tolrestat) on Urinary Albumin Excretion Rate and Glomerular Filtration Rate in IDDM Subjects With Nephropathy. Diabetes Care, (1993); 16(5): 789-95.

Gruszecki AC, Robinson CA, Kloda S, Brissie RM. High urine ethanol and negative blood and vitreous ethanol in a diabetic woman: a case report, retrospective case survey, and review of the literature. American Journal of Forensic Medicine and Pathology, (2005); 26(1): 96-8.


Refbacks

  • There are currently no refbacks.