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An increased polyol-pathway activity is implicated in the pathogenesis of some diabetic complications. Little is known about the sorbitol-dehydrogenase (SDH) activity in diabetic patients, although cataract is described in diabetes as well as in SDH deficiency. Therefore, we studied SDH activity and the relation with complications and with sorbitol accumulation in erythrocytes from 96 type 1 diabetics and 29 age- and sex-matched healthy subjects. When comparing these groups erythrocyte sorbitol (ERY-SOR) was significantly (P < 0.001) increased in the diabetic patients, but no difference in SDH could be demonstrated. In the diabetic patients ERY-SOR was predominantly related to the glycaemia (r = 0.37; P < 0.001). The SDH activity correlated with HbA1 (r = 0.20; P < 0.03). In diabetic patients with severe nephropathy the ERY-SOR value is no longer different from the control value. It was concluded that, in poor metabolic control the SDH activity is increased, which counteracts but does not prevent the sorbitol accumulation nor the genesis of complications. In patients with macroalbuminuria the ERY-SOR decreases to the normal range. Since SDH activity is similar in type 1 diabetics and controls the decreased ERY-SOR in this complication might be due to other metabolic pathways.

Fasting plasma zinc levels were determined in 45 IDDM and in 40 NIDDM patients. Mean values were similar in both groups, but diabetic men showed a significantly higher plasma zinc (p less than 0.05) than diabetic women. In patients with diabetic nephropathy a lower zinc level was associated with decreased plasma albumin as compared to patients without complications (p less than 0.001). Neuropathy and macro-angiopathy were also associated with lower zincemia (p less than 0.05) but in the presence of normal albumin levels. In IDDM without nephropathy a significant positive correlation was found between plasma zinc and plasma glucose, albumin, branched chain amino acids and glutamine, while in NIDDM without nephropathy a significant positive correlation exists between plasma zinc and the amino acids glutamine, valine, histidine and lysine.

Twenty seven insulin-dependent (type I) diabetic patients (mean +/- SD; age: 30 y +/- 12; duration of diabetes 12 y +/- 2.5) were treated for at least 12 weeks with two regimens differing only in their fatty acid composition. The energy in the diabetic diet was contributed 50%-55% by carbohydrates, 15%-20% proteins and 30% by lipids. The diet high in poly-unsaturated-fatty-acids (PUFA) contained 61% PUFA and 17% of saturated fatty acids (SFA) while the diet low in PUFA was composed of only 4% PUFA and of 65% SFA. Group I followed the diet high in SFA for six weeks and then switched to the diet high in PUFA. Group II followed the diets in the reverse order. After six weeks of treatment with the high PUFA diet, total serum cholesterol decreased from 195 mg % +/- 11.1 mg % in group I and 179 mg% +/- 12.1 % in group II to 169 mg +/- 10.2 and 142 mg % +/- 8.1 respectively. This fall was mainly due to highly significant decrease in LDL-Cholesterol. VLDL-cholesterol and HDL-cholesterol in both groups remained almost unchanged. In group I a significant decrease in serum triglyceride from 88 mg % +/- 9.2 to 70 mg % +/- 10.9 was found after six weeks of treatment with the high PUFA diet. The atherogenic index decreased significantly in both groups. Six weeks of treatment with the high SFA diet reversed these results. Serum cholesterol increased mainly due to the highly significant increase in LDL-cholesterol, VLDL-cholesterol, HDL-cholesterol and triglycerides remaining unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Since intracellular sorbitol is considered a factor perhaps involved in the pathogenesis of some diabetic complications, erythrocyte sorbitol content was measured in diabetics (IDDM and NIDDM) and in a control group and its relation with metabolic control was investigated. The erythrocyte sorbitol content was significantly increased in diabetic population (p less than 0.001) as compared to the controls. In newly diagnosed IDDMs the erythrocyte sorbitol content changed in parallel with the blood sugar level indicating that the accumulation can be reversed in erythrocytes. In a cross-sectional study a significant positive correlation existed in IDDMs between the concentration of red cell sorbitol and the plasma glucose concentration (r = 0.45; p less than 0.001). Also the HbA1 values correlated (r = 0.44; p less than 0.001) with the erythrocyte sorbitol content. In NIDDMs no correlation with metabolic control could be demonstrated.

There is growing evidence that differences in fat distribution can be predictive for differences in the prevalence of metabolic disturbances, cardio-vascular disease, stroke and death, independent of commonly used indices of obesity. This study evaluates regional body fat distribution as a possible main reason for hypertension in obese and non-obese type II diabetics. 42% of normal weight diabetics with abdominal obesity are hypertensive versus 47% of obese diabetics; only 5% hypertension could be found when a lower body segment fat distribution is present. A significant (p less than 0.001) correlation exists between fat mass topography and both systolic (r = 0.49) and diastolic (r = 0.49) blood pressure. This correlation remains true after correction for body mass index and percent glycosylated hemoglobin. These results suggest that localization of fat in the upper body segment should be considered as a additive risk for hypertension.

A positive correlation is found between the ATP concentration and the sperm motility characteristics. So ATP measurement may contribute to a better selection of patients; in vases of asthenospermia, a differential diagnosis between ultrastructural abnormalities and problems related to energy supply is possible without the expensive electron microscopy.

Obesity is known to be associated with an elevated risk for cardiovascular disease. Rheological disturbances could be factors contributing to these vascular complications. Therefore we have evaluated blood viscosity parameters in 128 obese (BMI greater than 28 kg/m2) adults and in 90 non-obese healthy subjects. Whole blood, plasma and erythrocyte viscosity values were determined with a Contraves LS30 viscosimeter. Plasma and whole blood viscosity were significantly (all P less than 0.001) increased in the obese subjects. The increased low shear erythrocyte viscosity suggested a diminished erythrocyte deformability in obesity. The rheological abnormalities were present even in the absence of impaired glucose tolerance, diabetes, hypertension or hyperlipidaemia. In the obese group the rheological parameters showed significant correlations (at least P less than 0.05) with BMI, insulin or C-peptide area during an oral glucose tolerance test and plasma lipids. Our findings demonstrate that obesity per se may be associated with abnormal blood viscosity properties.