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15 December 1995 | Volume 123 Issue 12 | Pages 919-924
Objective: To determine basal levels of cytosolic calcium ([Ca2+]i) and phagocytic activity in polymorphonuclear leukocytes (PMNLs) from patients with non-insulin-dependent diabetes (NIDDM).
Design: Prospective cohort study.
Setting: A university-county hospital.
Measurements: Cytosolic calcium levels, adenosine triphosphate (ATP) content, and phagocytosis of PMNLs from patients with NIDDM and from controls.
Intervention: In patients with NIDDM, we evaluated the effect of treatment with an oral hypoglycemic agent (glyburide) on [Ca2+]i levels, ATP content, and the phagocytosis of PMNLs.
Patients: 22 controls and 34 patients with NIDDM were examined. Fifteen patients were studied before and after 3 months of treatment with glyburide.
Results: Polymorphonuclear leukocytes from patients with NIDDM showed significantly elevated basal levels of [Ca2+]i (68 ± 9.6 compared with 43 ± 4.9 nmol/L; P < 0.01); reduced ATP content (1.30 ± 0.58 compared with 2.35 ± 0.45 nmol/106PMNLs; P < 0.01); and impaired phagocytosis (117 ± 21.0 compared with 145 ± 17.4 µg oil/107PMNLs per minute; P < 0.01) compared with controls. There was a direct and significant correlation (P < 0.01, r = 0.80) between [Ca2+]i levels in PMNLs and serum glucose levels and an inverse correlation between phagocytic ability and [Ca2+]i levels (P < 0.01; r = 0.62) as well as between phagocytic activity and fasting serum glucose levels (P < 0.01, r = 0.54) in patients with NIDDM. Glyburide therapy resulted in significant reduction in fasting serum glucose levels; in PMNLs, this treatment resulted in a significant reduction in [Ca2+]i levels, a significant increase in ATP content, and a significant improvement of phagocytosis.
Conclusions: Patients with NIDDM have elevated [Ca2+]i levels in PMNLs. This abnormality is probably induced by hyperglycemia and is primarily responsible for the impaired phagocytosis seen in these patients.
Author and Article Information
From the University of Southern California School of Medicine, Los Angeles, California.
ARTICLE
Polymorphonuclear Leukocytes in Non-Insulin-dependent Diabetes Mellitus: Abnormalities in Metabolism and Function
Grant Support: By National Institute of Diabetes and Digestive and Kidney Diseases grant DK 29955. Dr. Klin was supported by the Fogarty International Fellowship.
Request for Reprints: Shaul G. Massry, MD, Chief, Division of Nephrology, University of Southern California School of Medicine, 2025 Zonal Avenue, Los Angeles, CA 90033.
Current Author Addresses: Drs. Alexiewicz, Smogorzewski, Klin, and Massry: Division of Nephrology, University of Southern California School of Medicine, 2025 Zonal Avenue, Los Angeles, CA 90033.
Dr. Kumar: Division of Endocrinology, Diabetes and Hypertension, University of Southern California School of Medicine, 2025 Zonal Avenue, Los Angeles, CA 90033.
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