CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(01): 057-064
DOI: 10.1055/s-0041-1732817
Original Article

Estimation of Fluoride and Sirtuin1 in Patients with Diabetic Nephropathy in Kolar District of Karnataka, India

1   Department of Biochemistry, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
Kurpad N. Shashidhar
1   Department of Biochemistry, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
Raveesha Anjanappa
2   Department of General Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
Muninarayana Chandrappa
3   Department of Community Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
› Author Affiliations


Objective Prevalence of type-2 diabetes mellitus (DM) and diabetic nephropathy is growing rapidly in Asian countries, affecting low- and middle-income groups. One of the epidemiological issues of Kolar district is fluorosis; advanced glycation end product, carboxymethyl lysine (CML), and a molecule of interest Sirtuin1 are employed in the present study. In the correlation of fluoride with sirtuin1and CML with sirtuin1 of cases lies the important rationale of the study to assess the extent of kidney damage.

Materials and Methods This is a comparative cross-sectional study with three groups, each with 70 patients, as follows: G1, control; G2, diabetes with diabetic nephropathy; and G3, type-2 DM without any complications. Informed written consent was obtained from all study patients. All the routine investigations were performed by fully automated Vitro 5, 1 Fs, Vitros. Fasting insulin was analyzed by Vitro eCI and glycated hemoglobin was estimated by BioRad D10. Sirtuin1, CML, and fructosamine were estimated by double antibody sandwich technique.

Statistical Analysis The statistical analysis was performed by SPSS 20 (IBM) software. Means of normally distributed data were compared using analysis of variance (ANOVA), and not normally distributed data were compared by Kruskal–Wallis test. A p-value of less than 0.05 was considered statistically significant.

Results A decrease in sirtuin1, serum, and urine fluoride of group 2 (34.74 [25.08–53.2], 0.24 [0.2–0.5], and 0.24 [0.16–0.41]) was observed compared with other groups. Increased CML and fluoride act as prooxidant, restricting the effect of sirtuin1 on cellular damage, causing further complications such as increased insulin resistance and decreased insulin sensitivity.

Conclusion The alterations in serum sirtuin1 levels indicate the severity of damage due to stress during hyperglycemia and fluoride toxicity; hence, sirtuin1 can be considered as biomarker of aging. Subsequently, the correlation of CML, estimated glomerular filtration rate (eGFR), and fluoride with sirtuin1 indicates that increasing sirtuin1 may defend the forthcoming damage and could be considered in therapeutics.

Authors' Contributions

S.D.R. contributed in sample collection and analysis, data compilation and analysis. S.K.N. contributed in study design and protocol, article review, and reagent recruitment. R.A. contributed in patient selection and recruitment, treatment advice to patients, and diagnosis. M.C. contributed in field study and selection of cases from rural areas, data analysis, and results interpretation.

Statement of Ethics

After explaining the whole procedure in patients' understandable language and providing him/her with the patient information sheet, informed written consent following the Declaration of Helsinki was obtained from the study patients, which was approved by Central Ethics Committee No: SDUAHER/KLR/CEC/35/2018-19, dated: May 14, 2018.

Publication History

Article published online:
21 August 2021

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