Abstract
BackgroundAlthough assessment of glycated nail proteins may be a useful marker for monitoring of diabetes, their nature and formation are still poorly understood. Besides a detailed anatomical analysis of keratin glycation, the usefulness of glycated nail protein assessment for monitoring diabetic complications was investigated.Methods216 patients (94 males, 122 females; mean age ± standard deviation: 75.0 ± 8.7 years) were enrolled. Glycation of nail and eye lens proteins was assessed using a photometric nitroblue tetrazolium-based assay. Following chromatographic separation of extracted nail proteins, binding and nonbinding fractions were analyzed using one-dimensional gel electrophoresis. Using a hand piece containing a latch-type-bur, a meticulous cutting of the nail plate into superficial and deep layers was performed, followed by a differential analysis of fructosamine.ResultsUsing SDS PAGE, four and two bands were identified among the nonglycated and glycated nail fraction respectively. Significantly lower fructosamine concentrations were found in the superficial nail layer (mean: 2.16 ± 1.37 μmol/g nails) in comparison with the deep layer (mean: 4.36 ± 2.55 μmol/g nails) (P<0.05). A significant higher amount of glycated eye lens proteins was found in diabetes mellitus patients (mean: 3.80 ± 1.57 μmol/g eye lens) in comparison with nondiabetics (mean: 3.35 ± 1.34 μmol/g eye lens) (P<0.05). A marked correlation was found between glycated nail and glycated eye lens proteins [y (glycated nail proteins) = 0.39 + 0.99 x (eye lens glycated proteins); r2 = 0.58, P<0.001]. The concentration of glycated eye lens proteins and the HbA1c level were found to be predictors of the concentration of glycated nail proteins.ConclusionsGlycation of nail proteins takes place in the deep layer of finger nails, which is in close contact with blood vessels and interstitial fluid. Glycation of nail proteins can be regarded as a representative marker for diabetic glycation-associated target organ damage.
Highlights
In sub-Saharan Africa, the assessment of glycated proteins in human finger nails may be a useful marker for monitoring of diabetes in comparison with the classic glycemia markers [measurement of plasma glucose concentration, oral glucose tolerance test (OGTT) and determination of Haemoglobin A1c (HbA1c)] due to a less critical preanalytical phase and low reagent costs [1]
Lower fructosamine concentrations were found in the superficial nail layer in comparison with the deep layer (P
A significant higher amount of glycated eye lens proteins was found in diabetes mellitus patients in PLOS ONE | DOI:10.1371/journal.pone
Summary
In sub-Saharan Africa, the assessment of glycated proteins in human finger nails may be a useful marker for monitoring of diabetes in comparison with the classic glycemia markers [measurement of plasma glucose concentration, oral glucose tolerance test (OGTT) and determination of HbA1c] due to a less critical preanalytical phase and low reagent costs [1]. It should be interesting to study if the degree of glycation in finger nails is representative for the glycation of clinically more important target organs, such as the eye lens. This biochemical exploration could further confirm the usefulness of glycated nail protein assessment for monitoring diabetic complications. Assessment of glycated nail proteins may be a useful marker for monitoring of diabetes, their nature and formation are still poorly understood. Besides a detailed anatomical analysis of keratin glycation, the usefulness of glycated nail protein assessment for monitoring diabetic complications was investigated
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