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British Journal of Healthcare and Medical Research - Vol. 10, No. 1
Publication Date: February 25, 2023
DOI:10.14738/jbemi.101.13909. Ali, E. E. M., Dafalla, A. M., Mohammed, Y. A., & Nour, B. Y. M. (2023). Estimation of Monocytes and Platelets CD 36 Expression
Levels in Patients with Type 2 Diabetes Mellitus, Sudan. British Journal of Healthcare and Medical Research, Vol - 10(1). 180-184.
Services for Science and Education – United Kingdom
Estimation of Monocytes and Platelets CD 36 Expression
Levels in Patients with Type 2 Diabetes Mellitus, Sudan
Eglal Elamein Mohammed Ali
Faculty of Medical Laboratory Sciences University of Gezira, Wad Medani, Sudan
Abuagla M. Dafalla
Faculty of Medical Laboratory Sciences University of Gezira, Wad Medani, Sudan
Yousif Abdelhameed Mohammed
Faculty of Medical Laboratory Sciences University of Gezira, Wad Medani, Sudan
Bakri Yousif Mohamed Nour
Faculty of Medical Laboratory Sciences University of Gezira, Wad Medani, Sudan
Abstract
Background: Diabetes mellitus (DM) is a global health concern affects all ages. Over
the past few decades diabetes mellitus is a prevalent, potent devastating, medical
problem that has an increasing prevalence. CD36 is a multifunctional signaling
cellular receptor with different ligands specificity. It is expressed on different cells
including macrophages, platelets and monocytes. Objective: This a case control
study aimed to estimate monocytes/platelets CD36 levels in patients with type 2
diabetes mellitus in the period between 2019 and 2022. Methodology: 70 samples
collected from type 2 diabetic patients attending Zeenam Specialized center,
Khartoum, Sudan. And 30 samples collected from healthy individuals as control
group. 5ml of venous blood were collected from the participants, 2.5 ml were put
into a labeled EDTA containers; whole blood were collected to measure HbA1C
using I chroma; Boditech Med Inc., and monocytes/platelets CD36 expression levels
using CYTOMICs FC 590, Beckman coulter at Flow cytometery laboratory,
Khartoum, Sudan. Another 2.5 ml were put into labeled sodium fluoride container
to measure FBG using Biosystem chemistry analyzer BTS-302. Results: This study
showed that the levels of FBG, HbA1C and platelets CD36 expression were
significantly higher in type 2 diabetic patients compared with control group (P =
0.000, P = 0.001 and P = 0.012) respectively. And there are no statistical significant
difference in expression level of monocytes CD36 between cases and control (P =
0.366). Also this study found that monocytes CD36 has a statistically significant
correlation with fasting blood glucose (P = 0.009), and it is not correlated with
HbA1C (P = 0.547). Platelets CD36 has a statistically significant correlation with
fasting blood glucose, HbA1C and monocytes CD36 (P = 0.000) (Table 4). Conclusion:
This study concluded that platelets CD36 expression was significantly higher in type
2 diabetic patients compared with control group. And there are no statistical
significant difference in expression level of monocytes CD36 between cases and
control. Also it concluded that monocytes CD36 have a statistically significant
correlation with fasting blood glucose, and it is not correlated with HbA1C. Platelets
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Ali, E. E. M., Dafalla, A. M., Mohammed, Y. A., & Nour, B. Y. M. (2023). Estimation of Monocytes and Platelets CD 36 Expression Levels in Patients
with Type 2 Diabetes Mellitus, Sudan. British Journal of Healthcare and Medical Research, Vol - 10(1). 180-184.
URL: http://dx.doi.org/10.14738/jbemi.101.13909
CD36 have a statistically significant correlation with fasting blood glucose, HbA1C
and monocytes CD36.
Key words: Monocytes CD36, Platelets CD36, type 2 Diabetes Mellitus, Sudan.
INTRODUCTION
Diabetes mellitus (DM) is a global health concern affects all ages (Kulkarni N et.al, 2018). Over
the past few decades diabetes mellitus is a prevalent, potent devastating, medical problem that
has an increasing prevalence. And in twenty-first century it constitutes a major health challenge
(Tomic D et.al, 2022). It is estimated that the most common type of diabetes is type 2 diabetes
mellitus, which accounting for more than ninety percent of the total number of cases. For people
aged from fifty to seventy four years, it is reported as the fifth leading cause of death (Wu Y et.al,
2021). The cluster of differentiation 36 (CD36) is an 88-kDa transmembrane glycoprotein
(Castelblanco E et.al, 2020). It is a multifunctional signaling cellular receptor with different
ligands specificity. It is expressed on different cells including macrophages, platelets and
monocytes. In macrophages it serves as a scavenger receptor facilitating the uptake of modified
lipoproteins and apoptotic cells, and regulates carbohydrates and lipids metabolism,
participate mediating the transport of long chain fatty acids and insulin resistance. CD36 has
been mediated in a wide range of pathological conditions, such as cardiomyopathy diabetes and
atherosclerosis (Zimman A, Podrez E 2010). CD36 has been stated to be related with type 2
diabetes mellitus. Also it is reported that insulin resistance, hyperglycemia and oxidized low
density lipoproteins are leading cause of up-regulation of CD36 in macrophages and monocytes
(Castelblanco E et.al, 2020). And it has been suggested that this would partly illustrate the
accelerated foam cells formation and atherosclerosis in T2DM (Bacon S et.al, 2013). On platelets
surface CD36 is highly expressed and potentiates the activation of platelets (Yang M et.al, 2018).
In addition it has major role in angiogenesis and cellular adhesion regulations; act as
thrombospondin receptor. Regarding dyslipidemia and stimulated oxidative stress; platelet
CD36 interacts with small endogenous oxidized phospholipids which in turn lead to pro- thrombotic signaling and enhanced thrombosis (Zimman A, Podrez E 2010).
MATERIALS AND METHODS
Study Design and Participants
Case control study was done in the period between 2019 and 2022. It included 100 samples (70
cases, 30 controls) collected from volunteer patients with type 2 diabetes attending Zeenam
Specialized Clinical Center, Khartoum, Sudan. Monocytes/platelets CD36 expression levels
were performed on Flow cytometery laboratory, Khartoum, Sudan.
Data Collection and Statistical Analysis
Data was collected using a questionnaire filled by the investigator at the time of sample
collection. Collected data was tabulated and analyzed using statistical package for social
sciences (SPSS) program version 20, Ann-Whitney test, T test, a crosstabs and correlation were
performed.
Ethical Considerations
Ethical approval was obtained from the IRB of the Faculty of Medical Laboratory Science,
University of Gezira. All participants signed a standard informed consent.
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British Journal of Healthcare and Medical Research (BJHMR) Vol 10, Issue 1, February - 2023
Services for Science and Education – United Kingdom
Methods
5ml of venous blood were collected from the participants by using a sterile needle and syringe.
2.5 ml were put into a labeled EDTA containers; whole blood were used for measurement of
HbA1C and monocytes/platelets CD36 expression levels. Another 2.5 ml were put into labeled
sodium fluoride container to measure fasting blood glucose.
Fasting blood sugar (FBG) was measured using Biosystem chemistry analyzer BTS-302; Serial
No: 801010336, EU. HbA1C was measured using I chroma; Serial No: PFR10F181359, Boditech
Med Inc. Chuncheon, Korea. Expression level of monocytes/platelets CD36 was measured using
CYTOMICs FC 590, Beckman coulter.
RESULTS
This case control study was carried out on 70 patients with type 2 diabetes (cases) and 30
apparently healthy individuals (control group) with both sex. 27 (38.6%) were male and 43
(61.4%) were female (Table 1). 51 (72.1%) of them were uncontrolled diabetes and 19 (27.1%)
were controlled diabetes depending on HbA1C level (Table 2). According to disease duration
patients were distributed into three groups; 1 – 10 years (45.7%), 11 – 15 years (25.7 %) and
more than 15 years (28.6 %) (Table 2).
The result of this study showed that the levels of FBG, HbA1C and platelets CD36 expression
were significantly higher in type 2 diabetic patients compared with control group. And there
are no statistical significant difference in expression level of monocytes CD36 between cases
and control (Table 3). Also this study revealed that monocyte CD36 has a statistically significant
correlation with fasting blood glucose, and it is not correlated with HbA1C. Platelet CD36 has a
statistically significant correlation with fasting blood glucose, HbA1C and monocytes CD36
(Table 4).
Table 1: Frequency of patients according to gender
Frequency Percent
Male 27 38.6
Female 43 61.4
Total 70 100
Table 2: Distribution of patients according to HbA1C and disease duration
Frequency %
HbA1C Control 19 27.1
Uncontrolled 51 72.9
Total 70 100
Disease duration 1 - 10 32 45.7
11 - 15 18 25.7
> 15 20 28.6
Total 70 100