Plasma cholinesterase activity in obese type 2 diabetics

Abstract

Background: The metabolic syndrome which in recent times has been associated with obesity is known to be associated with increased morbidity and mortality. This group of patients tolerate surgery poorly and the metabolic syndrome has been partly blamed for this. Cholinesterase hydrolyzes succinylcholine, a potent muscle relaxant used during surgery. Deficiency of this enzyme results in sustained activity of succinylcholine leading to prolonged muscle relaxation and increased mortality.
Aim: This study looks at the possibility of a relationship between the metabolic syndrome and plasma cholinesterase activity with a view to exploring the reasons for the increased morbidity and mortality associated with surgeries in patients with the metabolic syndrome.
Methods: In this prospective study, 195 subjects were recruited, comprising 50 obese type- 2 diabetics (with the metabolic syndrome), 45 Obese type-2-diabetics (without the metabolic syndrome), 50 non-obese type-2-diabetics (without metabolic syndrome) and 50 non-diabetic, non-obese patients recruited as control. Standard criteria for the diagnosis of metabolic syndrome were used. Plasma cholinesterase was measured in all the groups using the kinetic colorimetric method.
Results: The result showed a significant reduction in the plasma cholinesterase activity of obese type-2-diabetic patients who also had the metabolic syndrome) (3315 ± 671i.u/L) when compared with the control group (8219 ± 815 i.u/L), subjects without the metabolic syndrome showed normal plasma cholinesterase levels.
Conclusion: Reduction in plasma cholinesterase activity is associated with the metabolic syndrome in obese type-2-diabetics.


Port Harcourt Medical Journal Vol. 1(1) September 2006: 39-43