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Study of Plasma Lipid Peroxidation,Lipids and Blood Sugar Level in Opium Addicts

Compared with Control Group

IS. Asgary, 2GhNaderi, 3M.Soghraty, 4P.Ahmadyand 4J.R.Shahrezaee

lAssistant Professor of Phannacognosy, Head of Basic Science Department2Assistant Professor of Biochemistry, Head of Laboratories

3.4General Practitioner, Isfahan Cardiovascular Research CenterIsfahan University of Medical.Sciences, Isfahan, IRAN

na : study

Icer .Oralew Delhi,

INTRODUCTIONDee 1999.

Nowadays, narcotics addiction has changed great human manifestations, besides decreasein active power of society. In recent century according to spread of narcotics addiction inhuman societies, it has become propounded as one of the most important human problems.

Addiction is not only destructive but also causes many social and individual problems.Opium is derived from poppy plant and contains more than 20 kinds of alkaloids. Prevalenceof addiction varies among different countries, cultures and jobs. In the United States despitefirm laws against entrance and distribution of narcotics that was made in 1914,use of narcoticsespecially heroin has increased in recent years. About 2.5 millions heroin addicts have beenreported in the US(8).. ,

In Iran despite nation wide struggle against this ominous phenomenon, narcoticsaddiction has increased in recent years. In the first 10 years of struggling against narcoticsin Iran, more than 5000 drug dealers were executed and more than 2500police were martyred.

Addiction has many etiologies, ethnic, hereditary, biologic, physical, 'psychologic, social,cultural, familial, occupational and economic. Unfortunately some of the people and even afew of the physicians believe that opium has useful effects on cardiovascular diseases (CVD)and diabetes. .

Studies show that heroin addiction causes hyperkalemia, morphine use can result incalcium inhibition, hypercholesterolemia(12) and inhibition of vascular endothelial growthfactor (VEGF) expression in myocardial ishemia(13). Central administration of opiates andopoid peptides may act indirect1yvia the sympathetic nervous system to cause hyperglycemiaand impaired insulin secretion, while peripheral administration tends to stimulate insulin

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and glucagons secretion(18). Thus, heroin addicts, like patients with non~insu1in-dependentdiabetes, does not respond appropriately to glucose signals(14).

As the increase in blood lipids~ lipid peroxidation and blood sugar are important CVDrisk factors, this study intenas to investigate the effect of opium on these biochemical factors.

MATERIALS AND METHODS

In this case-control study, we chose 32 opium addict men as case group and 32 cigarettesmoker non addict men as control group.

Urine analysis with morphine strip test was done for confirmation of no addiction incontrol group.

. As the majority of opium addicts were cigarette smoker, too, for elimination of cigaretteeffect,cigarette smokers were chosen as control group in this study.

The addict groups were 25-40 year-old men with 1 gr. daily opium use for at least 3years and their route of opium use was inhalation.

Control group was 25-40 year-old non addict cigarette smoker men. In both groupspatients with diabetes, hypertension and hypercholesterolemia were excluded.

No one in this study was on specificmedication or diet. Information was obtained byquestionnaires. Questionnaires contained information about duration of opium addictional1dconqomitant cigarette smoking, history of specificdisease ~d physical examination.. ,- Bloodsamplesin both groupswere obtainedfromveins and all of the sampleswereexamined in cardiovascular research center laboratory.

Fasting blood sugar, Total cholesterol, High density lipoprotein and Triglyceride weremeasured by Pars Azmoon kit and Elan autoanalyzer and Low density lipoprotein wascalculated with formula. Glycosylated hemoglobin (HbAIC)was measured by colorimetricmethod and malondialdehyde (MDA)was measured by Shimadz spectrophotometer (2,3,5). Data were analyzed by t-test and SPSSand EPI6statistical software.

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FINDINGS

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There was no significant statistical difference between the mean of cigarette smoking andthe mean of age in addict group compared to control group.

Mean of addiction duration in addict group was 8.92 :!:5 years and mean of their dailyopium use according to their states was 4.8 :!:1.5 gr.

Mean of serum FBS level in addict group was 84.03 :!:26.8 mg/ dl and in control groupwas 90.03 :!:32.3 mI/ dl, that there was no significant statistical difference between them(Table 1).

In this study the mean of HDL in addict group was lower compared with control group.There was no significant statistical difference in the mean of TG, between case group andcontrol group in this study. The mean of MDA in the current study was higher in addictgroup compared with control group but was not significant.

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DISCUSSION AND CONCLUSION

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opiuIn the current study, there was no significant statistical difference among FBS, HbAIC, TG,Total Cholesterol, HDL, LDL and malondialdehyde in opium group compared to controlgroup. Although one study demonstrated that morphine administration increases blood

168

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Table 1. Comparison of the mean of biochemical factors betweenaddicts group and control group.

rtant CVD:al factors. Group/

Biochemicalfactors

FBS(mg/ dl)HbAIC (%)

HDL-Ch (mg/ dl)LDL-Ch (mg/ dl)

Total-Ch (mg/ dl)TG (mg/ dl)

Malondialdehyde (p mol/lit)

Addictn=32

84.03 :f:26.88.04 :f:0.91

40.17 :f:8.99127 :f:41.48

208 :f:52.5

204 :f:1571.15 :f:0.2

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at least 3

Non addictn=32

90.03 :f:32.30

8.12 :f:2.07

42.43 :f:7.37137 :f:44.23

227 :f:57.1241 :f:1801.13 :f:0.17

P. Value

0.460.150.320.420.220.430.76

sugar and in another study, morphine was administrated to rats and added to their dailydiet and after that their total cholesterol and LDLwere increased (1, 10).

Unfortunately somepeople believe that opium decrE;asesblood sugar in diabeticpatients. and advise it as a treatment for diabetes. .

Study on rats has demonstrated that morphine administration and daily diet containingmorphine decreases HDL. In heroin addicts HDL has been lower compared with controlgroup (7). In our study mean of HDL in addict group was lower compared with controlgroup and this can show the greater risk for coronary disease in addict group (1,7).

In some of studies morphine administration to rat has decreased TG and serum TGlevels has been higher in heroin addict groups compared with control groups.

In the percent study, there was no significant statistical difference in the mean of TGbetween case group and control group.

MDA is a measurable index that shows lipid peroxidation and today it has confirmedthat lipid peroxidation and lipoproteins that changed due to oxidation, are major cause ofatherosclerosis.

On the other hand, it has been demonstrated that morphine stimulates malondialdehydeproduction (6).

In the current study, the mean ofmalondialdehyde in addict group was higher comparedwith control group but wasn't significant.Maybe with increasingthe samples, this differencebecome significant.

Therefore,we can say that increase ofperoxidation products likeMDA can demonstratethe greater risk for cardiovascular disease.

This study showed that opium use has no useful effect on blood sugar or blood lipidsreduction and if some ofthese biochemical factorshas been lower in addict group (althoughit isn't significant),may be it is due to economicaland nutritional problems in opium addicts.

In addition, effect of opium on other important cardiovascular risk factors likecoagulation factors is considerable. Another study demonstrated that fibrinogen, a majorand independent risk factor in development and progression of atherosclerosis-increases inopium addicts(4, 9, 11).

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