CROSS SECTIONAL EVIDENCE FOR OPPOSING EFFECTS OF HYPERGLYCAEMIA AND HYPERLIPIDAEMIA ON CHOLINESTERASE ACTIVITIES

Diabetes mellitus is increasing globally, creating a need for affordable biomarkers to supplement blood glucose and HbA1C monitoring. Plasma butyrylcholinesterase (BChE) and erythrocyte acetylcholinesterase (AChE) are promising candidates because they are easily measured and have known associations with metabolic disorders. This study examined whether BChE and AChE activities reflect diabetes type, glycemic control, chronic complications, and coexisting dyslipidemia.

In a cross-sectional study, plasma BChE and erythrocyte AChE activities were measured using an electrometric assay in 298 patients: they were divided according to diagnosed either with type 2 diabetes on monotherapy, or with type 2 diabetes on combination therapy, or with type 1 diabetes, and another group with isolated dyslipidemia. Thirty age- and sex-matched healthy individuals served as controls. Subgroups were stratified by glycemic control, complication status, therapy regimen, and comorbid conditions.

Both plasma BChE and erythrocyte AChE activities were significantly lower in nearly all type 2 diabetes subgroups compared to controls (p < 0.05). The largest reduction in enzyme levels was observed in patients with poorly controlled type 2 diabetes and chronic complications. The diabetes treatment regimen (monotherapy versus combination therapy) did not significantly influence enzyme levels. Concurrent hypertension was associated with a modest, inconsistent reduction in AChE activity only. In type 1 diabetes, a significant AChE decrease was observed only in well-controlled patients, indicating a weaker relationship between cholinesterase activity and type 1 disease. By contrast, patients with isolated dyslipidemia showed significantly elevated BChE and AChE levels relative to controls (p<0.05).

Declining cholinesterase activity-especially erythrocyte AChE-parallels worsening glycemic control and vascular complications in type 2 diabetes, whereas isolated dyslipidemia is associated with increased cholinesterase levels. Cholinesterase assays could serve as low-cost adjunct biomarkers in diabetes management, although prospective studies are needed to validate their prognostic utility.