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Turkish Journal of Medical Sciences Turk J Med Sci

(2017) 47: 996-1001


http://journals.tubitak.gov.tr/medical/
© TÜBİTAK
Research Article doi:10.3906/sag-1503-90

The effect of acetylsalicylic acid on vasopressin, serum insulin levels, insulin resistance,
and biochemical parameters in rats induced with experimental diabetes type 2
1, 2
Serkan ŞEN *, Sefa ÇELİK
1
Department of Medical Laboratory Techniques, Atatürk Vocational School of Health Services, Afyon Kocatepe University,
Afyonkarahisar, Turkey
2
Department of Medical Biochemistry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey

Received: 16.03.2015 Accepted/Published Online: 19.11.2015 Final Version: 12.06.2017

Background/aim: Acetylsalicylic acid (ASA) treatment in diabetic patients is very important owing to the increasing hyperactivity
of thrombocytes and atherosclerosis. In several investigations, it was reported that diabetes caused increased coronary artery disease,
cerebrovascular disease, and death. In this study, we aimed to investigate the effect of ASA on osmoregulation, glycemic control, and
some biochemical parameters in rats induced with experimental diabetes type 2.
Materials and methods: Twenty-four rats were randomly divided in four groups: control (I), ASA control (II), diabetic (III), and ASA
diabetic (IV). Diabetes was induced by streptozotocin treatment (30 mg/kg, twice, intraperitoneal injection) in obese rats. ASA (150
mg/kg body weight, orally) was administered for 5 weeks in the ASA control and ASA diabetic groups. Serum electrolytes, creatinine,
albumin, and total protein levels were analyzed with an autoanalyzer. Arginine vasopressin (AVP) and insulin were analyzed by ELISA
techniques.
Results: At the end of the study ASA treatments had decreased the fasting blood glucose levels but had interestingly increased the serum
AVP levels in diabetics rats.
Conclusion: AVP levels were increased 2-fold by ASA treatment in diabetic rats. For the first time in this study, the hypoglycemic effect
of ASA was attributed to an increase in blood volume by AVP levels. This explanation may be a new approach to the literature on this
topic.

Key words: Type 2 diabetes, arginine vasopressin, insulin resistance, osmoregulation

1. Introduction in diabetics. A 1% increase in HbA1c levels doubles the


Diabetes mellitus is characterized by chronic hyperglycemia risk of cardiovascular diseases (5).
developed as a result of disorders in carbohydrate, fat, Inflammation plays a key role in the development
and protein metabolisms related to disorders in insulin of atherosclerosis (6). It was also suggested that type 2
secretion, insulin action, or both (1) . diabetes has an effective role in atherosclerosis with its
Type 2 diabetes is the most common form of diabetes. NOS, NO, redox stress, and inflammatory components (7).
Its main disorders are characterized by insulin secretion Today it is clearly known that there are close relations
and activity. Type 2 diabetic patients usually have an between diabetes, inflammation, atherosclerosis, and
excess of insulin and insulin resistance rather than insulin thrombosis (8). In the global treatment strategies for type 2
deficiency (2). diabetes, acetylsalicylic acid (ASA) is used as a therapeutic
Morbidity and mortality rates of cardiovascular agent and its use is recommended (9). Therefore, ASA
disease in diabetic patients are high, and cardiovascular treatment for type 2 diabetics in order to minimize the risk
complications form the most extensive area in the cost of cardiovascular diseases is essential.
tables caused by diabetes complications (3). The risk of Arginine vasopressin (AVP) is produced in the
cardiovascular diseases for type 2 diabetics is 2.32 times supraoptic and paraventricular cores found in the
higher than that of nondiabetics (4). Additionally, there is hypothalamus and is transferred to the posterior pituitary
a link between cardiovascular diseases and glucose levels gland via the supraoptic hypophyseal channel and stored
* Correspondence: serkansen@aku.edu.tr
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ŞEN and ÇELİK / Turk J Med Sci

there. It is released by exocytosis in response to osmotic and were adapted to the environment by feeding with
and nonosmotic stimuli (10). standard pellet feed for 1 week. Rats, except the control
In this study, it was aimed to investigate the effect of and ASA control groups, were administered the HFD for 6
ASA on osmoregulation, glycemic control, and some weeks and the changes in weights of the rats in the control
biochemical parameters in rats induced with experimental and HFD-applied groups were monitored weekly.
diabetes type 2. At the end of the HFD administration period (6 weeks),
an insulin tolerance test (ITT) was performed on all rats
2. Materials and methods and the rats with insulin resistance were determined.
2.1. Animals As explained in the literature, HFD-administered rats
The 24 male Wistar rats of 6–8 weeks old (140–200 g) used that had a weight gain of 5% compared to control group
in this study were obtained from the Süleyman Demirel rats and additionally developed insulin resistance were
University Experimental Animal Research Center (Isparta, regarded as obese (15), and type 2 diabetes formation was
Turkey). Care and feeding of rats was carried out at 21 ± 2 carried out with STZ injection.
°C ambient temperature and 55%–60% relative humidity, 2.4. Formation of type 2 diabetes model
with a 12/12-h light/dark cycle. High-energy normal feed In the 8th week of the study, obese rats were starved for
and daily fresh water supply was provided continuously 12 h and fasting blood sugar (FBS) levels were measured
according to the groups. Rats were randomly divided in (Accu-Check Go, Bayer, Germany) in order to compare
four groups: control (I), ASA control (II), diabetic (III), the blood glucose levels after STZ injection. Following
and ASA diabetic (IV). ketamine (65 mg/kg) and xylazine (7 mg/kg) anesthesia,
2.2. Preparation of a high-fat diet rats were injected with STZ dissolved in citrate buffer
In order to cause experimental type 2 diabetes, insulin resis- (pH 4.5) with a 30 mg/kg dosage twice in weekly intervals
tance should be developed in diabetic rats. High-energy di- with i.p. injection. FBS levels of the rats were measured
ets are used for this purpose. However, the high-energy feed one week after the last injection and the rats with levels
used for this purpose has not been found from the manu- higher than 300 mg/dL FBS were regarded as having type
facturers in Turkey. Therefore, studies on type 2 diabetes 2 diabetes (16). Following the development of obesity, the
formation with streptozotocin (STZ) injection following rats in the type 2 diabetes model injected with a low dose
a high-energy diet were reviewed and the feeds used, en- (30 mg/kg) of double STZ injections (i.p.) were divided
ergy contents, and foods that increase the energy contents into groups for the following phases of the study.
were determined. The high-fat diet (HFD) administered to 2.5. Insulin tolerance test
test animals in order to create obesity or insulin resistance Insulin solutions prepared for the rats were administered
varies depending on the study and the fat content changed at a dose of 0.50 IU/kg by i.p. injection, and the plasma
between 22% and 60% (11–13). HFD content was prepared glucose levels before the injection (minute 0) and at
according to the average feed contents in studies using a minutes 15, 30, and 60 following the injection were
standard diet and is given in Table 1. measured and insulin resistance was determined.
2.3. Formation of insulin resistance in rats Very low or no decreases in FBS levels show that
Because the fastest weight gain in HFD-applied groups insulin resistance is established and the diabetes model is
started at the 5th week and continued until the rats were 20 type 2 (16,17). In many studies that applied the ITT, it was
weeks old, the study was initiated with rats of 6–8 weeks old reported that the glucose-lowering effect of insulin lasted
(14). Rats were brought to the Afyon Kocatepe University until the 30th minute; however, plasma glucoses started
Experimental Animal Research and Application Center to increase after the 30th minute due to gluconeogenesis

Table 1. The content of the high-fat diet and standard diet.

Standard pellet feed ingredients High-energy (fatty) feed ingredients


Fat ratio (%) 4.1 57.3
Protein ratio (%) 17 13.6
Carbohydrate ratio (%) 76.4 30.1
Other substances (%) 2.5 1.5
Energy level (cal/kg) 2600 4930

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ŞEN and ÇELİK / Turk J Med Sci

and hepatic glycogenolysis. In this manner, the peak in 3. Results


the antihyperglycemic activity of insulin is considered to 3.1. Effects of ASA treatment on blood biochemical pa-
occur at the 30th minute and 30-min data were used for rameters in type 2 diabetic rats
the ITT (18), and data obtained at the end of this time were Serum sodium, chloride, potassium, creatinine, albumin,
used for the statistical analyses. and total protein levels are shown in Table 2. According
2.6. Analysis of the biochemical parameters to these data, a significant difference was found in serum
The rats were sacrificed under ketamine and xylazine sodium levels between the ASA-applied diabetics group
anesthesia and intracardiac blood was taken with 10 mL and non-ASA-applied diabetics group (Figures 1A–1F;
syringes. The blood samples were centrifuged for 5 min Table 2).
at 4000 rpm and serum samples were obtained. Sodium, It was determined that serum sodium levels decreased
potassium, chloride, creatinine, total protein, and albumin following the ASA administration. Serum potassium levels
values of serum samples as biochemical parameters were between the ASA-applied diabetics group and other groups
analyzed at the Afyon Kocatepe University Ahmet Necdet were statistically significant; in the ASA-applied diabetics
Sezer Research and Training Hospital in the biochemistry group serum potassium levels increased (Figure 1).
laboratories using a Roche Cobas C501 autoanalyzer. Regarding the serum chloride levels, no significant
2.7. Determination of serum insulin and vasopressin lev- difference was found between the diabetic group and ASA
els by ELISA technique diabetic group, or between the control and ASA control
Both insulin and vasopressin were analyzed from blood group. However, the difference in serum chloride levels
samples. Analyses were carried out by ELISA techniques between the nondiabetic group (control and ASA control)
using commercial kits for insulin (EMD Millipore and diabetic group (diabetic and ASA diabetic) was
Corporation, USA) and vasopressin (Bachem, Switzerland) statistically significant and serum chloride levels in the
determinations by ELISA reader (Trinity Biotech, Ireland). diabetic group were lower (Figure 1; Table 2).
Serum creatinine levels in ASA-applied diabetic
2.8. Assessment of beta cell function (HOMA-β: Homeo-
groups were lower than those of non-ASA-applied
stasis Model Assessment, Beta Cell Function)
diabetic groups (Table 2). Serum albumin levels were also
With the blood glucose and insulin levels obtained at the
significantly lower in the ASA diabetic group than in other
end of the study, HOMA-β values were calculated with the
groups, as was the case for all biochemical parameters
following formula:
except serum potassium (Table 2). As a result of serum
HOMA-β = 20 × fasting insulin level (mU/L) / fasting
total protein analyses, it was found that the control group
glucose level (mmol/L) – 3.5 (19).
had significantly higher total protein values than the other
2.9. Assessment of insulin resistance (HOMA-IR: Ho- groups.
meostasis Model Assessment, Insulin Resistance)
3.2. Serum arginine vasopressin (antidiuretic hormone)
With the plasma glucose and insulin levels obtained at the
levels
end of the study, HOMA-IR values were calculated with
Vasopressin levels in the control group, ASA control
the following formula:
group, diabetic group, and ASA diabetic group were
HOMA-IR = 20 × fasting insulin level (mU/L) / fasting
2.33 ng/mL, 14.38 ng/mL, 37.03 ng/mL, and 70.4 ng/
glucose level (mmol/L) / 22.5 (19).
mL, respectively. Statistically significant differences were

Table 2. Changes in biochemical parameters.

Control ASA control Diabetic ASA diabetic P


Sodium (mEq/L) 141.17 ± 0.65b 142.60 ± 0.68b 140.50 ± 0.85b 133.5 ± 0.50a 0.001
Postassium (mEq/L) 5.18 ± 0.24a 5.46 ± 0.29a 5.28 ± 0.15a 6.28 ± 0.03b 0.003
Chlorine (mEq/L) 100.27 ± 0.92 b
100.64 ± 0.80 b
96.95 ± 1.27 a
95.82 ± 1.18 a
0.011
Creatinine (mg/dL) 0.39 ± 0.03b
0.35 ± 0.02a,b
0,45 ± 0.01c
0.33 ± 0.01 a
0.001
Albumin (g/dL) 3.45 ± 0.01b 3.47 ± 0.06b 3.77 ± 0.06c 3.18 ± 0.09a 0.001
T. protein (g/dL) 6.22 ± 0.043b 5.47 ± 0.15a 5.63 ± 0.06a 5.46 ± 0.07a 0.001

: The differences between values with different superscripted letters in the same line are statistically significant (P < 0.005).
a, b, c

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A. Sodium (mEq/L) B. Potassium (mEq/L)


145 b 8
b b b
6 a a a
140
a 4
135

130 2

125 0
Control ASA Diabetic ASA Control ASA Control Diabetic ASA
Control Diabetic Diabetic

C. Chlorine (mEq/L) D. Creatinine (mg/dL)


102 b 0.5 c
b b
100 0.4 a,b a
98 a 0.3
a
96 0.2

94 0.1

92 0
Control ASA Diabetic ASA Control ASA Diabetic ASA
Control Diabetic Control Diabetic

E. Albumin (g/dL) F. Total Protein (g/dL)


4 6.4 b
c
3.8 6.2
b 6
3.6 b
5.8 a
3.4 a a
a 5.6
3.2 5.4
3 5.2
2.8 5
Control ASA Diabetic ASA Control ASA Diabetic ASA
Control Diabetic Control Diabetic
Figure 1. Changes in serum biochemical parameters. A) Changes in serum sodium values between the groups. B) Changes in serum
potassium values between the groups. C) Changes in serum chlorine values between the groups. D) Changes in serum creatinine values
between the groups. E) Changes in serum albumin values between the groups. F) Changes in serum total protein values between the
groups.

determined between all groups except the control group Regarding the HOMA-IR results that show the insulin
and ASA control group (Table 3). resistance coefficients, similar to the HOMA-β results,
3.3. Serum insulin levels statistically significant differences were determined
There was no significant difference in insulin levels between control groups and diabetic groups. In other
between any groups. words, the insulin resistance coefficient was found
significantly higher in diabetic groups than in control
3.4. HOMA-β and HOMA-IR results
groups. Additionally, statistically insignificant decreases
According to HOMA-β data that show the beta cell
were observed in insulin resistance coefficients in
functionality, the differences between control groups
both control groups and diabetic groups with ASA
and diabetic groups were statistically significant. In this
administration (Table 3).
manner, beta cell functionality of the diabetic groups was
FBS findings show that the differences between diabetic
lower than that of control groups. Additionally, statistically
groups and nondiabetic groups were not significant (Table
nonsignificant decreases were observed in beta cell
3). As a result of ASA administration, a significant decrease
functionality in both control groups and diabetic groups
was found in the FBS levels in the ASA diabetic group
with ASA administration (Table 3).

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Table 3. Serum arginine vasopressin, insulin, and FBS levels, and results of insulin resistance and beta cell function.

Control ASA Control Diabetic ASA Diabetic P


Vasopressin (ng/mL) 2.33 ± 0.44a
14.38 ± 2.95a
37.03 ± 7.11b
70.40 ± 3.86c
0.001
Insulin (ng/mL) 0.328 ± 0.059 a
0.242 ± 0.022 a
0.369 ± 0.048 a
0.253 ± 0.024 a
0.157
HOMA-β 0.075 ± 0.014a 0.060 ± 0.004a 0.023 ± 0.002b 0.017 ± 0.002b 0.001
HOMA-IR 1.333 ± 0.245a 0.929 ± 0.144a 5.323 ± 0.778b 4.113 ± 0.437b 0.001
FBS (mg/dL) 90.83 ± 2.86 a
85.00 ± 6.70a
405.33 ± 17.25 b
341.00 ± 27.22 c
0.001

: The differences between values with different superscripted letters in the same line are statistically significant (P < 0.005). FBS:
a, b, c

Fasting blood sugar. HOMA-β: Homeostasis Model Assessment, Beta Cell Function. HOMA-IR: Homeostasis Model Assessment,
Insulin Resistance.

compared to the diabetic group. The FBS levels decreased was found that glycemic states were suppressed in ASA
directly proportional to the insulin resistance coefficients diabetics by making significant differences in FBS with
(Table 3). ASA administration between the diabetic group and ASA
3.5. Insulin tolerance test results diabetic group.
Very low or no decreases in FBS levels show that insulin It was shown that AVP was synthesized 70% more in
resistance was established and that the diabetes model diabetic rats compared to nondiabetic rats (22). Similarly,
was type II (16,17). In many studies that applied the ITT, it was reported that AVP levels were higher in diabetics
it was reported that the glucose-lowering effect of insulin than in nondiabetics (23). In this manner, AVP results
lasted until the 30th minute; however, the plasma glucose obtained in this study were found to be parallel to the data
level started to increase after the 30th minute due to reported in the literature.
gluconeogenesis and hepatic glycogenolysis. The reason for higher AVP synthesis in diabetics
In this manner, the peak in the antihyperglycemic compared to nondiabetics is still unknown. However,
activity of insulin is considered to occur at the 30th minute it was suggested that this increase is associated with the
and 30-min data were used for ITT (18). In this manner, regulation of the osmotic balance (24). Examining the
30-min data obtained during ITT studies were used for the control and ASA control groups and the diabetic and
statistical analyses. ASA diabetic groups in this study, it was found that ASA
According to the 30-min data, insulin sensitivity in the
application contributed to the increase of AVP levels and
HFD group (diabetic group) was found to be higher than
this increase was statistically significant between ASA
that in the control group, meaning that insulin resistance
diabetic and diabetic groups.
had developed.
It was shown that potent inhibition of AVP activity
4. Discussion occurred due to the increase in PGE2 production, and this
The main objective of diabetes treatment is to reach also caused nephrogenic diabetes insipidus (NDI) (25).
normal blood glucose levels, eliminate the symptoms, and It was also found that as a result of the PGE2 synthesis
prevent or delay the complications. In this study, the effect inhibition caused by using NSAIDs such as indomethacin,
of ASA on osmoregulation and glycemic control in terms polyuria caused by NDI was decreased (26). In light of
of diabetes has been discussed, considering the relations these two mutually supportive studies, it is understood
between ASA, obesity, insulin resistance, diabetes, that PGE2 is an inhibitor of AVP. In the literature, it was
cardiovascular disease, and AVP secretion. also clearly reported that PG synthesis was inhibited by
In the literature, it was reported that salicylates ASA by inhibiting the COX pathway (27). In light of this
decreased the FBS by 13% (P < 0.002) and HbA1c by 17% information, it can be concluded that ASA has a positive
(20). In another study, it was reported that salicylates effect on AVP secretion by inhibiting the AVP inhibitor
decreased the HbA1c levels and therefore might be a PGE2.
new way of treatment for glycemic control in type II With this study, a new approach is presented for
diabetics; however, it was emphasized that further studies the subject. In diabetic groups, it was found that AVP
are required for renal and cardiac safety (21). Parallel to decreased significantly with ASA administration and this
the literature results mentioned above, in this study, it indicates that blood glucose levels were relatively increased

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ŞEN and ÇELİK / Turk J Med Sci

as a result of high AVP concentrations of hypoglycemic Acknowledgement


activity caused by ASA. Additionally, the low results The authors acknowledge with gratitude the cooperation
of other biochemical parameters including chloride, of the people who collected and managed the database of
albumin, total protein, and creatine, similar to the blood their institution. This study was supported by the Afyon
glucose results found in the ASA-administered diabetic Kocatepe University Scientific Research Projects Unit
group, indicate that high AVP levels were dilutional. (Project No: 10.Tip.18).

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