MALONDIALDEHYDE IN TYPE 2 DIABETICS AND ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a progressive chronicdisease with high prevalence all over the world. It is expected to have 693million people affected by diabetes by 2045. Many body systems areaffected due to complications of DM with major effect on thecardiovascular system. Dyslipidemia is one of the major risk factors forcardiovascular disease in diabetes mellitus. Malondialdehyde (MDA) is ahighly toxic end product formed by lipid oxidation that mediates its toxiceffects due to its high reactivity particularly towards proteins and DNA.Malondialdehyde interacts both irreversibly and reversibly with proteinsand phospholipids causing profound effects, especially in the collagen ofthe cardiovascular system. Normally, MDA level remains within normalvalues due to antioxidant effects, but in DM these protective effects aredisrupted.Objective: Measure serum Malondialdehyde level as a marker of lipidperoxidation in type 2 diabetic patients and its association with othercardiovascular risk factors.Patients and methods: The study included 40 diabetic patients recruitedfrom Outpatient Diabetes Clinic at Alexandria Main University Hospitalin addition to healthy 40 healthy subjects as a control group. Basic data,clinical examination and laboratory analysis were obtained from all thesubjects within the two groups. Serum Malondialdehyde (MDA) wasmeasured in the participants within the two groups by using ELISA kit.Results: The mean serum MDA level was statistically significant higherin the diabetic cases as compared to the controls (Median MDA was30.72nmol /ml in cases and 25.16 nmol /ml in the control). There is asignificant increase in serum MDA level with increasing the risk of CVdisease in the whole study subjects and in the diabetic cases. In the casesgroup MDA shows positive correlation with all the study parametersexcept high density lipoproteins (HDL) where it revealed negativecorrelation. BY ROC curve analysis, a cutoff point more than > 26.57 had62.5% sensitivity, 70% specificity, 66.4 % positive predictive value (PPV)and 72.5% negative predictive value (NPV).Conclusion: Malondialdehyde is a non-invasive biomarker that could beutilized in differentiation of T2DM cases form healthy controls in additionfor identifying the high-risk diabetic patients for cardiovascular disease(CVD). However, further large-scale studies are recommended toaccurately determine its sensitivity and specificity.