Oxidant/antioxidant status of Sudanese Type II diabetic patients with multiple complications

Abstract

Background: Diabetes-associated oxidative stress is induced by both increase in production of plasma-free radical concentrations and a significant reduction in antioxidant defence mechanisms, and it is associated with the pathophysiology of diabetes mellitus and its complications. Objectives: To evaluate the oxidant and antioxidant status in Type II diabetic patients with complications and diabetic patients without complications (DWC) compared to normal subjects and their association with diabetic complications. Materials and Methods: Plasma levels of malondialdehyde (MDA), antioxidant Vitamin C and antioxidant enzyme, superoxide dismutase (Cu-Zn SOD) activity were estimated in patients with diabetic nephropathy (DN), patients with diabetic neuropathy (DNe), diabetic patients with coronary artery disease (CAD), DWC, and controls matched for age, sex, body mass index and study region. Spectrophotometry and enzyme-linked immunosorbent assay techniques have been applied for the determination of MDA, Vitamin C and superoxide dismutase (SOD). Results: Comparing the level of Vitamin C and activity of SOD in all groups, it was observed that the lowest concentrations were found in CAD, DN and DNe groups, higher in DWC, and the highest in the control group. On the contrary, MDA levels (as an indicator of oxidative stress) were found to be increased in CAD, DN and DNe groups as compared to DWC and control groups. SOD and Vitamin C were found inversely correlated with glycosylated haemoglobin and MDA levels in all diabetic groups regardless of their complications. Multivariate model showed that all the variables independently associated with the diabetic complications. Conclusions: There is an imbalance between the oxidants and antioxidants in diabetic patients with complications and patients of DWC as compared to healthy groups.