Plasma lipid peroxidation and antioxidiant nutrients in type 2 diabetic patients.
OBJECTIVE
Observation shows diabetic patients to be more prone to oxidative stress because of hyperglycemia. The elevation of free radical production by this hyperglycemic production may exacerbate cardiovascular complication in diabetes. This study aims to investigate the oxidative stress related parameters in type 2 DM. Since the effects of glycemic control and cardiovascular complications in DM on these parameters has been not fully determined, the comparison between plasma MDA (malondialdehyde) and antioxidant nutrients with their age-matched normal healthy group may be used to determine the susceptibility of oxidative stress in this type of DM.


METHODS
MDA and antioxidant nutrients (vitamin A, C, E and beta-carotene) were analyzed in plasma of 19 subjects with poorly controlled type 2 DM (fasting plasma glucose [FPG] > 180 mg/dl), 26 subjects with fairly controlled type 2 DM (FPG < or = 180 mg/dl), and 20 subjects with type 2 DM complicated coronary heart disease (CHD) who were matched for age and gender. Twenty healthy subjects with normal plasma glucose level (FPG < 110 mg/dl) and matched for age and gender served as a control group. In all groups of DM these oxidative stress parameters were compared to a normal group.


RESULTS
The plasma MDA levels were significantly higher in all types of DM compared to age-matched normal control. Plasma antioxidant vitamin C and E significantly lower only in poorly controlled and CHD complicated type 2 DM, respectively. The mean of plasma vitamin E level was lowest in type 2 DM complicated with CHD. No significant differences in both plasma vitamin A and beta-carotene were noted between any types of DM and age-matched normal healthy group. The positive correlation between MDA and FPG was demonstrated in most group of patients with their normal subjects except in fairly controlled type 2 DM and negative correlation between vitamin E and FPG was also demonstrated in type 2 DM with CHD.


CONCLUSIONS
These findings suggested that diabetic patients were susceptible to oxidative stress and higher plasma glucose level had an association with free radical-mediated lipid peroxidation. The lowest level of vitamin E in type 2 DM complicated with CHD indicated that oxidative stress played an important role in cardiovascular complication and vitamin E supplementation may be necessary for treatment and prevention in this group of diabetics.
Peerapatdit
Thavatchai
T
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Patchanans
Natchai
N
Likidlilid
Atip
A
Poldee
Saiphon
S
Sriratanasathavorn
Charn
C
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000032:analysis*; D001161:Arteriosclerosis / Q000209:etiology; D001205:Ascorbic Acid / Q000097:blood; D001786:Blood Glucose; D016022:Case-Control Studies; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D015227:Lipid Peroxidation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018384:Oxidative Stress; D012307:Risk Factors; D014810:Vitamin E / Q000097:blood
D000975:Antioxidants; D001786:Blood Glucose; D014810:Vitamin E; D001205:Ascorbic Acid