Marker of lipid peroxidation related to diabetic nephropathy in Indonesian type 2 diabetes mellitus patients.
OBJECTIVE
Even though diabetes patients exhibit an increased oxidative stress, its correlation with diabetic nephropathy is not fully understood. The purpose of this study was to determine whether lipid peroxidation marker correlates well with eGFR and UACR in type 2 diabetes mellitus patients.


METHODS
We collected urine and serum samples of Indonesian type 2 diabetes mellitus outpatients with normo- and microalbuminuria at a Local Government Clinic (from ages: 39-74 years). Urinary 8-iso-PGF2α was measured by ELISA, the serum malondialdehyde by TBARS assay, and urinary albumin by BCG albumin assay. eGFR was calculated using the corrected-Cockcroft-Gault (CG), MDRD, and CKD-EPI equation. Other necessary data were obtained through questionnaires.


RESULTS
The results showed that the increasing level of malondialdehyde was mildly correlated with the decline in eGFR (MDRD). In contrary, there was a significant positive correlation between 8-iso-PGF2α concentration and eGFR based on the corrected-CG, MDRD study, and CKD-EPI equation (r=0.457, p<0.001; r=0.424, p<0.001; r=0.443, p<0.001). This relationship still persisted in the normoalbuminuric subjects (n=43) (r=0.491, p=0.001; r=0.461, p=0.002; r=0.455, p=0.002). The multivariate analysis showed that 8-iso-PGF2α together with fasting plasma glucose was the most predictive factor for the high 2-quantile eGFR (adjusted OR 1.001, (95% CI, 1.000-1.001)). However, there was no significant correlation between UACR with malondialdehyde (r=0.268, p=0.050) and 8-iso-PGF2α(r=-0.030, p=0.808). UACR itself was inversely correlated with eGFR based on the corrected-CG, the MDRD, and CKD-EPI (r=-0.232, p<0.05; r=-0.228, p<0.05; r=-0.232, p<0.05).


CONCLUSIONS
Increased 8-iso-PGF2α and malondialdehyde in type 2 diabetes mellitus patients may play a role in the pathophysiologic significance of diabetic nephropathy, even while considering the effect of potential confounders.
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia. Electronic address: rani@farmasi.ui.ac.id.
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Sauriasari
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
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Andrajati
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
Azizahwati
Division of Renal and Hypertension, Ciptomangunkusumo Hospital, Indonesia.
Dharmeizar
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
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Saputri
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
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Muris
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
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Manfaatun
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
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Amanda
Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.
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Setiawan
Department of Gerontology Research, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.
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Sakano
Department of Environmental Biochemistry, Okayama University of Science, Japan.
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Wang
Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.
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Ogino
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism*; D008875:Middle Aged; D015995:Prevalence; D013053:Spectrophotometry
D015415:Biomarkers; C075750:8-epi-prostaglandin F2alpha; D008315:Malondialdehyde; D003404:Creatinine; D015237:Dinoprost
8-iso-PGF(2α); Diabetes Mellitus; Estimated Glomerular Filtration Rate; Urine Albumin to Creatinine Ratio