title: Inflammation, coagulation, endothelial dysfunction and oxidative stress in prediabetes--Biomarkers as a possible tool for early disease detection for rural screening.
abstract: OBJECTIVE
  This study aims to increase understanding of the connection between oxidative stress and inflammation in diabetes disease progression to provide a basis for investigating improved diagnostic possibilities, treatment and prevention of prediabetes.
  
  
  METHODS
  Differences in the level of biochemical markers of oxidative stress (erythrocyte GSH/GSSG and urinary 8-isoprostane), inflammation (CRP, IL-6), endothelial dysfunction (plasma homocysteine, urinary 8-hydroxy-2-deoxy-guanosine) and coagulation/fibrinolysis (C5a, D-Dimer) were determined in prediabetes and control subjects.
  
  
  RESULTS
  While no difference was found in the 8-isoprostane levels between the two groups, the erythrocyte GSH/GSSG ratio was significantly reduced in the prediabetes group compared to control, indicating increased oxidative stress in the prediabetic state. Both urinary 8-OHdG and surprisingly also plasma homocysteine were significantly elevated in the prediabetes group, indicating endothelial dysfunction. The inflammation markers were slightly elevated in the prediabetic subjects and the same trend was found for the coagulation/fibrinolysis markers C5a and D-Dimer. These results were however not significant.
  
  
  CONCLUSIONS
  The small elevation of blood glucose levels in the prediabetic state may have a detectable influence on endothelial function as indicated by changes to 8-OHdG, indicating an increased DNA-damage and homocysteine release from endothelial cells. Increased oxidative stress as indicated by the reduced GSH/GSSG ratio is likely to be the link between the moderate hyperglycaemia in prediabetes and pathological changes in endothelial function, which in the long-term may promote atherogenesis and result in the development of cardiovascular disease. Early detection of prediabetes is essential to avoid diabetes development and the associated complications like cardiovascular disease. The GSH/GSSG ratio and biomarkers like urinary 8-OHdG and plasma homocysteine offer a possible tool for the assessment of prediabetes in prevention screenings.
authors.affiliation: Nutrition Science, University of Potsdam, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Maschirow
authors.affiliation: Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates.
authors.forename: K
authors.initials: K
authors.lastname: Khalaf
authors.affiliation: School of Medicine, University of Tasmania, Hobart, Australia.
authors.forename: H A
authors.initials: HA
authors.lastname: Al-Aubaidy
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, Australia; School of Community Health and Centre for Research in Complex Systems, Charles Sturt University, Albury, Australia. Electronic address: hjelinek@csu.edu.au.
authors.forename: H F
authors.initials: HF
authors.lastname: Jelinek
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001774:Blood Chemical Analysis; D001777:Blood Coagulation; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011236:Prediabetic State / Q000175:diagnosis*; D012423:Rural Health
chemical_list: D015415:Biomarkers
keywords: Coagulation; Endothelial dysfunction; Inflammation; Oxidative stress; Prediabetes