Oxidative stress and other risk factors associated with diabetic nephropathy in type 2 diabetes mellitus
Introduction. The aim of the study was to examine whether biomarkersof oxidative stress and antioxidant enzyme activities are among other riskfactors for diabetic nephropathy (DN).Methods. The study involved 70 patients with type 2 diabetes (37 males,aged 41 to 81 years) allocated to two groups: one of 32 patients with DNand the other of 38 patients without DN. In the study of oxidative stress 15healthy persons were included. All examined patients were interviewed andunderwent objective examination. Their serum and urine samples were analyzedin order to estimate the quality of glycoregulation and kidney function.Protein thiol groups (P-SH), antioxidant enzyme activities [superoxidedismutase (SOD) and glutathione peroxidase (GPX)] were determined inplasma spectrophotometrically and malondialdehyde-adducts (MDA) byenzyme immunoassay.Results. No significant differences were found between the two groupsfor demographic characteristics, duration and treatment of diabetes, bloodpressure, fasting glucose level and HbA1c. Patients with DN had a higherbody mass index, lower estimated glomerular filtration rate (eGFR) andhigher albuminuria and proteinuria. Plasma activity of GPX and SOD as wellas levels of MDA adducts and P-SH groups were similar in patients with andwithout DN, but GPX and SOD plasma activities were significantly lower andplasma level of MDA significantly higher in all patients than in healthy controls.Patient gender, age, BMI, HbA1c and plasma level of P-SH and MDAwere selected as significant predictors of DN. Patient age, duration of diabetes,serum phosphorus, uric acid levels and plasma SOD activity were negativelyassociated with eGFR. Patient age, serum levels of protein and albuminand plasma GPX activity were negatively, while systolic BP, serum levelsof uric acid and cholesterol were positively associated with proteinuria.Conclusion. Biomarkers of oxidative protein and lipid damage were selectedas risk factors for DN, besides several other well known risk factors.