Oxidative stress markers in type 2 diabetes patients with diabetic nephropathy

Clin Exp Nephrol. 2017 Apr;21(2):283-292. doi: 10.1007/s10157-016-1283-7. Epub 2016 May 27.

Abstract

Background: Epidemiological studies show that 5-40 % of type 2 diabetes (T2DM) patients have diabetic nephropathy, and oxidative stress is one of several underlying mechanisms. We investigated associations between oxidative stress markers and severity of diabetic nephropathy.

Methods: Fifty-nine T2DM patients from the endocrinology outpatient department were included, and their levels of oxidative stress markers were measured. Three groups were determined by their urine albumin-to-creatinine ratio (UACR): group A (UACR < 30 mg/g, n = 22); group B (30 ≤ UACR < 300 mg/g, n = 22); and group C (UACR ≥ 300 mg/g, n = 15).

Results: Vitamin C levels correlated negatively and moderately with serum creatinine (γ = -0.459, p < 0.001), urine albumin (γ s = -0.458, p = 0.001) and UACR (γ s = -0.408, p = 0.001), but only weakly with hydroxy-2-deoxyguanosine (8-OHdG) and estimated glomerular filtration rate (eGFR). Vitamin C levels decreased as 8-OHdG, serum creatinine, albumin and UACR increased. T2DM patients with more severe diabetic nephropathy had lower vitamin C levels.

Conclusion: Our results identified several oxidative stress markers that may be clinically important in diabetic nephropathy. Studies with larger sample sizes should be undertaken to confirm these findings.

Keywords: Antioxidant; Diabetes mellitus; Diabetic nephropathy; Oxidative stress; Vitamin C.

MeSH terms

  • 8-Hydroxy-2'-Deoxyguanosine
  • Aged
  • Albuminuria / blood
  • Albuminuria / etiology
  • Albuminuria / urine
  • Antioxidants / analysis
  • Ascorbic Acid / blood
  • Biomarkers / blood
  • Biomarkers / urine
  • Creatinine / blood
  • Creatinine / urine
  • Deoxyguanosine / analogs & derivatives
  • Deoxyguanosine / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / urine
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / diagnosis
  • Diabetic Nephropathies / etiology*
  • Diabetic Nephropathies / urine
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Oxidative Stress*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Severity of Illness Index

Substances

  • Antioxidants
  • Biomarkers
  • 8-Hydroxy-2'-Deoxyguanosine
  • Creatinine
  • Deoxyguanosine
  • Ascorbic Acid