The Effect of Type Two Diabetes Mellitus on Superoxide Dismutase (SOD) Activity and its Correlation with HbA1c in Iraqi Patients
Abstract
Diabetes mellitus (DM) is a group of metabolic disorders, characterized by hyperglycemia resulting from defects in insulin action, insulin secretion or both. Increasing evidence suggests that the oxidative stress plays a role in the pathogenesis of diabetes mellitus and its complications. The current study includes (130) T2DM patients (group P) [51 males and 79 females with an ages range (35 to 55) and ages mean 49.89 years], they are sub-grouped into three categories according to their HbA1c value. Patients with HbA1c less than 7 are considered as good controlled diabetic patients (30 patients) (group P1), while patients with HbA1c between 7 and 8 were considered as medium controlled diabetic patients (40 patients) (group P2), and the patients whom their HbA1c more than 8 are considered as poorly controlled diabetic patients (60 patients) (group P3). The results of patients group were compared with control healthy subjects (35 subjects) (group C) [14 males and 21 Females were with an age range from 35 to 55 years and ages mean 45.51 years]. Patients and controls were characterized in terms of glycated hemoglobin (HbA1c), serum levels of Cu (μg/L), Zn (μg/L), malondialdehyde (MDA) (mmol/L) and superoxide dismutase activity (SOD) activity (U/ml). The HbA1c has been found to be significantly higher in diabetic patients group (P) in comparison to group C. Serum Zn level has been found to be significantly lesser in group P in comparison to group C. Serum Cu level showed an increase in group P, although it is not significance in comparison to group C. Serum SOD activity shown a significant decrease in group P in comparison to group C. Serum MDA level showed a significantly higher value in diabetic patients group P in comparison to group C. The serum Zn was decreased as HbA1c increased i.e. serum Zn level in group C was higher than patients groups, and its value in group P1 higher than group P2 and that was higher than group P3, while serum Cu level was increased as HbA1c increase, i.e. serum Cu level in group P3 higher than group P2 and that higher than group P1, while group C gave the maximum value. The serum SOD activity was decreased as HbA1c increased, i.e. SOD activity was found to be significantly higher in group P1 in comparison with group P2 and P3, while serum MDA level in group P3 was significantly higher than group P2, and P1.
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Introduction
Diabetes mellitus (DM) is a general term for a group of heterogeneous disturbances of metabolism for which the main result is chronic hyperglycaemia (high blood glucose level); it is usually due to either impaired insulin secretion or impaired insulin action or both [1].
DM can be classified into four categories:
Type 1 DM: It is characterized by β-cell destruction which leads to absolute insulin deficiency; it is usually mediated by immune mechanisms [2].
Type 2 DM: It is usually associated with other health problems such as obesity; it can range from predominant insulin resistance with relative insulin deficiency to prevailing defective secretion with insulin resistance [1& 2].
Gestational DM: It is glucose tolerance impairments that first appear or are first diagnosed during pregnancy [2].
Other specific types of DM: Diseases of the exocrine pancreas (e. g. cystic fibrosis), disease of Endocrinopathies (e. g. Cushing syndrome), drug induced (e. g. glucocorticoids) and genetic defects of the β-cell function (e. g Maturity Onset Diabetes of the Young (MODY)) [1&2].
Conclusion
Type 2 DM patients have a risk of oxidative stress due to increasing the level of serum MDA and decreasing superoxide dismutase activity. And the HbA1c value between 7 to 8 % cannot be considered as an acceptable HbA1c value, due the severing of oxidative stress rising manifested clearly in this patients group.