Antioxidant status of Type 2 diabetic patients with and without nephropathy attending Federal Medical Center Keffi, Nasarawa State

Abstract

Background: Oxidative stress originating from hyperglycaemia is involved in the pathogenesis of diabetic nephropathy. Antioxidants  play important role in ameliorating the effect of oxidative damage caused by free radical.

Aim: The aim of the present study was to evaluate antioxidant levels in type 2 diabetic patients with nephropathy in the region and to  compare it with those of type 2 diabetics without nephropathy and healthy non-diabetic controls.

Methodology: One hundred and  twenty-two (122) participants consisting of (60) diabetic test subjects and (62) apparently healthy control subjects were recruited with  their consent. The diabetic subjects were further categorized into two groups (32) with type 2 diabetics with nephropathy (DWN), and (28)  type 2 diabetics without nephropathy (DWON)) and were compared with (28) apparently healthy non-diabetic controls. Fasting  blood glucose (FBG) and glycated haemoglobin (HbA1c), serum creatinine (SCr) and random urine proteins (UPr) were assayed by  routine laboratory methods. Serum antioxidant levels (superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT), vitamin  E (VE) and vitamin A (VA)), were measured using standard commercial reagent kits. Statistical package for the social sciences  (SPSS version 23) was used for data analysis.

Results: The results were expressed as mean ± SD and Pearson correlation was analysed to ascertain the relationship among variables. There was significant increase seen in FBG, HbA1c, SCr, eGFR and SOD and decrease in GPX,  CAT and Vitamin E in type 2 diabetic patients with and without nephropathy as compared with control population, whereas vitamin A level  was unaltered amongst the groups. Negative correlation was seen between eGFR and SOD enzyme activity in diabetic group, while  CAT and vitamin E showed strong positive correlation to eGFR in the diabetic groups. Duration of disease was found to be more in the  diabetic with nephropathy than in diabetic without nephropathy. Mean age did not show any significant difference among the groups  (p=0.0732).

Conclusion: The present study observed that the change in level of antioxidants of diabetic subjects is more severe than in  apparently healthy subjects and higher in DWN than DWON. Present study may suggest the benefits of antioxidants in combating the  free radicals of oxidative stress which is a major contributor in the pathophysiology of diabetic nephropathy.