Study the role of oxidative stress in type2 Diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder in which the long-term hyperglycemia initiates oxidative stress, inflammation, and lipid abnormalities  that  further  promote  vascular  injury  and  diabetic  complications. Oxidative stress is increasingly recognized as a mechanistic pathway for aberrant metabolism to endothelial dysfunction and organ damage caused by increased lipid peroxidation and rundown in antioxidant defense mechanisms.Aim: To study the role of  oxidative  stress  in  patients  with  T2DM  by  comparing  lipid  peroxidation (malondialdehyde; MDA), antioxidant enzymes (glutathione peroxidase; GPx and superoxide dismutase; SOD), and related metabolic indices between diabetic patients and  healthy  controls,  and  to  evaluate  the  predictive  performance  of  oxidative biomarkers for diabetic complications.
Methods: A hospital-based case–control study was conducted in Tikrit city, Iraq, starting on 30 September 2025.  The applications of this research have been more broadly associated with 65 patients who had experienced T2DM at Tikrit Teaching Hospital, as documented in healthy volunteers referred to sex and age. Firstly, venous blood samples were drawn and sent to HbA1c for testing and analysis, while using the i-chroma II and immunofluorescence. Serum MDA, GPx, and SOD were assessed with the help of ELISA kits, and lipid profile parameters were analyzed through enzymatic colorimetric procedures. Initially, all statistical analyses were performed using SPSS v. 23.1. Independent sample t-tests were applied for comparisons between groups. The use of ROC curve analysis was determined, as per the criterion, the specific diagnostic abilities of MDA and HbA1c to anticipate diabetic complications.
Results: Baseline age and sex distribution were comparable between groups, whereas BMI and hypertension frequency were significantly higher in the diabetic group. HbA1c was markedly elevated in patients with T2DM (8.6 ± 1.4%) compared with controls (5.3 ± 0.5%; p < 0.001). Oxidative stress was significantly increased in T2DM, with higher MDA (182.4 ± 44.8 vs. 94.6 ± 23.2 nmol/mL; p < 0.001) and lower antioxidant enzymes GPx (25.8 ± 6.8 vs. 40.1 ± 7.3 U/L; p < 0.001) and SOD (14.9 ± 3.5 vs. 23.0 ± 4.7 U/mL; p < 0.001). Diabetic patients also demonstrated a more atherogenic lipid profile (higher total cholesterol, triglycerides, LDL, and VLDL with lower HDL; all p  ≤ 0.002). ROC analysis indicated that MDA had better predictive performance for diabetic complications than HbA1c (AUC 0.85 vs. 0.81), with an optimal cutoff of 155 nmol/mL (sensitivity 82%, specificity 80%).
Conclusion: An oxidative imbalance helped the study find oxidative stress. The imbalance showed higher lipid peroxidation and lower activities being present in diabetes care affected by Pokemon. Oxidative stress markers, that is MDA data, performed much better than HbA1c. Thus, oxidative stress markers could offer additional information on the risk categories of diabetic complications as compared to glycemic indices alone.