Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus

Atila Altuntaş; Bünyamin Aydın; Sıddıka Ersoy; Özcan Erel; Hasret Demirel; Şeniz Tutum

doi:10.17343/sdutfd.1767002

TR EN

Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus

Abstract

Objective Diabetic nephropathy (DN) remains one of the most serious complications of type 2 diabetes mellitus (T2DM). Traditionally, disease progression has been evaluated through albuminuria, yet increasing evidence highlights the role of oxidative stress and redox imbalance in DN pathogenesis. The present study was designed to evaluate dynamic thiol/disulfide homeostasis across albuminuria stages and to explore its potential role as a complementary systemic oxidative stress marker alongside albuminuria in T2DM. Material and Method A total of 122 individuals were included and categorized into four study groups: 30 healthy participants (Group 1), 31 normoalbuminuric diabetic patients (Group 2), 31 patients with microalbuminuria (Group 3), and 30 patients with macroalbuminuria (Group 4). Plasma thiol/disulfide parameters were measured using the automated method developed by Erel and Neselioglu, while urinary albumin concentrations were determined by immunoturbidimetric assay. Results Progressive decreases in both native and total thiol levels were observed with advancing severity of albuminuria (p<0.001). Disulfide concentrations showed a downward trend in macroalbuminuric patients (p=0.019), although disulfide-related ratios remained largely unchanged across the groups. Correlation analyses identified significant negative associations between thiol concentrations and diabetes duration, HbA1c, as well as CRP levels (p<0.001). Conclusion Dynamic thiol/disulfide balance reflects systemic oxidative stress but cannot fully substitute for albuminuria as a marker of DN. Instead, it appears to provide complementary insight into oxidative mechanisms associated with DN severity in T2DM patients.

Keywords

Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus

Abstract

Objective Diabetic nephropathy (DN) remains one of the most serious complications of type 2 diabetes mellitus (T2DM). Traditionally, disease progression has been evaluated through albuminuria, yet increasing evidence highlights the role of oxidative stress and redox imbalance in DN pathogenesis. The present study was designed to evaluate dynamic thiol/disulfide homeostasis across albuminuria stages and to explore its potential role as a complementary systemic oxidative stress marker alongside albuminuria in T2DM. Material and Method A total of 122 individuals were included and categorized into four study groups: 30 healthy participants (Group 1), 31 normoalbuminuric diabetic patients (Group 2), 31 patients with microalbuminuria (Group 3), and 30 patients with macroalbuminuria (Group 4). Plasma thiol/disulfide parameters were measured using the automated method developed by Erel and Neselioglu, while urinary albumin concentrations were determined by immunoturbidimetric assay. Results Progressive decreases in both native and total thiol levels were observed with advancing severity of albuminuria (p<0.001). Disulfide concentrations showed a downward trend in macroalbuminuric patients (p=0.019), although disulfide-related ratios remained largely unchanged across the groups. Correlation analyses identified significant negative associations between thiol concentrations and diabetes duration, HbA1c, as well as CRP levels (p<0.001). Conclusion Dynamic thiol/disulfide balance reflects systemic oxidative stress but cannot fully substitute for albuminuria as a marker of DN. Instead, it appears to provide complementary insight into oxidative mechanisms associated with DN severity in T2DM patients.

Keywords

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.

Ethical Statement

This study was approved by the Suleyman Demirel University Clinical Research Ethics Committee (Date: 15.04.2020, No: 72867572.050.01.04). The study was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent to participate and publish was obtained from all individual participants or legal guardians included in the study.

References

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Details

Primary Language

English

Subjects

Nefroloji

Journal Section

Research Article

Authors

Atila Altuntaş
0000-0001-9196-3133
Türkiye

Bünyamin Aydın
0000-0003-2059-1074
Türkiye

Sıddıka Ersoy
0000-0001-8094-8042
Türkiye

Özcan Erel
0000-0002-2996-3236
Türkiye

Hasret Demirel ^*
0000-0002-5548-3797
Türkiye

Şeniz Tutum
0009-0000-5989-7340
Türkiye

Publication Date

March 21, 2026

Submission Date

August 16, 2025

Acceptance Date

February 13, 2026

Published in Issue

Year 2026 Volume: 33 Number: 1

DOI

https://doi.org/10.17343/sdutfd.1767002

IZ

https://izlik.org/JA26SP76ZF

Cite

RIS / Bibtex

APA

Altuntaş, A., Aydın, B., Ersoy, S., Erel, Ö., Demirel, H., & Tutum, Ş. (2026). Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus. Medical Journal of Süleyman Demirel University, 33(1), 71-77. https://doi.org/10.17343/sdutfd.1767002

AMA

1.Altuntaş A, Aydın B, Ersoy S, Erel Ö, Demirel H, Tutum Ş. Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus. Med J SDU. 2026;33(1):71-77. doi:10.17343/sdutfd.1767002

Chicago

Altuntaş, Atila, Bünyamin Aydın, Sıddıka Ersoy, Özcan Erel, Hasret Demirel, and Şeniz Tutum. 2026. “Dynamic Thiol Disulfide Homeostasis As a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus”. Medical Journal of Süleyman Demirel University 33 (1): 71-77. https://doi.org/10.17343/sdutfd.1767002.

EndNote

Altuntaş A, Aydın B, Ersoy S, Erel Ö, Demirel H, Tutum Ş (March 1, 2026) Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus. Medical Journal of Süleyman Demirel University 33 1 71–77.

IEEE

[1]A. Altuntaş, B. Aydın, S. Ersoy, Ö. Erel, H. Demirel, and Ş. Tutum, “Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus”, Med J SDU, vol. 33, no. 1, pp. 71–77, Mar. 2026, doi: 10.17343/sdutfd.1767002.

ISNAD

Altuntaş, Atila - Aydın, Bünyamin - Ersoy, Sıddıka - Erel, Özcan - Demirel, Hasret - Tutum, Şeniz. “Dynamic Thiol Disulfide Homeostasis As a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus”. Medical Journal of Süleyman Demirel University 33/1 (March 1, 2026): 71-77. https://doi.org/10.17343/sdutfd.1767002.

JAMA

1.Altuntaş A, Aydın B, Ersoy S, Erel Ö, Demirel H, Tutum Ş. Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus. Med J SDU. 2026;33:71–77.

MLA

Altuntaş, Atila, et al. “Dynamic Thiol Disulfide Homeostasis As a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus”. Medical Journal of Süleyman Demirel University, vol. 33, no. 1, Mar. 2026, pp. 71-77, doi:10.17343/sdutfd.1767002.

Vancouver

1.Atila Altuntaş, Bünyamin Aydın, Sıddıka Ersoy, Özcan Erel, Hasret Demirel, Şeniz Tutum. Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus. Med J SDU. 2026 Mar. 1;33(1):71-7. doi:10.17343/sdutfd.1767002