The Relationship of Oxidative and Metabolic Parameters With Hemoglobin A1c in Type 2 Diabetes Mellitus

Abstract

Objectives: It has been shown that patients with Diabetes Mellitus (DM) have increased oxidative stress and impaired antioxidant defense system which appears to be a contributory factor for initiation and progression of complications in diabetes. In this study, we aimed to demonstrate the relationship of oxidative and metabolic parameters with Hemoglobin A1c in type 2 diabetes mellitus. Materials and Methods: One hundred and fourteen male and female patients with new onset type 2 diabetes mellitus (DM) without complications were recruited for this study. Besides their systolic and diastolic blood pressures, Body Mass Index (BMI) and age, serum levels of fasting blood sugar, Hemoglobin A1c (HbA1c), LDL, HDL, triglyceride (TG), H2O2, antioxidant capacity (AOC), glutathione (GSH) and malondialdehyde (MDA) were determined in these patients. The median HbA1c value of the subjects was determined and the oxidative and metabolic parameters of the ones who were below the median value were compared with the oxidative and metabolic parameters of the ones who were above the median value. Parametric values were statistically analyzed by student-t test. Results: There wasn’t any statistically significant difference in terms of age and sex between the groups. The subjects who had HbA1c levels below the median value (7,58) showed lower systolic and diastolic blood pressure compared to ones who had HbA1c levels above the median value. This result was statistically significant (p<0.05). The subjects who had HbA1c levels below the median value (7,58) also showed lower serum triglyceride levels compared to ones who had HbA1c levels above the median value. This result was also statistically significant (p<0.05). The subjects who had HbA1c levels below the median value (7,58) had lower LDL, H2O2 and MDA levels, and higher HDL and GSH levels but these results were not found to be statistically significant. Conclusion: In type 2 DM patients, as HbA1 level increases, oxidative stress increases, metabolic parameters increase and GSH decreases. Therefore, improvement in lifestyle to reduce HbA1c is very important in diabetic patients

Keywords

• Oxidative Stress,Hemoglobin A1c,Diabetes Mellitus

Tip 2 Diabetes Mellitus’lu Hastalarda Oksidatif ve Metabolik Parametrelerin HemoglobinA1c ile İlişkisi

Öz

Amaç: Bugüne kadar yapılan çalışmalar, tip 2 diabetes mellitus (DM)’lu hastalarda artmış oksidatif stres ve bozulmuş antioksidan savunma sisteminin diyabete bağlı komplikasyonların başlaması ve ilerlemesinde rol oynadığını ortaya koymuşlardır. Çalışmamızda tip 2 diabetes mellitus’lu hastalarda oksidatif stres belirteçleri, antioksidan ve metabolik parametrelerin Hemoglobin A1c (HbA1c) değerleri ile ilişkisini ortaya koymaya çalıştık. Materyal ve Metot: Yeni tanı almış komplikasyonsuz Diabetes Mellitus Tip 2 olan 114 hastanın; sistolik ve diyastolik kan basıncı, beden kütle indeksi (BKİ), yaş özelliklerinin yanı sıra açlık kan şekeri, HbA1c, LDL, HDL, trigliserid (TG), hidrojen Peroksit (H2O2), antioksidan kapasite (AOK), glutatyon (GSH) ve malondialdehid (MDA) seviyelerine bakıldı. Bu hastaların ortanca HbA1c değeri hesaplanıp ortalamanın altında ve üstünde kalan hastalarda oksidatif ve metabolik parametreler karşılaştırıldı. Parametrik değerlerin istatistiksel analizinde student-t testi kullanıldı. Bulgular: Deneklerimizin yaş ve cinsiyet dağılımı tamamen eşit idi. Hemoglobin A1c ortanca değeri (7,58) altında kalan deneklerimizin sistolik kan basıncı Hemoglobin A1c değerleri daha yüksek olanlara kıyasla anlamlı olarak daha düşük bulundu (p<0,05). Yine Hemoglobin A1c ortanca değerin altında kalan deneklerimizde serum trigliserid değerleri, HbA1c değerleri daha yüksek olanlara kıyasla anlamlı olarak daha düşük bulundu (p<0,05). HbA1c değerleri ortanca değerin altında kalan hastalarda serum LDL, MDA ve H2O2 değerleri daha düşük bulundu ancak her iki grup arasındaki fark istatistiksel olarak anlamlı değildi. HbA1c değerleri ortanca değerin altında kalan hastalarda serum HDL ve GSH değerleri daha yüksek bulundu ancak her iki grup arasındaki fark istatistiksel olarak anlamlı değildi. Sonuç: Tip 2 DM’li hastalarda HbA1c değeri arttıkça oksidatif stres artmakta, metabolik parametreler yükselmekte ve GSH düşmektedir. Bu nedenle, DM hastalarında HbA1c azaltabilecek sağlıklı yaşam tarzı değişiklikleri büyük önem taşımaktadır.

Anahtar Kelimeler

• Oksidatif stres,Hemoglobin A1c,Diabetes Mellitus

Kaynakça

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