Determination and Evaluation of the Plasma Levels of Malondialdehyde, Antioxidant Vitamins (A, E, C) and Selenium in Sudanese Patients with Type 2 Diabetes. A study in Khartoum state, Sudan

Abstract

A cross-sectional study conducted during the period from January 2009 to December 2011 to determine and evaluate the plasma levels of Malondialdehyde, antioxidants vitamins (A, E, C) and selenium in Sudanese patients with type 2 diabetes mellitus. Two hundred eighty five patients with type 2 diabetes mellitus were selected as a test group from. The test group was compared with the control group which included 100 apparently healthy volunteers (non diabetics). Blood specimens were collected from both groups, and plasma levels of Malondialdehyde, antioxidants vitamins (A, E, C) and selenium, in addition to fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were determined. Age and gender of the test group were matched with the control group. The results of this study indicate a significantly raised means of the plasma levels of malondialdehyde, fasting plasma glucose, and blood HbA1C of the test group when compared with healthy control subjects, whereas the means of the plasma levels of antioxidant vitamins (A, E, C), and selenium showed significant reduction when compared with that of the control group. The results of the present study indicate also significant elevations of the mean of plasma levels of antioxidant vitamins (A, E,) and selenium of the diabetic patients on multivitamins when compared with those not taking multivitamins, and there is significant reduction of the means of plasma levels of MDA, FPG, and blood HbA1C% of the diabetic patients on multivitamins when compared with those not taking multivitamins, where as there is insignificant difference between the mean of plasma levels of vitamin C between the two groups. Whereas there is insignificant difference between the mean of plasma levels malondialdehyde, antioxidant vitamins (A, E, C), selenium, fasting plasma glucose, and blood HbA1C% of the diabetic patients on hypoglycemic drugs and those on diet control. The results of the current study indicate significant reduction of the means of plasma levels of antioxidant vitamins (A, E, C) of the diabetic patients with hypertension when compared with normotensive diabetic patients, where as there is insignificant difference between the means of plasma levels of malondialdehyde, selenium, plasma fasting glucose, and blood HbA1C between the two groups. In this study there is insignificant difference between the means of the plasmas levels of antioxidant vitamins (A, E, C), fasting plasma glucose, and blood HbA1C of the diabetic patients with ischemic heart disease and those without ischemic heart disease, and there is significant increase in the mean of plasma levels of malondialdehyde of patients with ischemic heart disease and those without this disease, also there is significant decrease in the mean of plasma levels of selenium of the patients with ischemic heart disease and those without this disease. The results of this study indicate significant strong positive correlation between HbA1C percentage and fasting plasma glucose (FPG), and significant negative correlation between HbA1C and plasma selenium, whereas there is insignificant weak positive correlation between HbA1C and plasma levels of malondialdehyde, vitamin A, and vitamin C, also there is weak negative correlation between HbA1C and vitamin E. The current study indicate no correlation between the BMI and plasma levels of MDA, selenium, vitamin A, vitamin E, FPG, and HbA1C, and there is insignificant weak negative correlation between the BMI and the plasma levels of vitamin C. The results of the current study indicate no correlation between the duration of disease (in years) and the plasma levels of MDA, selenium, vitamin A, and vitamin C, and show weak positive correlations between the duration of diabetes (in years) and plasma levels of vitamin E, and HbA1C, also there is moderate positive correlation between the duration of diabetes (in years) and FPG, also the study showed insignificant negative correlation between the duration of diabetes (in years) and the BMI. In conclusion; the current study indicates that the plasma levels of Malondialdehyde, antioxidants vitamins (A, E, C), selenium, fasting plasma glucose, and glycated hemoglobin (HbA1c) are important markers for evaluation of oxidative stress, antioxidants status, and glycemic control of diabetic patients respectively, so they can be used as prognostic markers for prediction of oxidative stress, antioxidants status, and glycemic control of diabetic patients especially in patients with complications such as hypertension, ischemic heart disease, lipid abnormalities, and uncontrolled diabetes.