Imbalance of Oxidant/Antioxidant Status and Risk Factors for Saudi Type 2 Diabetic Patients with Retinopathy

Abstract

Aims: To estimate the oxidant/antioxidant status in type 2 diabetic patients with retinopathy; and to correlate a number of independent variables (age, gender, education, body mass index, duration of diabetes, glycosylated haemoglobin, hypertension) to development of retinopathy. Study design: Case-control study. Place and Duration of Study: Research laboratories, Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University from April 2010 to April 2011. Methodology: One-hundred diabetic patients with retinopathy recruited from King Fahad Specialist Hospital- Buraidah were included in the study. The control groups were: control group 1 consisted of sixty type 2 diabetic patients without retinopathy recruited from Diabetes and Endocrinology Center, KFSH, Buraidah, KSA; and control group 2 consisted of sixty healthy "non diabetic subjects" recruited from public places, i.e. Estarahes (party lounges). Plasma, serum, and erythrocyte lysate were prepared from blood of each subject. Human serum 8-OHdG, plasma MDA, and erythrocyte lysate Cu-Zn SOD were estimated by using commercial kits supplied by Northwest, U.S.A. Data was analyzed using SPSS software and Win Episcope software. P- values < 0.05 were considered significant. Results: Age, education, duration of diabetes, poor glycaemic control, and hypertension were consistently associated with development of retinopathy (OR 5.891, 4.44, 10.420, 1.699, 1.820 respectively). Moreover, increased plasma MDA, increased serum 8-OHdG levels, decreased Cu-Zn SOD activity were observed in diabetic patients with retinopathy compared to subjects in control groups. In addition, negative correlations were found between plasma MDA and Cu-Zn SOD activity, HbA1c & Cu-Zn SOD activity as well in all subjects. Conclusion: This report emphasizes the important role of oxidative stress in the development of retinopathy in type 2 diabetes suggesting that blocking of oxidative stress is a crucial step for delayed progression of diabetic retinopathy and hence the need for antioxidant supplements to postpone the severity of diabetic retinopathy.