Elsevier

Clinical Biochemistry

Volume 33, Issue 8, November 2000, Pages 669-674
Clinical Biochemistry

The Effect of Dietary Treatment on Erythrocyte Lipid Peroxidation, Superoxide Dismutase, Glutathione Peroxidase, and Serum Lipid Peroxidation in Patients with Type 2 Diabetes Mellitus

https://doi.org/10.1016/S0009-9120(00)00190-9Get rights and content

Abstract

Objectives: The aim of the present study was to investigate the effect of dietary treatment on serum and erythrocyte lipid peroxidation and erythrocyte antioxidative enzyme activity of patients with Type 2 diabetes.

Design and methods: A total of 30 patients with newly diagnosed as Type 2 diabetes were enrolled to the study. A total of 30 healthy subjects served as controls. Diabetic patients were given standard dietary treatment that was composed of 50% to 55% carbohydrate and 30% fat for 2 months. No diet was applied for controls. For both groups serum and erythrocyte lipid peroxidation and erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were obtained at first and at the end of 2 months.

Results: Diabetic patients had higher serum and erythrocyte lipid peroxidation than those of controls before dietary treatment(p < 0.05). However, there was no absolute differences in erythrocyte SOD and GSH-Px (p > 0.05). At the end of 2 months of dietary treatment, while diabetics had still higher glucose and erythrocyte lipid peroxidation than controls (p < 0.05), serum lipid peroxidation, erythrocyte SOD, and GSH-Px levels did not differ significantly from those of controls (p > 0.05). In diabetic patients, after 2 months of dietary treatment, whereas serum and erythrocyte lipid peroxidation decreased, erythrocyte SOD and GSH-Px activities showed significant increase (p < 0.05).

Conclusions: Our results showed significant alteration in serum and erythrocyte lipid peroxidation and erythrocyte antioxidant enzyme status of patients with Type 2 diabetes by dietary treatment. However, whether such alterations have clinical importance for diabetic patients needs further investigation.

Introduction

Diabetes mellitus is by far the most common serious metabolic disorder, with a world-wide prevalence estimated to be between 1% and 5%. All forms of diabetes, both inherited and acquired, are characterized by hyperglycemia, a relative or absolute lack of insulin, and development of specific microvascular pathology in the retina and renal glomerulus. Diabetes also increases the risk of developing typical atherosclerotic arterial disease by two- to sixfold (1). There has been currently great interest in the potential contribution of increased oxidative stress to the development of complications in diabetes mellitus (2). An increase in oxidative stress may occur due to an increase in free radical production 3, 4. The biologic effects of free radicals are controlled in vivo by a wide range of antioxidant such as vitamins A and C, carotenoids, glutathione, and antioxidant enzymes. Among these enzymes, superoxide dismutase (SOD) catalyzes dismutation of the superoxide anion (O−2) into H2O2 and glutathione peroxidase (GSH-Px) and catalase both detoxify H2O2 and convert lipid hydroperoxides to nontoxic alcohols 5, 6. Also, other an increase in oxidative stress may occur due to a reduction in these antioxidant defenses (7).

Some studies on diabetes showed a significant increase in the products of both plasma and tissue lipid peroxidation compared to controls (8). On the other hand, it has been reported that antioxidant capacity decreases in diabetic patients (9). These findings resulted in new approaches to the treatment of diabetic patients, and the relevant studies focused on the support of antioxidant systems of the sufferers. As known, in diabetes, basic treatment is intensive dietary treatment. Does such a dietary treatment have any effect on oxidative stress and antioxidant system? To answer this question, We investigated if standard dietary treatment had any effect on erythrocyte lipid peroxidation, SOD, GSH-Px and serum lipid peroxidation in Type 2 diabetic patients.

Section snippets

Methods

Thirty patients who admitted to the Department of Internal Medicine and were diagnosed with new Type 2 diabetes through common clinical and laboratory findings. New criteria presented in 1995 of the American Diabetes Association were taken as diagnostic criteria (10). Patients with symptoms of diabetes who had fasting plasma glucose ≥ 126 mg/dL (7 mmol/L) were accepted as diabetics. Five of 30 patients had impaired fasting glucose (fasting plasma glucose ≥ 110 mg/dL, but < 126 mg/dL). The

Results

Table 2 and Table 3 show prediet and postdiet results of patients and controls. As seen from the tables, prediet diabetics had higher glucose, serum lipid peroxidation and erythrocyte lipid peroxidation levels than those controls (p < 0.05). However, there was no absolute difference regarding erythrocyte GSH-Px and SOD activities (p > 0.05). At the end of 2 months of dietary treatment, although diabetics had still higher glucose and erythrocyte lipid peroxidation than controls (p < 0.05), serum

Discussion

Oxygen free radicals produced during normal aerobic metabolism have been implicated in several pathophysiological mammalian processes. The importance of free radical-mediated fatty acid oxidation has received much attention. The generation of active oxygen species may lead to lipid peroxidation and formation of reactive products, which may be involved in severe damage of cell molecules and structures. Free radicals and peroxides are involved in pathogenesis of aging and in various diseases such

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