MALONDIALDEHYDE IN TYPE 2 DIABETICS AND ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

Shalash, M.; Badra, M.; Imbaby, S.; ElBanna, E.

doi:10.21608/jmalexu.2020.147116

MALONDIALDEHYDE IN TYPE 2 DIABETICS AND ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

Document Type : Original Article

Authors

¹ Department of Internal Medicine , Faculty of Medicine, Alexandria University, Egypt.

² Department of Chemical and Clinical pathology, Faculty of Medicine, Alexandria University, Egypt.

³ Department of MBBCH, Alexandria University.

10.21608/jmalexu.2020.147116

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a progressive chronic
disease with high prevalence all over the world. It is expected to have 693
million people affected by diabetes by 2045. Many body systems are
affected due to complications of DM with major effect on the
cardiovascular system. Dyslipidemia is one of the major risk factors for
cardiovascular disease in diabetes mellitus. Malondialdehyde (MDA) is a
highly toxic end product formed by lipid oxidation that mediates its toxic
effects due to its high reactivity particularly towards proteins and DNA.
Malondialdehyde interacts both irreversibly and reversibly with proteins
and phospholipids causing profound effects, especially in the collagen of
the cardiovascular system. Normally, MDA level remains within normal
values due to antioxidant effects, but in DM these protective effects are
disrupted.
Objective: Measure serum Malondialdehyde level as a marker of lipid
peroxidation in type 2 diabetic patients and its association with other
cardiovascular risk factors.
Patients and methods: The study included 40 diabetic patients recruited
from Outpatient Diabetes Clinic at Alexandria Main University Hospital
in addition to healthy 40 healthy subjects as a control group. Basic data,
clinical examination and laboratory analysis were obtained from all the
subjects within the two groups. Serum Malondialdehyde (MDA) was
measured in the participants within the two groups by using ELISA kit.
Results: The mean serum MDA level was statistically significant higher
in the diabetic cases as compared to the controls (Median MDA was
30.72nmol /ml in cases and 25.16 nmol /ml in the control). There is a
significant increase in serum MDA level with increasing the risk of CV
disease in the whole study subjects and in the diabetic cases. In the cases
group MDA shows positive correlation with all the study parameters
except high density lipoproteins (HDL) where it revealed negative
correlation. BY ROC curve analysis, a cutoff point more than > 26.57 had
62.5% sensitivity, 70% specificity, 66.4 % positive predictive value (PPV)
and 72.5% negative predictive value (NPV).
Conclusion: Malondialdehyde is a non-invasive biomarker that could be
utilized in differentiation of T2DM cases form healthy controls in addition
for identifying the high-risk diabetic patients for cardiovascular disease
(CVD). However, further large-scale studies are recommended to
accurately determine its sensitivity and specificity.

Keywords