Oxidative Stress in Type 2 Diabetes with Iron Deficiency in Asian Indians
A close relationship exists between iron metabolism, diabetes and oxidative stress. Both diabetes and redox active iron are individually known to enhance oxidative stress. However, the role of iron deficiency and oxidative stress in diabetes is not clear; hence, the levels of oxidative stress in type 2 diabetes with and without iron deficiency have been compared. Two groups of 30 patients each with diabetes were selected (one group with iron deficiency and the other group with normal iron levels) and compared with 30 normal healthy controls. The anthropometric parameters, fasting blood sugar, iron profile and oxidative stress parameters (malondialdehyde levels (index of lipid peroxidation) and serum uric acid levels (antioxidant)) were measured. While the diabetes group had significantly increased serum levels of ferritin (an acute phase reactant and antioxidant) in comparison with normal controls (P=0.040), the diabetic group with iron deficiency had decreased serum levels of iron (P =0.000), ferritin (P = 0.000) and uric acid (P = 0.006) and increased levels of malondialdehyde (P = 0.000) in comparison with diabetics without iron deficiency. This study shows an increase in oxidative stress in the diabetic group with iron deficiency together with reduction in antioxidant levels could further promote prooxidant levels and inflammation and in turn result in the development of complications in this high-risk Asian Indian population.
If the inline PDF is not rendering correctly, you can download the PDF file here.
Fernandez-Real JM Lopez-Bermejo A Ricart W. Crosstalk between iron metabolism and diabetes. Diabetes 2002; 51: 2348-54.
Swaminathan S Alam MG Fonseca VA Shah SV. The role of iron in diabetes and its complications. Diabetes Care 2007; 30: 1926-33.
Thomas MC Maclsaac RJ Tsalamandris C Power D Jerems G. Unrecognized anemia in patients with diabetes. Diabetes Care 2003; 26: 1164-9.
Gutteridge JM Rowley DA Halliwell B. Superoxide-dependent formation of hydroxyl radicals and lipid peroxidation in the presence of iron salts. Detection of ‘catalytic’ iron and antioxidant activity in extracellular fluids. Biochem J 1982; 206: 605-9.
Galaris D Pantopoulos K. Oxidative stress and iron homeostasis: mechanistic and health aspects. Crit Rev Clin Lab Sci 2008; 45: 1-23.
Campenhout AV Campenhout CV Lagrou AR Abrams P Moorkens G Gaal LV et al. Impact of diabetes mellitus on the relationships between iron- inflammatory- and oxidative stress status. Diabetes Metab Res Rev 2006; 22: 444-54.
Yoo JH Maeng HY Sun YK Kim YA Park DW Park TS et al. Oxidative status in iron-deficiency anemia. J Clin Lab Anal 2009; 23: 319-23.
Toxqui L Piero AD Courtois V Bastida S Sanchez-Muniz FJ Vaquero MP. Iron deficiency and overload: Implications in oxidative stress and cardiovascular health. Nutr Hosp 2010; 25: 350-65.
Parasuram MK Natesh PR Mohan DM Sabitha N Janakarajan VN Balasubramanian N. Role of oxidative stress and antioxidants in children with IDA. International Journal of Collaborative Research on Internal Medicine & Public Health 2010; 2: 2-18.
Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. WHO Geneva Switzerland 2006.
Park K. Nutrition and health. Park's Textbook of preventive and social medicine. 20th ed. Jabalpur India: Banarsidas Bhanot 2009 539pp.
Wilbur KM Bernheim F Shapiro OW. The TBARS reagent as test for the oxidation of unsaturated fatty acids by various agents. Arch Biochem Biophys 1943; 24: 305-13.
Cook JD Lipschitz DA Miles LE Finch CA. Serum ferritin as a measure of iron stores in normal subjects. Am J Clin Nutr 1974; 27: 681-7.
Tuomainen TP Nyyssonen K Salonen R Tervahauta A Korpela H Lakka T et al. Body iron stores are associated with serum insulin and blood glucose concentrations. Population study in 1013 eastern Finnish men. Diabetes Care 1997; 20: 426-8.
Herbert V Shaw S Jayatilleke E Stopler-Kasdan T. Most free-radical injury is iron-related: it is promoted by iron hemin holoferritin and Vitamin C and inhibited by desferoxamine and apoferritin. Stem Cells 1994; 12: 289-303.
Mojiminiyi OA Marouf R Abdella NA. Body iron stores in relation to the metabolic syndrome glycemic control and complications in female patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2008; 18: 559-66.
Torti FM Torti SV. Regulation of ferritin genes and protein. Blood 2002; 99: 3505-16.
Baccin AC Lazzaretti LL Brandao VDM Manfredini V Peralba MCR Benfato MS. Oxidative stress in older patients with iron deficiency anaemia. J Nutr Health Aging 2009; 13: 666-70.
Aslan M Horoz M Kocyigit A Ozgonul S Celik H Celik M et al. Lymphocyte DNA damage and oxidative stress in patients with iron deficiency anemia. Mutat Res 2006; 601: 144-9.
Lee SMK Lee AL Winters TJ Tam E Jaleel M Stevinkel P et al. Low serum uric acid level is a risk factor for death in incident hemodialysis patients. Am J Nephrol 2009; 29: 79-85.
Sevanian A Davis KJ Hochstein P. Serum urate as an antioxidant for ascorbic acid. Am J Clin Nutr 1991; 54: 1129S-34S.
Culleton BF Larson MG Kannel WB Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 1999; 131: 7-13.