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The effect of hemodialysis on accelerated atherosclerosis in diabetic patients: correlation of carotid artery intima-media thickness with oxidative stress.
J Diabetes Complications 2009 Jul-Aug; 23(4):257-64JD

Abstract

OBJECTIVE

Both diabetes and hemodialysis (HD) are associated with increased oxidative stress. The aim of this study was to clarify the effect of maintenance HD on oxidative stress parameters in diabetic patients and to explore any relation between carotid artery intima-media thickness (CIMT) and oxidative stress markers.

METHODS

Twenty Type 2 diabetic patients undergoing chronic maintenance HD, 20 type 2 diabetic patients with normal renal function, and 20 age- and sex-matched healthy subjects were included. Serum thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCO), and nitrite/nitrate levels were determined as oxidative stress markers. Serum vitamin E, plasma sulfhydryl (P-SH), erythrocyte glutathione (GSH) levels, and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonography.

RESULTS

Both diabetic patient groups had enhanced oxidative stress indicated by higher levels of TBARS, PCO, and nitrate/nitrite and lower activities of SOD, CAT, and GPx compared to controls. Diabetic patients undergoing HD had significantly higher CIMT (P=.001) and higher levels of nitrite/nitrate (P=.05), PCO (P=.03), and GSH (P=.04) but significantly lower levels of P-SH (P<.001), serum vitamin E (P=.04), SOD (P=.02), CAT (P=.001), and GPx (P=.006) compared to diabetic patients with normal renal functions. There were significant negative correlations between CIMT and SOD (r=-0.50, P<.001), CAT (r=-0.41, P=.003), and P-SH levels (r=-0.51, P<.001) and significant positive correlation between CIMT and nitrite/nitrate levels (r=0.41, P=.003) and TBARS (r=0.35, P=.02). Linear regression analysis showed TBARS was significantly and positively correlated with CIMT (P=.04), while SOD and P-SH were significantly and negatively correlated with CIMT (P=.05 and P=.02, respectively).

CONCLUSIONS

Hemodialysis exacerbates oxidative stress and disturbances in antioxidant enzymes in diabetic patients. Serum nitrite/nitrate and TBARS can be used as positive determinants, while erythrocyte SOD, CAT activities, and P-SH level can be used as negative determinants of atherosclerosis assessed by CIMT in diabetic patients.

Authors+Show Affiliations

Department of Nephrology, Pamukkale University Medical Faculty, Denizli, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18413174

Citation

Dursun, Belda, et al. "The Effect of Hemodialysis On Accelerated Atherosclerosis in Diabetic Patients: Correlation of Carotid Artery Intima-media Thickness With Oxidative Stress." Journal of Diabetes and Its Complications, vol. 23, no. 4, 2009, pp. 257-64.
Dursun B, Dursun E, Suleymanlar G, et al. The effect of hemodialysis on accelerated atherosclerosis in diabetic patients: correlation of carotid artery intima-media thickness with oxidative stress. J Diabetes Complicat. 2009;23(4):257-64.
Dursun, B., Dursun, E., Suleymanlar, G., Ozben, B., Capraz, I., Apaydin, A., & Ozben, T. (2009). The effect of hemodialysis on accelerated atherosclerosis in diabetic patients: correlation of carotid artery intima-media thickness with oxidative stress. Journal of Diabetes and Its Complications, 23(4), pp. 257-64. doi:10.1016/j.jdiacomp.2007.12.007.
Dursun B, et al. The Effect of Hemodialysis On Accelerated Atherosclerosis in Diabetic Patients: Correlation of Carotid Artery Intima-media Thickness With Oxidative Stress. J Diabetes Complicat. 2009;23(4):257-64. PubMed PMID: 18413174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of hemodialysis on accelerated atherosclerosis in diabetic patients: correlation of carotid artery intima-media thickness with oxidative stress. AU - Dursun,Belda, AU - Dursun,Evrim, AU - Suleymanlar,Gultekin, AU - Ozben,Beste, AU - Capraz,Irfan, AU - Apaydin,Ali, AU - Ozben,Tomris, Y1 - 2008/04/16/ PY - 2007/10/13/received PY - 2007/12/16/revised PY - 2007/12/27/accepted PY - 2008/4/17/pubmed PY - 2009/9/4/medline PY - 2008/4/17/entrez SP - 257 EP - 64 JF - Journal of diabetes and its complications JO - J. Diabetes Complicat. VL - 23 IS - 4 N2 - OBJECTIVE: Both diabetes and hemodialysis (HD) are associated with increased oxidative stress. The aim of this study was to clarify the effect of maintenance HD on oxidative stress parameters in diabetic patients and to explore any relation between carotid artery intima-media thickness (CIMT) and oxidative stress markers. METHODS: Twenty Type 2 diabetic patients undergoing chronic maintenance HD, 20 type 2 diabetic patients with normal renal function, and 20 age- and sex-matched healthy subjects were included. Serum thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCO), and nitrite/nitrate levels were determined as oxidative stress markers. Serum vitamin E, plasma sulfhydryl (P-SH), erythrocyte glutathione (GSH) levels, and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonography. RESULTS: Both diabetic patient groups had enhanced oxidative stress indicated by higher levels of TBARS, PCO, and nitrate/nitrite and lower activities of SOD, CAT, and GPx compared to controls. Diabetic patients undergoing HD had significantly higher CIMT (P=.001) and higher levels of nitrite/nitrate (P=.05), PCO (P=.03), and GSH (P=.04) but significantly lower levels of P-SH (P<.001), serum vitamin E (P=.04), SOD (P=.02), CAT (P=.001), and GPx (P=.006) compared to diabetic patients with normal renal functions. There were significant negative correlations between CIMT and SOD (r=-0.50, P<.001), CAT (r=-0.41, P=.003), and P-SH levels (r=-0.51, P<.001) and significant positive correlation between CIMT and nitrite/nitrate levels (r=0.41, P=.003) and TBARS (r=0.35, P=.02). Linear regression analysis showed TBARS was significantly and positively correlated with CIMT (P=.04), while SOD and P-SH were significantly and negatively correlated with CIMT (P=.05 and P=.02, respectively). CONCLUSIONS: Hemodialysis exacerbates oxidative stress and disturbances in antioxidant enzymes in diabetic patients. Serum nitrite/nitrate and TBARS can be used as positive determinants, while erythrocyte SOD, CAT activities, and P-SH level can be used as negative determinants of atherosclerosis assessed by CIMT in diabetic patients. SN - 1873-460X UR - https://www.unboundmedicine.com/medline/citation/18413174/The_effect_of_hemodialysis_on_accelerated_atherosclerosis_in_diabetic_patients:_correlation_of_carotid_artery_intima_media_thickness_with_oxidative_stress_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1056-8727(08)00003-2 DB - PRIME DP - Unbound Medicine ER -