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Glycaemic status in relation to oxidative stress and inflammation in well-controlled type 2 diabetes subjects
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Department of Biosciences and Nutrition, Karolinska Institute.
Department of Biosciences and Nutrition, Karolinska Institute.
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2009 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 101, no 10, 1423-1426 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the present observational study was to investigate the relationships between glycaemic status and levels of oxidative stress and inflammation in well-controlled type 2 diabetes subjects. Metabolic variables (weight, BMI, waist circumference (waist), blood glucose, glycated Hb (HbA1c), insulin, blood lipids), biomarkers of oxidative stress (8-iso-PGF, malondialdehyde, 8-oxo-7,8-dihydro-2'-deoxyguanosine, formamido pyrimidine glycosylase-sites, frequency of micronucleated erythrocytes, nitrotyrosine) and inflammatory markers (high sensitivity C-reactive protein (hsCRP), IL-6, cyclo-oxygenase-catalyzed PGF-metabolite) were measured. Fifty-six patients (thirty women and twenty-six men, age 62.3 (SD 7.0) years, HbA1c 6.1 (SD 0.9) %, BMI 28.3 (SD 3.8) kg/m2, waist 99.6 (SD 11.1) cm) were included in the study. HbA1c (r 0.29, P=0.03) and blood glucose (r 0.33, P=0.01) correlated positively with 8-iso-PGF. Positive correlations were also observed between HbA1c and nitrotyrosine (r 0.42, P=0.01), waist and hsCRP (r 0.37, P=0.005), hsCRP and IL-6 (r 0.61, P<0.0001) and between PGF-metabolite and 8-iso-PGF (r 0.27, P=0.048). The present study indicates that glycaemic status is associated with oxidative stress even in subjects with well-controlled type 2 diabetes. Furthermore, inflammation was more related to abdominal obesity than to glycaemic control. A large number of biomarkers of oxidative stress and inflammation were investigated, but only a few associations were found between the markers. This could be due to the fact that none of these biomarkers biosynthesises via similar pathways or simultaneously owing to their diverse nature and origin.

Place, publisher, year, edition, pages
2009. Vol. 101, no 10, 1423-1426 p.
Keyword [en]
Glycaemic control, Oxidative stress, Inflammation, Diabetes mellitus type 2
National Category
Medical and Health Sciences
Research subject
Nutrition
Identifiers
URN: urn:nbn:se:uu:diva-122214DOI: 10.1017/S0007114508076204ISI: 000267026900001PubMedID: 19459227OAI: oai:DiVA.org:uu-122214DiVA: diva2:310398
Available from: 2010-04-14 Created: 2010-04-07 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Effect of Dietary Antioxidants on Oxidative Stress, Inflammation and Metabolic Factors: Studies in Subjects with Overweight and with Type 2 Diabetes
Open this publication in new window or tab >>Effect of Dietary Antioxidants on Oxidative Stress, Inflammation and Metabolic Factors: Studies in Subjects with Overweight and with Type 2 Diabetes
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Observational studies have indicated that fruit and vegetables, and dietary antioxidants may play an important role in reducing the risk of chronic diseases, potentially by affecting pathogenic mechanisms such as oxidative stress and inflammation. Clinical trials investigating the effects of supplementation with single or a few antioxidants in high doses have, however, shown inconsistent results and thus have not been able to support the observational findings.

It was therefore hypothesised that a supplement, containing a combination of antioxidants mainly extracted from fruit and vegetables, and supplied at moderate doses, might act more beneficially than single antioxidants given at pharmacological doses. The effects of such a supplement were investigated in two interventional studies described in this thesis. The effects on antioxidant status, metabolic control, oxidative stress and inflammation were investigated in overweight men and in patients with type 2 diabetes, subjects that could be expected to have elevated levels of oxidative stress and inflammatory activity.

The results of the studies did not support the hypothesis that supplementation with antioxidants from fruit and vegetables may have beneficial effects by counteracting oxidative stress and inflammation, despite markedly increased plasma antioxidant concentrations. However, interesting associations were observed in diabetes patients at baseline between intake of antioxidant rich food as well as levels of antioxidants in plasma, and markers of oxidative stress and inflammation. These associations are compatible with the hypothesis that a high intake of fruit and vegetables and dietary antioxidants decrease oxidative stress levels, have anti-inflammatory effects and a beneficial influence on glycaemic control. The results also indicated that glycaemic control may affect the level of oxidative stress.

The absence of beneficial effects from antioxidants might to some extent be explained by the initial levels of oxidative stress and inflammation and by the antioxidative status in the subjects included in the studies. Since the levels generally were comparable with those observed in healthy subjects, this might have decreased the ability to observe any beneficial effects of supplementation with additional antioxidants.

Continued investigations are needed to characterise the individuals who potentially might benefit from antioxidant supplementation. In view of apparent positive effects from a high intake of fruit and vegetables found in observational studies and until more knowledge is available from interventional trials about possible benefits and potential risks of antioxidant supplementation it still seems reasonable to recommend a diet rich in fruit and vegetables.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 76 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 634
Keyword
Antioxidants, supplementation, fruit and vegetables, oxidative stress, isoprostanes, lipid peroxidation, oxidative damage to DNA, glycaemic control, inflammation, overweight, type 2 diabetes
National Category
Medical and Health Sciences
Research subject
Nutrition
Identifiers
urn:nbn:se:uu:diva-134938 (URN)978-91-554-7977-0 (ISBN)
Public defence
2011-02-04, Mariasalen, Stiftets Hus, Dragarbrunnsgatan 71, Uppsala, 13:15 (English)
Opponent
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Available from: 2011-01-14 Created: 2010-12-02 Last updated: 2011-03-11Bibliographically approved

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