Document Type : Original Article(s)


1 Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

2 Associate Professor, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Nutrition and Biochemistry, The International Campus, Tehran University of Medical Sciences, Kish, Iran

5 Professor, Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran


BACKGROUND: This study was designed to compare lipid peroxidation and antioxidant enzymes activity in Type 2 diabetes patients with good or weak glycemic control. METHODS: In this case-control study, 62 Type 2 diabetic patients with glycated hemoglobin (HbA1c) between 6 and 8 were enrolled as the controlled group and 55 patients with HbA1c > 8 were selected as an uncontrolled group. Patients were all referred to Iranian Diabetes Association in Tehran, Iran, from 2010 onward. Groups were chosen by convenience sampling and were matched based on age, sex and duration of disease. Demographic questionnaire, two 24-hour food recall, HbA1c, insulin, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase were measured in blood samples. Data were analyzed by Food Processor II and SPSS software. RESULTS: A mean daily consumption of energy, carbohydrate, protein, and fat was not significantly different between two groups. MDA in the uncontrolled group was significantly higher than controlled group (2.03 ± 0.88 vs. 1.65 ± 1.01 nmol/ml; P = 0.030). A mean SOD was slightly higher in the uncontrolled group comparing to the control group (843.3 ± 101.9 vs. 828.0 ± 127.3 U/g Hb; P = 0.400). CONCLUSION: These data suggest that MDA as a lipid peroxidation indicator is higher in uncontrolled diabetes probably due to chronic high blood sugar followed by higher oxidative stress.   


  1. Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus--present and future perspectives. Nat Rev Endocrinol 2012; 8(4): 228-36.
  2. Kilpatrick ES, Rigby AS, Atkin SL. A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care 2008; 31(11): 2198-202.
  3. Izadi M, Fazel M, Karbasi-Afshar R, Saadat SH, Nasseri MH, Jonaidi-Jafari N, et al. Glycemic control in type 2 diabetes mellitus prevents coronary arterial wall infection. ARYA Atheroscler 2014; 10(3): 141-6.
  4. Nikkar B, Khosravi-Boroujeni H, Kolahdouzan M, Ghoreishyan M, Ebadi S, Mohamadzadeh A, et al. Is responsiveness to weight loss diets affected by family history of diabetes? ARYA Atheroscler 2014; 10(3): 164-8.
  5. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM, et al. Tests of glycemia in diabetes. Diabetes Care 2004; 27(7): 1761-73.
  6. Sabanayagam C, Liew G, Tai ES, Shankar A, Lim SC, Subramaniam T, et al. Relationship between glycated haemoglobin and microvascular complications: is there a natural cut-off point for the diagnosis of diabetes? Diabetologia 2009; 52(7): 1279-89.
  7. Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 2008; 31(Suppl 1): S61-S78.
  8. Chang CM, Hsieh CJ, Huang JC, Huang IC. Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus. Acta Diabetol 2012; 49(Suppl 1): S171-S177.
  9. Pandey KB, Rizvi SI. Biomarkers of oxidative stress in red blood cells. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155(2): 131-6.
  10. Monaghan P, Metcalfe NB, Torres R. Oxidative stress as a mediator of life history trade-offs: mechanisms, measurements and interpretation. Ecol Lett 2009; 12(1): 75-92.
  11. Miao L, St Clair DK. Regulation of superoxide dismutase genes: implications in disease. Free Radic Biol Med 2009; 47(4): 344-56.
  12. Likidlilid A, Patchanans N, Peerapatdit T, Sriratanasathavorn C. Lipid peroxidation and antioxidant enzyme activities in erythrocytes of type 2 diabetic patients. J Med Assoc Thai 2010; 93(6): 682-93.
  13. Mancino R, di Pierro D, Varesi C, Cerulli A, Feraco A, Cedrone C, et al. Lipid peroxidation and total antioxidant capacity in vitreous, aqueous humor, and blood samples from patients with diabetic retinopathy. Mol Vis 2011; 17: 1298-304.
  14. Srivatsan R, Das S, Gadde R, Manoj-Kumar K, Taduri S, Rao N, et al. Antioxidants and lipid peroxidation status in diabetic patients with and without complications. Arch Iran Med 2009; 12(2): 121-7.
  15. Benzie IF. Lipid peroxidation: a review of causes, consequences, measurement and dietary influences. Int J Food Sci Nutr 1996; 47(3): 233-61.
  16. Aebi H. Catalase in vitro. Methods Enzymol 1984; 105: 121-6.
  17. Mawatari S, Saito K, Murakami K, Fujino T. Absence of correlation between glycated hemoglobin and lipid composition of erythrocyte membrane in type 2 diabetic patients. Metabolism 2004; 53(1): 123-7.
  18. Turk HM, Sevinc A, Camci C, Cigli A, Buyukberber S, Savli H, et al. Plasma lipid peroxidation products and antioxidant enzyme activities in patients with type 2 diabetes mellitus. Acta Diabetol 2002; 39(3): 117-22.
  19. Yin H, Xu L, Porter NA. Free radical lipid peroxidation: mechanisms and analysis. Chem Rev 2011; 111(10): 5944-72.
  20. Ahmed FN, Naqvi FN, Shafiq F. Lipid peroxidation and serum antioxidant enzymes in patients with type 2 diabetes mellitus. Ann N Y Acad Sci 2006; 1084: 481-9.
  21. Seghrouchni I, Drai J, Bannier E, Riviere J,
  22. Calmard P, Garcia I, et al. Oxidative stress parameters in type I, type II and insulin-treated type 2 diabetes mellitus; insulin treatment efficiency. Clin Chim Acta 2002; 321(1-2): 89-96.
  23. Colak E, Majkic-Singh N, Stankovic S, Sreckovic-Dimitrijevic V, Djordjevic PB, Lalic K, et al. Parameters of antioxidative defense in type 2 diabetic patients with cardiovascular complications. Ann Med 2005; 37(8): 613-20.
  24. Arai K, Maguchi S, Fujii S, Ishibashi H, Oikawa K, Taniguchi N. Glycation and inactivation of human Cu-Zn-superoxide dismutase. Identification of the in vitro glycated sites. J Biol Chem 1987; 262(35):
  25. -72.
  26. Halliwell B. Free radicals and antioxidants-quo vadis? Trends Pharmacol Sci 2011; 32(3): 125-30.
  27. Fang YZ, Yang S, Wu G. Free radicals, antioxidants, and nutrition. Nutrition 2002; 18(10): 872-9.