The Value of 8-iso Prostaglandin F2 Alpha and Superoxide Dismutase Activity as a Clinical Indicator of Oxidative Stress in Type II Diabetes Mellitus

Abstract

Introduction: Type II Diabetes Mellitus (T2DM) is a serious metabolic disorder in which Oxidative Stress (OS) is responsible for tissue damage and complications. An 8-iso prostaglandin F2 alpha (8-iso-PGF2α) is a stable and abundant active product of oxidative stress that could promote complications in DM and could be used as a biomarker for the detection of oxidative injury and lipid peroxidation. Aim: The study was designed to evaluate the accuracy of 8-iso prostaglandin F2 alpha (8-iso-PGF2α) and Superoxide Dismutase (SOD) activity as a biomarker of OS in T2DM and to verify their relation with the glycaemic control and lipid profile. Materials and Methods: This is a cross-sectional case control study that included 58 (20 good glycaemic control and 38 poor glycaemic control) T2DM patients from Al-Noor Specialist Hospital, Holly Makkah and 20 healthy volunteers. 8-iso-PGF2α was measured by quantitative ELISA and SOD enzyme activity assayed by colorimetric technique. Data were analysed using SPSS version 20. All numerical data were represented as mean±SD. ANOVA test was used for comparisons between the different groups. Receiver Operating Characteristic (ROC) curve was conducted to calculate sensitivity and specificity. Results: There was a highly significant increase in 8-iso-PGF2α level in the uncontrolled DM cases compared to both the control and controlled DM groups (p<0.001) and it showed positive correlation with HBA1c (r = 0.817 and p<0001). SOD activity showed a highly significant decrease in the controlled and uncontrolled DM group compared to the control group (p<0.001) with larger reduction in the uncontrolled group (p 0.009). Based on ROC curve analysis, 8-iso PGF2α at a cut-off 113.8 pg/mL showed 100% sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPP) for prediction of OS associated with poor glycaemic control. Levels lower than 2.37 SOD activity can predict OS with 87.8% sensitivity, 66.7% specificity, 90.3% PPV and 73.5% NPV. Conclusion: This study highlights the validity of 8-iso-PGF2α as a biomarker of OS with high accuracy compared to SOD in T2DM that make it worthy to move serum 8-iso-PGF2α detection from research to clinical utility.

Keywords

• 8-isoprostane
• diabetic complications
• enzymatic antioxidant
• reactive oxygen species