High predictive ability of glycated hemoglobin on comparison with oxidative stress markers in assessment of chronic vascular complications in type 2 diabetes mellitus

Abstract

Objective: To validate the diagnostic utility of oxidative stress markers along with glycated hemoglobin (HbA1c ) in the assessment of chronic vascular complications in type 2 diabetes mellitus (DM).

Methods: Ischemia modified albumin (IMA), advanced oxidation protein products (AOPP) and malondialdehyde (MDA) were measured in 100 type 2 DM (without complications n = 50, with complications n = 50) and healthy controls (n = 50). Diagnostic potential was evaluated by receiver operating characteristic analysis and their relationships to risk variables were analyzed.

Results: MDA, IMA and AOPP were significantly increased in diabetics, both with and without complications. Oxidative stress parameters correlated with fasting blood glucose and HbA1c (independent predictors). Duration of diabetes was an independent predictor for AOPP and MDA. The association of IMA with diabetes duration was lost on multiple regression analysis. Area under the curve, sensitivity and specificity for MDA were 0.795, 84%, 66%; for AOPP, they were 0.762, 82%, 56%; for IMA, they were 0.611, 60%, 52%; and for HbA1c, they were 0.848, 90%, 70%, respectively.

Conclusion: MDA and AOPP could be considered better than IMA in the evaluation of diabetes progression, but MDA is more useful as a diagnostic indicator to detect vascular complications. HbA1c measurement is of greater value than the oxidative stress markers in the prediction of vascular complications.

Keywords: Advanced oxidation protein products; glycated hemoglobin; ischemia modified albumin; malondialdehyde; risk factors.