Relationship between selected micronutrient deficiencies and oxidative stress biomarkers in diabetes mellitus patients with foot ulcers in Ibadan, Nigeria

Relationship between selected micronutrient deficiencies and oxidative stress biomarkers in diabetes mellitus patients with foot ulcers in Ibadan, Nigeria

Background/aim: Micronutrients are indispensable in the prevention of diseases and maintenance of good health. Their deficiencies have been implicated in several diseases associated with oxidative stress (OS). This study aimed at investigating the levels of some vitamins and minerals in association with OS markers in diabetic foot ulcer (DFU) patients in Ibadan, Oyo State, Nigeria. Materials and methods: Seventy DFU patients and 50 apparently healthy volunteers (controls) were recruited for the study. Blood samples of 10 mL were collected after a 10-h overnight fast from each participant after obtaining their consent. Levels of oxidative stress biomarkers such as lipid peroxide (LPO), 8-hydroxyl-2′-deoxyguanosine (8-OHdG), total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and micronutrients such as vitamin C, vitamin E, copper, selenium, and zinc were determined. Results: Significant increases in the levels of LPO and 8-OHdG and GPx activity were found in DFU patients compared to controls (P < 0.001). Significant decreases in vitamin C (P = 0.003), selenium, vitamin E, and TAS concentrations were detected between DFU patients and controls (P < 0.001). However, nonsignificant decreases in SOD activity and copper and zinc levels were observed when DFU patients and controls were compared (P > 0.05). Vitamin C was significantly positively correlated with GPx and selenium was significantly negatively correlated with 8-OHdG in the DFU group. However, nonsignificant correlations were observed between other micronutrients and oxidative stress biomarkers of both the DFU and control groups. Conclusion: Diabetes mellitus patients with foot ulcers may require micronutrient supplementation for proper control and maintenance of oxidant/antioxidant homeostasis.

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  • 1. Desalu OO, Salawu FK, Jimoh AK, Adekoya AO, Busari OA, Olokoba AB. Diabetic foot care: self reported knowledge and practice among patients attending three tertiary hospitals in Nigeria. Ghana Med J 2011; 45: 60-65.
  • 2. Ogbera AO, Adedokun A, Fasanmade OA, Ohwovoriole AE, Ajani M. The foot at risk in Nigerians with diabetes mellitus: the Nigerian scenario. Int J Endocrinol Metab 2005; 4: 165-173.
  • 3. Opara EC. Oxidative stress, micronutrients, diabetes mellitus and its complications. J Roy Soc Health Promot Health 2002; 122: 28-34.
  • 4. Pandey KB, Mishra N, Rizvi SI. Protein oxidation biomarkers in plasma of type 2 diabetic patients. Clin Biochem 2010; 43: 508-511.
  • 5. Machlin LJ, Bendich A. Free radical tissue damage: protective role of antioxidant nutrients. FASEB J 1987; 1: 441-445.
  • 6. Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease. 9th ed. Philadelphia, PA, USA: Lea & Febiger; 1999.
  • 7. Evans P, Halliwell B. Micronutrients: oxidant/antioxidant status. Brit J Nutr 2001; 85: S67-74.
  • 8. Granados-Silvestre MA, Ortiz-Lopez MG, Montufar-Robles I, Menjivar-Iraheta M. Micronutrients and diabetes: the case of minerals. Cir Cir 2014; 82: 97-103.
  • 9. Mooradian AD, Failla M, Hoogwerf B, Maryniuk M, WylieRosett, J. Selected vitamins and minerals in diabetes. Diabetes Care 1994; 17: 464-479.
  • 10. Narasimha RK, Suchetha NK, Damodara GKM, Swathi KR. The evaluation of micronutrients and oxidative stress and their relationship with the lipid profile in healthy adults. J Clin Diagn Res 2013; 7: 1314-1318.
  • 11. Bonnefont-Rousselot D, Bastard JP, Jaudon MC, Delattre J. Consequences of the diabetic status on the oxidant/antioxidant balance. Diabetes Metab 2000; 26: 163-176.
  • 12. Tiwari BK, Pandey KB, Abidi AB, Rizvi SI. Markers of oxidative stress during diabetes mellitus. Biomarkers 2013; 2013: 378790. 13. Wagner FW Jr. The diabetic foot. Orthopedics 1987; 10: 163- 172.
  • 14. Nouroouz-Zadeh J, Tajaddini SJ, McCarthy S, Betteridge DJ, Wolff SP. Elevated levels of authentic plasma hydroperoxides in NIDDM. Diabetes 1995; 44: 1054-1058.
  • 15. Patel PR, Bevan RJ, Mistry N, Lunec J. Evidence of oligonucleotides containing 8-hydroxy-2′-deoxyguanosine in human urine. Free Radical Bio Med 2007; 42: 552-558.
  • 16. Shen J, Deininger P, Hunt JD, Zhao H. 8-Hydroxy-2′- deoxyguanosine (8-OH-dG) as a potential survival biomarker in patients with nonsmall-cell lung cancer. Cancer 2007; 109: 574-580.
  • 17. Miller NJ, Rice-Evans C, Davies MJ, Gopinathan V, Milner A. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci 1993; 84: 407-412.
  • 18. Kyaw A. A simple colorimetric method for ascorbic acid determination in blood plasma. Clin Chim Acta 1978; 86: 153- 157.
  • 19. Quaife ML, Scrimsham NS, Lowry OH. Determination of vitamin E. J Biol Chem 1949; 80: 1229.
  • 20. Baker H, Frank O. Clinical Vitaminology. New York, NY, USA: Wiley; 1968.
  • 21. Kaneko JJ. Clinical Biochemistry of Domestic Animals. 4th ed. New York, NY, USA: Academic Press; 1999.
  • 22. Pleban PA, Munyani A, Beachum J. Determination of selenium concentration and glutathione peroxidase activity in plasma and erythrocytes. Clin Chem 1982; 28: 311-316.
  • 23. Arthur JR, Boyne R. Superoxide dismutase and glutathione peroxidase activities in neutrophils from selenium deficient and copper deficient cattle. Life Sci 1985; 36: 1569-1575.
  • 24. Suttle NF. Copper deficiency in ruminants; recent developments. Vet Rec 1986; 119: 519-522.
  • 25. Paglia DE, Valentine WN. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J Lab Clin Med 1967; 70: 158-169.
  • 26. Kraus RJ, Ganther HE. Reaction of cyanide with glutathione peroxidase. Biochem Bioph Res Co 1980; 96: 1116-1122.
  • 27. Obrosova IG. Increased sorbitol pathway activity generates oxidative stress in tissue sites for diabetic complications. Antioxid Redox Sign 2005; 7: 1543-1552.
  • 28. Shenkin A. Micronutrients in health and disease. Postgrad Med J 2006; 82: 559-567.
  • 29. Tiwari AK, Rao JM. Diabetes mellitus and multiple therapeutic approaches of phytochemicals: present status and future prospects. Curr Sci 2002; 83: 30-38.
  • 30. Piconi L, Quagliaro L, Ceriello A. Oxidative stress in diabetes. Clin Chem Lab Med 2003; 41: 1144-1149.
  • 31. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: impact on human health. Pharmacogn Rev 2010; 4: 118-126.
  • 32. Valko M, Leibfritz D, Moncola J, Cronin MTD, Mazura M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell B 2007; 39: 44-84.
  • 33. Valavanidis A, Vlachogianni T, Fiotakis C. 8-Hydroxy-2′- deoxyguanosine (8-OHdG): A critical biomarker of oxidative stress and carcinogenesis. J Environ Sci Heal C 2009; 27: 120- 139.
  • 34. Halliwell B, Chirico S. Lipid peroxidation: its mechanism, measurement, and significance. Am J Clin Nutr 1993; 57: 715S-724S.
  • 35. Martín-Gallán P, Carrascosa A, Gussinye M, Dominguez C. Biomarkers of diabetes-associated oxidative stress and antioxidant status in young diabetic patients with or without subclinical complications. Free Radical Bio Med 2003; 34: 1563-1574.
  • 36. Collins AR, Raslova K, Somorovska M, Petrovska H, Ondrusova A, Vohnout B. DNA damage in diabetes: correlation with a clinical marker. Free Radical Bio Med 1998; 25: 373-377.
  • 37. Shin CS, Moon BS, Park KS, Kim SY, Park SJ. Serum 8-hydroxyguanosine levels are increased in diabetic patients. Diabetes Care 2001; 24: 733-737.
  • 38. Bolajoko EB, Mossanda KS, Adeniyi FA, Akinosun O, Fasanmade A, Moropane M. Antioxidant and oxidative stress status in type 2 diabetes and diabetic foot ulcer. S Afr Med J 2008; 98: 614-617.
  • 39. Bozkurt F, Tekin R, Gulsun S, Satici O, Deveci O, Hosoglu S. The levels of copper, zinc and magnesium in type II diabetic patients complicated with foot infections. Int J Diabetes Dev C 2013; 33: 165-169.
  • 40. Damms-Machado A, Weser G, Bischoff S. Micronutrient deficiency in obese subjects undergoing low caloric diet. Nutr J 2012; 11: 34-43.
  • 41. Sharma SR, Poddar R, Sen P, Andrews JT. Effect of vitamin C on collagen biosynthesis and degree of birefringence in polarization sensitive optical coherence tomography (PSOCT). Afr J Biotechnol 2008; 7: 2049-2054.
  • 42. Gupta MM, Chari S. Lipid peroxidation and antioxidant status in patients with diabetic retinopathy. Indian J Physiol Pharmacol 2005; 49: 187-192.
  • 43. Shim JE, Paik HY, Shin CS, Park KS, Lee HK. Vitamin C nutriture in newly diagnosed diabetes. J Nutr Sci Vitaminol 2010; 56: 217-221.
  • 44. Rema M, Mohan V, Bhaskar A, Shanmugasundaram KR. Does oxidant stress play a role in diabetic retinopathy? Indian J Ophthalmol 1995; 43: 17-21.
  • 45. Merzouk S, Hichami A, Madani S, Merzouk H, Berrouighet AY. Antioxidant status and levels of different vitamins determined by high performance liquid chromatography in diabetic subjects with multiple complications. Gen Physiol Biophys 2003; 22: 15-27.
  • 46. Kljai K, Runje R. Selenium and glycogen levels in diabetic patients. Biol Trace Elem Res 2001; 83: 223-229.
  • 47. Kornhauser C, Garcia-Ramirez JR, Wrobel K, Perez-Luque E, Garray-Sevilla M, Wrobel K. Serum selenium and glutathione peroxidase concentration in type 2 diabetes mellitus patients. Prim Diabetes Care 2008; 64: 1.
  • 48. Bhatia S, Shukla R, Madhu SV, Gambhir JK, Prabhu KM. Antioxidant status, lipid peroxidation and nitric oxide end products in patients of type 2 diabetes mellitus with nephropathy. Clin Biochem 2003; 36: 557-562.
  • 49. Zargar AH, Bashir MI, Masoodi SR, Laway BA, Wani AI, Khan AR, Dar FA. Copper, zinc and magnesium levels in type-1 diabetes mellitus. Saudi Med J 2002; 23: 539-542.
  • 50. Babalola OO, Ojo LO, Akinleye AO. Status of the levels of lead and selected trace elements in type 2 diabetes mellitus patients in Abeokuta, Nigeria. Afr J Biochem Res 2007; 1: 127-131.
  • 51. Ugwuja EI, Nwibo AN, Ezenkwa US, Oshim AN, Nnabu RC, Ogiji ED, Ogbanshi M. Effects of diabetes complications and glycaemic control on some mineral elements in Nigerians patients with diabetes. J Diabetology 2014; 1: 1-8.
  • 52. Dosoo DK, Rana SV, Offe-Amoyaw K, Tete-Donkor D, Maddy SQ. Total antioxidant status in type 2 diabetic patients in Ghana. Diabetes Int 2000; 10: 26-27.
  • 53. Akinosun OM, Bolajoko EB. Total antioxidant status in type 2 diabetic patients: experienced at University College Hospital (UCH) Ibadan, Nigeria. Niger J Clin Pract 2007; 10: 126-129.
  • 54. Wolf SP, Dean RT. Glucose auto-oxidation and protein modification. The potential role of ‘autoxidative glycosylation’ in diabetes. J Biochem 1987; 245: 243-250.
  • 55. Giugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care 1996; 1: 257- 267.
  • 56. Low PA. The role of oxidative stress and antioxidant treatment in experimental diabetic neuropathy. Diabetes 1997; 46: 538- 542.