Erythrocyte oxidative stress in clinical management of diabetes and its cardiovascular complication: A review

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Abstract

Diabetes mellitus is a chronic disease in its own capacity, but it is also regarded as both a cardiovascular risk factor as well as a cardiovascular disease due to its propensity to progress to a stage of cardiovascular co-morbidity. The pathophysiology of cardiovascular complication in diabetes has been consistently reported to involve hyperglycaemia-induced oxidative stress. The erythrocyte has an array of endogenous antioxidants involved in quenching both oxidant production and the exponential chain reactions in diabetes. When the erythrocyte is oxidatively stressed, evidenced by depleted level of reduced glutathione and/or increased malondialdehyde in the erythrocyte membrane, the risk of diabetes progression and its cardiovascular sequelae including atherosclerosis and coronary artery disease become exacerbated. Virtually all studies that determined erythrocyte malondialdehyde and glutathione in diabetes have shown consistent increased and reduced levels respectively. Furthermore, cardiovascular complication of diabetes has been reported to commence at the prediabetes stage. Current coronary artery disease screening programs based on the presence of two or more risk factors being present are failing to identify optimal numbers with increased risk of diabetes and cardiovascular complications, thereby limiting early interventions. Screening that includes erythrocyte oxidative stress determination may provide an additional marker for both preclinical and advanced disease. In this review, a concise description of erythrocyte oxidative stress involvement in diabetes mellitus and its cardiovascular sequelae is presented. Antioxidant action and interaction within the erythrocyte is also described with emphasis on why current coronary artery disease screening markers do not extrapolate to the erythrocyte oxidative stress markers.
Original languageEnglish
Pages (from-to)35-43
Number of pages9
JournalBritish Journal of Biomedical Science
Volume64
Issue number1
Publication statusPublished - 2007

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