Assessment of levels of selected trace elements as predictors of oxidative stress in type 2 diabetic patients using Multivariate Statistical Analysis

Disturbances in levels of trace elements and oxidative stress are associated with the glycemic status, which is implicated in the development and progression of diabetes. The present study was conducted on 50 patients with type 2 diabetes, 40 years of age, gender and body mass index matched with healthy controls (Damanhur Educational Hospital, El Beheira, Egypt). Fasting blood glucose (FBG), serum catalase, paraoxonase activity, and malondialdehyde (MDA) levels were measured spectrophotometrically. The blood serum was digested and then used to determine the levels of seven trace elements, such as Cr, Fe, Cu, Zn, Cd, As and Se, using inductive coupled plasma mass spectroscopy (ICP-MS). The mean of serum catalase, paraoxonase activities and the concentration of Fe, Se, Zn, and Cd were significantly decreased, whereas the level of malondialdehyde (MDA) and the concentrations of Cu, Cd and As were significantly higher in type 2 diabetic group compared with the control group. The multivariate receiver operating characteristic (ROC) curve and variable importance in projection (VIP) scores were used to analysis the data. VIP score revealed that As, Fe and Se were strongly associated with the oxidative stress in type 2 diabetic patients. The best cut-off values for serum concentrations of Fe, Se and As were 46.78, 215 and 1.01 μg L-1, respectively, which discriminated between diabetic patients with oxidative stress from the control group. The study showed that changes in trace element concentrations in diabetic patients may contribute to the lowering of antioxidant enzymes t, further leading to the progress of T2DM.