Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 diabetes mellitus


ÜNLÜTÜRK U., Bahçecioğlu A., Samadi A., LAY İ., BAYRAKTAR M., DAĞDELEN S.

Journal of Endocrinological Investigation, vol.46, no.12, pp.2547-2554, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 46 Issue: 12
  • Publication Date: 2023
  • Doi Number: 10.1007/s40618-023-02110-7
  • Journal Name: Journal of Endocrinological Investigation
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE
  • Page Numbers: pp.2547-2554
  • Keywords: Glycemic variability, Mean amplitude of glycemic excursions, Mean of daily differences, Oxidative stress, Oxysterol, Type 1 diabetes mellitus
  • Hacettepe University Affiliated: Yes

Abstract

Purpose: Hyperglycemia and glycemic variability (GV) are associated with oxidative stress in patients with diabetes mellitus (DM). Oxysterol species, produced by the non-enzymatic oxidation of cholesterol, are potential biomarkers of oxidative stress. This study examined the relationship between auto-oxidized oxysterols and GV in patients with type 1 DM. Methods: Thirty patients with type 1 DM using a continuous subcutaneous insulin infusion pump therapy and a healthy control group (n = 30) were included in this prospective study. A Continuous Glucose Monitoring System device was applied for 72 h. Blood samples were taken for oxysterols produced by non-enzymatic oxidation [7-ketocholesterol (7-KC) and cholestane-3β, 5α, 6β-triol (Chol-Triol)] levels at 72 h. Short-term glycemic variability parameters, mean amplitude of glycemic excursions (MAGE), the standard deviation of glucose measurements (Glucose-SD), and mean of daily differences (MODD) were calculated with continuous glucose monitoring data. HbA1c was used to evaluate glycemic control and HbA1c-SD (the SD of HbA1c over the past year) for long-term glycemic variability. Results: 7-KC and Chol-triol levels were significantly higher in the study group than in the control group. Strong positive correlations were found between 7-KC with MAGE(24–48 h) and Glucose-SD(24–48 h). 7-KC was positively correlated with MAGE(0–72 h) and Glucose-SD(0–72 h). No significant correlation was found between HbA1c and HbA1c -SD with oxysterol levels. The regression models showed that SD(24–48 h) and MAGE(24–48 h) predicted 7-KC levels while HbA1c did not. Conclusions: Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 DM independent of long-term glycemic control.