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Comparison of catalase, glutathione peroxidase and malondialdehyde levels in tears among diabetic patients with and without diabetic retinopathy

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Abstract

Background

Various studies suggest that oxidative stress has a role in the etiology of diabetes mellitus (DM) and its complications. Detection of antioxidant enzymes and malondialdehyde (MDA) level in ocular fluid may provide the possible biomarkers for monitoring the progression of diabetic retinopathy (DR). The aim of this study was to compare catalase, glutathione peroxidase (GPx) and MDA levels in tears among diabetic patients with and without DR.

Methods

A cross-sectional study was conducted among type 2 DM patients. The patients were divided into three groups: no DR, non-proliferative DR (NPDR) and proliferative DR (PDR). Tears samples were collected using Schirmer strips for measurement of catalase, GPx and MDA.

Results

A total of 171 patients were recruited in this study (no DR, 58 patients; NPDR, 57 patients; PDR, 56 patients). There was significant difference in the mean level of GPx in tears between the three groups (no DR, 658.08 ± 115.70 U/L; NPDR, 653.78 ± 87.90 U/L; PDR, 605.31 ± 107.47 U/L, respectively) before and after adjustment for covariates (p = 0.013 and p = 0.001, respectively). Bonferroni post-hoc analysis showed PDR group had significantly lower mean GPx level than in no DR (p=0.001) and NPDR (p=0.037) after adjustment for covariates. There was no significant difference of mean catalase and MDA in the tears between the three groups before and after adjustment for covariates.

Conclusion

This study demonstrated that diabetic patient with DR is associated with low level of GPx in tears, suggesting that this antioxidant enzyme is a potential biomarker for predicting the presence of DR.

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All the data and materials are contained within the manuscript.

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Acknowledgements

The authors thank staff from Immunology Lab, School of Medical Sciences, Universiti Sains Malaysia, for their technical assistance for this study. A special thanks to Dr Wan Nor Ariffin Wan Mansor, Biostatistics and Research Methodology Unit, Universiti Sains Malaysia, for his assistance and advice of the statistical analysis.

Funding

This research was partially supported by Research University Grant from Universiti Sains Malaysia (grant no: 1001/PPSP/812194).

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

    Kiu Kwong-Han & Embong Zunaina

  2. Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia

    Embong Zunaina

  3. Department of Ophthalmology, Hospital Selayang, 68100, Batu Caves, Selangor, Malaysia

    Hashim Hanizasurana

  4. Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

    Abd Aziz Che-Badariah

  5. Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

    Che Hussin Che-Maraina

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  1. Kiu Kwong-Han
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  2. Embong Zunaina
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Contributions

KKH: Conceptualization, data curation, formal analysis, methodology, writing—original draft. EZ: Conceptualization, data curation, formal analysis, funding acquisition, methodology, writing—review & editing, supervision, project administration. HH: Conceptualization, formal analysis, methodology, supervision. AACB: Conceptualization, data curation, formal analysis, methodology, supervision. CHCM: Conceptualization, data curation, formal analysis, methodology, supervision.

Corresponding author

Correspondence to Embong Zunaina.

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Ethics approval

The study was approved by the Institutional Review Board (IRB) of Universiti Sains Malaysia (USM) [ref: USM/ Jawatankuasa Etika Penyelidikan Manusia (JEPeM)/276.2. (4)] and followed the tenets of the declaration of Helsinki. Written and informed consent of participants was obtained for each patient prior to the study.

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All authors approved the manuscript for publication.

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The authors declare that they have no competing interests.

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Kwong-Han, K., Zunaina, E., Hanizasurana, H. et al. Comparison of catalase, glutathione peroxidase and malondialdehyde levels in tears among diabetic patients with and without diabetic retinopathy. J Diabetes Metab Disord 21, 681–688 (2022). https://doi.org/10.1007/s40200-022-01030-2

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