Zitouni, Karima; (2005) Ethnic differences in antioxidant defence in patients with type 2 diabetes. Doctoral thesis , UCL (University College London).

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Abstract

Objective: Throughout the Western World, the incidence of end-stage renal disease (ESRD) due to diabetes mellitus is 4-6 times greater in patients of Afro-Caribbean origin compared with Caucasians. The mechanism of increased susceptibility to renal failure in patients of Afro-Caribbean origin is poorly understood. Even after adjusting for the higher prevalence of diabetes and hypertension. An increase in oxidative stress is considered to promote the development of long-term complications in diabetes mellitus. This may be a factor in the increased susceptibility to nephropathy in patients of Afro-Caribbean compared with Caucasians in the United Kingdom. The objective of this study was to examine the plasma antioxidant defence system in relation to the presence or absence of microalbuminuria and smoking habits in Afro-Caribbean patients and Caucasians. Studied population: Type 2 diabetic patients (n=80; Afro-Caribbean: n=35 and Caucasian: n= 45) with mean age of 65 years and mean duration of diabetes of 14.2 years, were recruited. Of these patients, 46 patients had normoalbuminuria and 34 patients had microalbuminuria. Results: Afro-Caribbean patients exhibited lower vitamin E, glutathione and total thiols Compared to Caucasian patients. Afro-Caribbean patients also showed higher superoxide dismutase and lower glutathione peroxidase activities compared to Caucasian patients. Plasma dehydroascorbate was elevated in the Afro-Caribbean patients when compared to Caucasians. Total antioxidant capacity as assessed by HOCl and O2- quenching of pholasin chemilumenescence was elevated in the Afro-Caribbean patients compared to Caucasians. Conclusions: Overall this study has revealed that African descent is a determinant of impaired antioxidant defence systems. Lower vitamin E, glutathione and total thiol levels that simultaneously coincided with elevated dehydroascorbate levels and increased SOD and lower GPx activities suggests that Africans experience enhanced oxidative stress compared with Caucasians. These findings may partially explain the increased susceptibility of Afro-Caribbean diabetic patients to kidney failure compared to Caucasians.

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