Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2019
Thesis Language: Turkish
Student: ERTUĞRUL DEMİREL
Supervisor: MEHMET AYHAN KARAKOÇ
Abstract:The aim of this study was to investigate the role of oxidative stress in the etiopathogenesis and the diagnosis of diabetic neuropathy. The dynamic thiol-disulfide homeostasis was chosen as the marker of oxidative stress. Our study was planned as a prospective, cross-sectional, case-control study. Participants were selected among the type 2 Diabetes Mellitus patients who have applied Gazi University Faculty of Medicine Hospital between 01.07.18 – 01.01.19. Patients were divided into 2 groups according to absence or presence of diabetic neuropathy by using The United Kingdom Screening Test. 36 Patients with neuropathy and 29 without neuropathy were included in the study. Demographic data of the patients were recorded during the physical examination. Biochemical data were noted from Gazi University Hospital System. Total thiol, native thiol levels were measured from serum samples and disulfide levels, disulfide /total thiol, native thiol /total thiol and disulfide /native thiol levels were calculated. No significant difference was found between the groups in terms of age, BMI, presence of hypertension, diabetes duration and diabetes treatment(p=0,149/ 0,322/0,209/0,523; respectively). Also HbA1c, Fasting Blood Sugar, BUN, Creatinine, AST, ALT, Total Cholesterol, Triglyceride, LDL, HDL levels were 78 similar(p=0,630/ 0,915/ 0,353/ 0,156/ 0,579/ 0,812/ 0,054/ 0,668/ 0,069/ 0,447/ 0,372; respectively). Although, there was no significant difference in total thiol, disulphide levels and native thiol/total thiol, disulphide/total thiol, disulphide/native thiol ratios between the patients with and without neuropathy(p=0,868/ 0,316/ 0,170/ 0,136/ 0,170; respectively), native thiol levels were found lower in neuropathy group(p= 0,041). Because of the gender inequality, native thiol levels tested in terms of gender and neuropathy presence by using two way variance analysis. As result of the analysis, a significant difference was observed in native thiol levels according to gender(p = 0.035) while no difference was founded according to neuropathy(p= 0.07). In our study, there was no significant difference in the dynamic thiol-disulfide balance between neuropathic and non-neuropathic diabetes patients. This may be associated by variety in pathological mechanisms and that shows us in formation of diabetic neuropathy oxidative damage is insufficent to explain pathognesis, alone. We found that thiol-disulphide homeostasis is not a beneficial marker in the diagnosis of diabetic neuropathy. In addition, females had lower levels of native thiol than males. Low native thiol levels in women with DM suggest that female patients with type 2 diabetes may be more susceptible to oxidative stress than male patients.