# Association of Oxidative Stress Markers with Cardio-Kidney-Metabolic Parameters and Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus

## TL;DR

This study explores how oxidative stress and inflammation relate to kidney function and cardiovascular disease in type 2 diabetes patients.

## Contribution

The study identifies oxidative stress markers as potential predictors of cardiovascular outcomes in type 2 diabetes.

## Key findings

- NOx was an independent predictor of estimated glomerular filtration rate.
- MPO was correlated with glycated hemoglobin, CRP, and serum albumin.
- Smoking and MPO were independent predictors of the composite outcome of death or cardiovascular event.

## Abstract

We aimed to investigate the association between oxidative stress (OS), inflammation, and kidney function and the predictive ability of OS for mortality and cardiovascular disease in 143 patients with type 2 diabetes (T2DM) and various degrees of kidney function. At baseline, we assessed catalase, nitrogen oxides (NOx), malondialdehyde (MDA), advanced oxidation products (AOPPs), myeloperoxidase (MPO)], kidney function, and C-reactive protein (CRP). All patients were followed for 57 months, with the combined primary outcome of death/cardiovascular (CV) event, whichever occurred first. NOx was an independent predictor of estimated glomerular filtration rate (B = −0.097, p = 0.006), and MPO was correlated with glycated hemoglobin (r = 0.17, p = 0.046), CRP (r = −0.18, p = 0.032), and serum albumin (r = 0.2, p = 0.011, Spearman’s rho). During the follow-up, 24 composite events were documented. Kaplan–Meier curves showed that smoking (p = 0.029), serum albumin (p = 0.014), and MPO (p = 0.024, log-rank test) were associated with the outcome. In multivariate Cox regression models, smoking and MPO were independent predictors of the composite outcome (hazard ratio—HR = 2.8, p = 0.004, 955 confidence interval—CI 1.05–7.5 and HR = 0.99, p = 0.015, 95% CI: 0.98–1.00, respectively), after adjustment for several cofactors. OS might be associated with CV disease in T2DM.