Evaluation of Plasma Malondialdehyde as a Predictive Biomarker for Oxidative Stress in Patients with Type 2 Diabetes Mellitus: A Case-Control Study.

Dr. G. N. ] Pradeep; Dr. T. Pavani  Kiranmai

doi:10.51168/sjhrafrica.v7i3.2492

Authors

Dr. G. N. Pradeep Senior Resident, Department of Biochemistry, Government Medical College, Mahabubabad, Telangana, India
Dr. Thandu Pavani Kiranmai Associate Professor, Department of Biochemistry, Government Medical College, Suryapet, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2492

Keywords:

Type 2 diabetes mellitus, oxidative stress, malondialdehyde, lipid peroxidation, Glycated hemoglobin, Receiver operating characteristic curve

Abstract

Background:

Type 2 diabetes mellitus is frequently accompanied by oxidative stress driven by sustained hyperglycemia. Malondialdehyde (MDA), an end-product of lipid peroxidation, can serve as a surrogate marker of systemic oxidative damage.

Objectives:

To estimate plasma MDA and HbA1c levels in adults with type 2 diabetes mellitus and to compare these values with those of healthy controls, and to examine the association between MDA and glycemic status.

Methods:

A hospital-based case-control study was conducted at Government General Hospital, Suryapet, from July 2024 to September 2024. Sixty adults with clinically diagnosed type 2 diabetes mellitus (duration 2-5 years; age 30-60 years) and sixty age- and sex-matched apparently healthy controls were enrolled. Fasting venous blood was collected in EDTA vacutainers. Plasma MDA was quantified using a sandwich ELISA method, and HbA1c was measured by an enzymatic method on an automated analyzer. Group comparisons, Pearson correlation, and ROC analysis were performed.

Results:

Mean HbA1c was significantly higher in cases than controls (8.59 ± 1.72% vs 5.45 ± 0.29%; p<0.00001). Plasma MDA was also markedly elevated in cases compared with controls (12.57 ± 2.61 nmol/mL vs 5.92 ± 0.67 nmol/mL; p<0.00001). Among cases, plasma MDA showed a strong positive correlation with HbA1c (r=0.9155; p<0.00001). ROC analysis demonstrated excellent discrimination between cases and controls, with an area under the curve of 0.989. The optimal MDA cutoff of 8.3 nmol/mL showed 98.3% sensitivity and 100% specificity.

Conclusion:

Plasma MDA demonstrated a strong association with glycemic status and excellent diagnostic performance for identifying oxidative stress among adults with type 2 diabetes mellitus. Routine MDA assessment could complement glycemic monitoring for early risk stratification of oxidative complications.

Recommendations:

Optimise glycaemic control and incorporate periodic plasma MDA assessment alongside HbA1c in T2DM follow-up.

Author Biographies

Dr. G. N. Pradeep, Senior Resident, Department of Biochemistry, Government Medical College, Mahabubabad, Telangana, India

completed his MBBS from Pondicherry Institute of Medical Sciences, Puducherry (2013) and obtained his MD in Biochemistry from Government Medical College, Suryapet, Telangana (2025). He is currently serving as a Senior Resident at Government Medical College, Mahabubabad. His academic and clinical interests include metabolic diseases, glycaemic biomarkers, and oxidative stress–related mechanisms in diabetes mellitus, with a focus on translating laboratory markers into clinically meaningful risk stratification. ORCiD: https://orcid.org/0009-0005-0047-7778

Dr. Thandu Pavani Kiranmai, Associate Professor, Department of Biochemistry, Government Medical College, Suryapet, Telangana, India

completed her MBBS from Kamineni Institute of Medical Sciences, Narketpally, Nalgonda (2010), and obtained her MD in Biochemistry from Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad (2015). She subsequently pursued Senior Residency at Niloufer Hospital, Osmania Medical College, Hyderabad. Her academic interests focus on clinical biochemistry, metabolic disorders, and biomarker-based evaluation of disease processes, with particular emphasis on oxidative stress–related pathways. She has published research in both national and international peer-reviewed journals and has actively contributed to academic forums, including chairing scientific sessions at national conferences. ORCID iD: https://orcid.org/0009-0002-4739-2825

References

Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843. doi:10.1016/j.diabres.2019.107843. PMID:31518657.

Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865):813-820. doi:10.1038/414813a. PMID:11742414.

Giacco F, Brownlee M. Oxidative stress and diabetic complications. Circ Res. 2010;107(9):1058-1070. doi:10.1161/CIRCRESAHA.110.223545. PMID:21030723.

Hameed I, Masoodi SR, Mir SA, Nabi M, Ghazanfar K, Ganai BA. Type 2 diabetes mellitus: from a metabolic disorder to an inflammatory condition. World J Diabetes. 2015;6(4):598-612. doi:10.4239/wjd.v6.i4.598. PMID:25987957.

Bhatti JS, Sehrawat A, Mishra J, et al. Oxidative stress in the pathophysiology of type 2 diabetes and related complications: current therapeutic strategies and future perspectives. Free Radic Biol Med. 2022;184:114-134. doi:10.1016/j.freeradbiomed.2022.03.007. PMID:35398495.

Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress: a concise review. Saudi Pharm J. 2016;24(5):547-553. doi:10.1016/j.jsps.2015.03.013. PMID:27752226.

Ayala A, Munoz MF, Arguelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev. 2014;2014:360438. doi:10.1155/2014/360438. PMID:24999379.

Kesavulu MM, Giri R, Kameswara Rao B, Apparao C. Lipid peroxidation and antioxidant enzyme levels in type 2 diabetics with microvascular complications. Diabetes Metab. 2000;26(5):387-392. PMID:11119018.

Likidlilid A, Patchanans N, Peerapatdit T, Sriratanasathavorn C. Lipid peroxidation and antioxidant enzyme activities in erythrocytes of type 2 diabetic patients. J Med Assoc Thai. 2010;93(6):682-693. PMID:20572373.

Goodarzi MT, Varmaziar L, Navidi AA, Parivar K. Study of oxidative stress in type 2 diabetic patients and its relationship with glycated hemoglobin. Saudi Med J. 2008;29(4):503-506. PMID:18382788.

Nakhjavani M, Esteghamati A, Nowroozi S, Asgarani F, Rashidi A, Khalilzadeh O. Type 2 diabetes mellitus duration: an independent predictor of serum malondialdehyde levels. Singapore Med J. 2010;51(7):582-585. PMID:20730399.

D'Souza JMP, D'Souza RP, Vijin VF, et al. High predictive ability of glycated hemoglobin on comparison with oxidative stress markers in assessment of chronic vascular complications in type 2 diabetes mellitus. Scand J Clin Lab Invest. 2016;76(1):51-57. doi:10.3109/00365513.2015.1092048. PMID:26494020.

American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S20-S42. doi:10.2337/dc24-S002. PMID:38078589; PMCID: PMC10725812.

International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327-1334. doi:10.2337/dc09-9033. PMID:19502545.