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Antioxidant status, oxidative stress and DNA damage in the aetiology of malnutrition related diabetes mellitus.

Undernutrition is a preeminent feature of the two major clinical syndromes, protein dependent diabetes mellitus (PDDM) and fibrocalculous pancreatic diabetes (FCPD) that has been grouped together under the term malnutrition related diabetes mellitus (MRDM).[l] Although, MRDM represents only a few percent of the world population suffering from diabetes, it is a major health problem within developing countries. Investigation of these forms of the disease indicates that a genetic predisposition cannot be clearly established, and several hypotheses related to dietary-deficiency and environmental chemical exposure have been proposed. Oxidative stress induced by oxygen free radicals has been implicated in the pathogenesis of many human diseases in recent years.[2] It is becoming increasingly plausible that antioxidant deficiency leading to the exposure of pancreatic B-cells to increased oxidative stress may be implicated in the aetiology and pathogenesis of MRDM. increased oxidative stress (a high prooxidant/antioxidant ratio) which is based on evidence of increased lipid peroxidation and reduced antioxidant reserve.[3] A deficiency in the nutritional supply and availibility of antioxidants which may occur in MRDM may have consequences in terms of failure of the first line of defence against oxygen radical induced damage.[4] The aim of the study was to assess the antioxidant status and levels of oxidative stress and DNA damage in malnourished patients displaying PDDM (n=24), FCPD (n=14), non-insulin dependent diabetes mellitus (NIDDM) (n=46), and age matched controls (n=67). All diabetic patients were under 30 years and newly diagnosed to avoid complicating variables such as insulin therapy and control subjects were matched for age, BMI and socioeconomic status. Plasma vitamins A, C, and E were measured by HPLC [5,6], whilst antioxidant enzymes in red cell concentrate were measured on the Cobas Fara autoanalyser[7-10]. DNA damage within nucleated blood cells was measured using a sensitive ELISA.[11]