The association of oxidative stress biomarkers with type 2 diabetes mellitus: A systematic review and meta-analysis

Abstract

Background and Aims: Oxidative stress plays a major role in the development of type 2 diabetes mellitus (T2DM). However, there were controversial outcomes in the literature between the association of oxidative stress biomarkers and T2DM. The purpose of this systematic review and meta-analysis was to critically examine the association of oxidative stress biomarkers with T2DM. Methods: We systematically searched different electronic databases including PubMed/Medline, EMBASE, ScienceDirect, Web of Science, and Cochrane Library to find the relevant studies up to May 2021. The pooled standard mean difference (SMD) with a 95% confidence interval (CI) was used to define the variation between the study groups. Results: A total of 22 case-control studies with 2853 subjects (1667 diabetic patients and 1186 healthy controls) were found to be eligible for this meta-analysis. The pooled results of meta-analysis showed a significant difference in the levels malondialdehyde (SMD [95% CI]: 2.27 [1.62, 2.91]), nitric oxide (SMD [95% CI]: 1.40 [0.00, 2.81]), glutathione (SMD [95% CI]: −1.76 [−2.94, −0.59]), and total antioxidant status (SMD [95% CI]: −1.40 [−2.28, −0.51]) between the patient group and healthy subjects, whereas no significant difference was observed in the superoxide dismutase levels (SMD [95% CI]: −1.20 [−2.55, 0.15]) and glutathione peroxidase levels (SMD [95% CI]: 0.07 [−2.80, 2.94]). Conclusion: The present analysis suggests that oxidative stress might have a potential role in the pathogenesis of T2DM in humans. However, further studies should be needed to elucidate the possible mechanism and strengthen this evidence.