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Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 diabetes mellitus

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Abstract

Purpose

Hyperglycemia and glycemic variability (GV) are associated with oxidative stress in patients with diabetes mellitus (DM). Oxysterol species, produced by the non-enzymatic oxidation of cholesterol, are potential biomarkers of oxidative stress. This study examined the relationship between auto-oxidized oxysterols and GV in patients with type 1 DM.

Methods

Thirty patients with type 1 DM using a continuous subcutaneous insulin infusion pump therapy and a healthy control group (n = 30) were included in this prospective study. A Continuous Glucose Monitoring System device was applied for 72 h. Blood samples were taken for oxysterols produced by non-enzymatic oxidation [7-ketocholesterol (7-KC) and cholestane-3β, 5α, 6β-triol (Chol-Triol)] levels at 72 h. Short-term glycemic variability parameters, mean amplitude of glycemic excursions (MAGE), the standard deviation of glucose measurements (Glucose-SD), and mean of daily differences (MODD) were calculated with continuous glucose monitoring data. HbA1c was used to evaluate glycemic control and HbA1c-SD (the SD of HbA1c over the past year) for long-term glycemic variability.

Results

7-KC and Chol-triol levels were significantly higher in the study group than in the control group. Strong positive correlations were found between 7-KC with MAGE(24–48 h) and Glucose-SD(24–48 h). 7-KC was positively correlated with MAGE(0–72 h) and Glucose-SD(0–72 h). No significant correlation was found between HbA1c and HbA1c -SD with oxysterol levels. The regression models showed that SD(24–48 h) and MAGE(24–48 h) predicted 7-KC levels while HbA1c did not.

Conclusions

Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 DM independent of long-term glycemic control.

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The data are available on request from the authors.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. A. Samadi

    Present address: Joint Laboratory of Applied Ecotoxicology, Korea Institute of Science and Technology Europe, KIST EU), Campus 7.1, 66123, Saarbrucken, Germany

  2. U. Ünlütürk and A. B. Bahçecioğlu contributed equally to this work.

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey

    U. Ünlütürk, M. Bayraktar & S. Dağdelen

  2. Department of Internal Medicine, Hacettepe University, Ankara, Turkey

    U. Ünlütürk, A. B. Bahçecioğlu, M. Bayraktar & S. Dağdelen

  3. Department of Medical Biochemistry, School of Medicine, Hacettepe University, Ankara, Turkey

    A. Samadi & İ. Lay

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  1. U. Ünlütürk
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Contributions

UÜ and ABB: conception and design of the work, analysis, and interpretation of data, drafting the manuscript. AS and İL: performing biochemical analyses in the laboratory and revising the manuscript. MB and SD: conception and design of the work, analysis and interpretation of data, and revising the manuscript.

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Correspondence to U. Ünlütürk.

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This research involves human participants. Ethical approval has been obtained from the ethical committee of Hacettepe University (Project number: 16969557-271).

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Ünlütürk, U., Bahçecioğlu, A.B., Samadi, A. et al. Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 diabetes mellitus. J Endocrinol Invest 46, 2547–2554 (2023). https://doi.org/10.1007/s40618-023-02110-7

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