Oxysterol species: reliable markers of oxidative stress in diabetes mellitus



To assess the plasma oxysterol species 7-ketocholesterol (7-Kchol) and cholestane-3β,5α,6β-triol (chol-triol) as biomarkers of oxidative stress in type 1 and type 2 diabetes mellitus (DM).


In total, 26 type 1 and 80 type 2 diabetes patients, along with 205 age- and gender-matched healthy controls, were included in this study. Oxysterols were quantified by liquid chromatography coupled with tandem mass spectrometry and N,N-dimethylglycine derivatization. Correlations between oxysterols and clinical/biochemical characteristics of the diabetes patients, and factors affecting 7-Kchol and chol-triol, were also determined.


Plasma 7-Kchol and chol-triol levels were significantly higher in type 1 and type 2 diabetes patients compared to healthy controls (P < 0.001). Significant positive correlations were observed between oxysterol levels and levels of glycated hemoglobin (HbA1c), glucose, serum total cholesterol, low-density lipoprotein, very-low-density lipoprotein, and triglycerides, as well as the number of coronary risk factors. Statins, oral hypoglycemic agents, and antihypertensive agents reduced the levels of oxysterols in type 2 diabetes patients. Statin use, HbA1c levels, and the number of coronary risk factors accounted for 98.8% of the changes in 7-Kchol levels, and total cholesterol, smoking status, and the number of coronary risk factors accounted for 77.3% of the changes in chol-triol levels in type 2 diabetes patients.


Plasma oxysterol levels in DM, and particularly type 2 DM, may yield complementary information regarding oxidative stress for the clinical follow-up of diabetes patients, especially those with coronary risk factors.

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This study was supported by a grant from Hacettepe University Scientific Research Projects Coordination Unit (Project No: THD 201610908), Ankara, Turkey.

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Conceived, designed the study IL, AG. Wrote the paper IL, AS. Evaluated the patients SNS, AG. Performed the experiments AS, IL. Analyzed the data SK, AS, IL, AG, SNS. Contributed reagents/materials IL, FA.

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Correspondence to I. Lay.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study protocol adhered to the Declaration of Helsinki Guidelines and was approved by the Ethics Committee of Hacettepe University (GO 15/662).

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Informed consent was obtained from each study participant.

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Samadi, A., Gurlek, A., Sendur, S.N. et al. Oxysterol species: reliable markers of oxidative stress in diabetes mellitus. J Endocrinol Invest 42, 7–17 (2019). https://doi.org/10.1007/s40618-018-0873-5

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  • Oxysterols
  • Diabetes mellitus
  • Oxidative stress
  • LC–MS/MS
  • Tandem mass spectrometry