Estrés oxidativo en familiares sanos de pacientes diabéticos tipo 2 y con síndrome metabólico

RESUMEN  Introduccion : El estres oxidativo, (imbalance entre la produccion de los radicales libres generados por el metabolismo aerobico, y los mecanismos antioxidantes que los contrarrestan), ha sido implicado como mecanismo fundamental en la aparicion de disfuncion endotelial, resistencia a la insulina, diabetes mellitus tipo 2 (DM2) y el desarrollo de enfermedad cardiovascular.  Objetivo : evaluar si existia o no evidencia de estres oxidativo, mediante la identificacion de malonildialdehido serico (MDA), como producto de peroxidacion lipidica, en sujetos sanos con antecedentes de DM2 y comparar los resultados con los de sujetos sanos sin antecedentes de DM2 y con los de individuos con sindrome metabolico (SM). Evaluamos 74 personas de ambos sexos, entre 15 y 50 anos de edad, divididos en 3 grupos. 1-Control de sanos (26), 2- Sanos con familiares con DM 2 (29) , 3- SM (19). Determinamos aspectos clinicos y de laboratorio: IMC, circunferencia abdominal, glicemia, colesterol, HDL-c, LDL-c, colesterol no HDL, trigliceridos, insulina, HOMA, BUN, creatinina, PCR y MDA.  Resultados : los valores de MDA fueron significativamente mayores en el grupo de individuos con SM. No hubo diferencia significativa entre los individuos sanos y los sanos con familiares DM2, a pesar de que en estos ultimos, los valores fueron mas elevados. Niveles disminuidos de HDL-c se correlacionaron debilmente en forma inversa con los niveles de MDA. Los valores de PCR fueron mayores en los pacientes con SM, pero no hubo diferencias con los grupos de personas normales. Conclusiones: los pacientes con SM presentaron en forma precoz, evidencia de estres oxidativo elevado, aun antes de la elevacion de biomarcadores de inflamacion como la PCR. No pudimos demostrar evidencia de estres oxidativo en individuos sanos con familiares DM2.  ABSTRACT  Background : oxidative Stress, (Imbalance between the production of free radicals, generated by aerobic metabolism, and the antioxidant mechanisms that resists them), has been implied as a fundamental mechanism in the appearance of endothelial disfunction, insulin resistance, diabetes mellitus 2 (DM2) and the development of cardiovascular disease.  Objective : to evaluate if there is any evidence of oxidative stress by means of the seric malondialdehyde (MDA) identification, as a biomarker product of lipid peroxidation, in healthy subjects with a family history of DM2 and compare the results with those of healthy subjects without this history, as well in individuals with Metabolic syndrome. There were evaluated 74 subjects between 15 and 50 years old, who were divided in 3 groups. 1-Healthy (26). 2-Healthy with relatives with DM 2 (29). 3- MS (19). We determined clinical aspects and of laboratory: BMI, abdominal circumference, glucose, cholesterol, HDL-c, LDL-c, non-HDL cholesterol, triglycerides, insulin, HOMA, BUN, creatinine, C-Reactive Protein (CRP) and MDA.  Results : The values of MDA were significantly higher in the group of individuals with MS. There was no significant difference between the healthy individuals and the healthy ones with relatives DM2, although in the the last group, values were high. Low levels of HDL-c correlated inversely and weakly with the MDA levels. The levels of CRP were higher in the patients with MS but there were no significant differences with the group of healthy individuals. Conclusions: Patients with MS presented early evidence of elevated oxidative stress, even before a significant elevation of inflammation biomarkers like the CRP occured. We could not demonstrate evidence of oxidative stress in healthy individuals with diabetic relatives