Serum lipid peroxidation potential as a biomarker for risk-stratification of coronary artery disease in patients with type 2 diabetes mellitus

We examined the serum lipid peroxidation potential as an estimate of systemic oxidative stress levels in people with type 2 diabetes (T2D) for coronary artery disease (CAD) risk stratification. We prospectively recruited patients and categorized them into four subgroups based on diabetes and severity of CAD [Gensini score 20, significant CAD]: non-diabetics with non-significant CAD, diabetics with non-significant CAD, non-diabetics with significant CAD and diabetics with significant CAD. Lipid profile, HbA1c, fasting blood glucose, and oxidized LDL were assessed. A newly developed assay estimated serum lipid peroxidation potential. Circulatory oxidized LDL levels were significantly higher in patients with severe CAD compared to non-diabetics with non-significant CAD, however no significant differences were observed across the four subgroups. Diabetics with non-significant CAD demonstrated significantly elevated serum lipid peroxidation potential compared to non-diabetics with non-significant CAD. Intriguingly, serum lipid peroxidation potential was markedly elevated in diabetics with non-significant CAD compared to both diabetics and non-diabetics with significant CAD. Poor glycemic control and reduced blood total antioxidant capacity were the primary factors contributing to increased serum lipid peroxidation potential in diabetics with non-significant CAD group. We found that people with T2D who are associated with non-significant CAD are more vulnerable to oxidative stress than those with significant CAD. The study demonstrates the application of 'serum lipid peroxidation potential' assay for risk-stratification of CAD in people with T2D. •People with type 2 diabetes who have non-severe coronary artery disease are more vulnerable to oxidative stress.•Serum lipid peroxidation potential is a valuable marker for coronary artery disease risk assessment in diabetics.•The developed assay is sensitive, low-cost, and easily implementable in routine clinical practice.