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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 5 Issue 5, July-August 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1380
Comparative Studies of Diabetes in Adult Nigerians:
Lipid Profile and Antioxidants Vitamins (A and C)
Egejuru, Leonard O1
; Akubugwo, Emmanuel I2
; Ugorji, Beatrice N3
1,3
Ministry of Health, Owerri, Nigeria
2
Department of Biochemistry, Abia State University, Uturu, Nigeria
ABSTRACT
Diabetes mellitus affects the metabolism of carbohydrates and fats
which if not properly managed will alter the lipid profile and
antioxidant vitamins of the body system. However information on the
extend and health consequences of these, are scarce in Nigeria. This
study compared the lipid profile and some antioxidant vitamins in
diabetics and apparently healthy adults were conducted in Imo State
Nigeria. Standard protocols were followed for all determination of
samples obtained from patients at two major tertiary health
institutions in the state. The mean fasting blood sugar (FBS)
concentrations of the experimental group were 8.36±1.1mmol/L for
males, 9.75±0.5mmol/L for females while the control was
4.8±0.44mmol/L for both sexes. Majority of subjects with diabetes
were within the ages of 40years and above. Dyslipidemia was higher
among diabetic patients compared to control, while there were
significant increases in low density lipoprotein cholesterol (LDL),
triglyceride (TG) and reduction in high density lipoprotein
cholesterol (HDL) compared to the controls. Also there were
significant reductions in antioxidant vitamins C and E of the
experimental groups compared to the controls (P > 0.05).
Antioxidants maybe a prospect in the treatment/ management of
diabetes. More robust studies are needed to further confirm these
findings and identify other causes.
KEYWORDS: diabetes mellitus, dyslipidemia, antioxidant vitamin,
fasting blood sugar
How to cite this paper: Egejuru,
Leonard O | Akubugwo, Emmanuel I |
Ugorji, Beatrice N "Comparative Studies
of Diabetes in Adult Nigerians: Lipid
Profile and Antioxidants Vitamins (A
and C)" Published
in International
Journal of Trend in
Scientific Research
and Development
(ijtsrd), ISSN: 2456-
6470, Volume-5 |
Issue-5, August
2021, pp.1380-1384, URL:
www.ijtsrd.com/papers/ijtsrd45021.pdf
Copyright © 2021 by author (s) and
International Journal of Trend in
Scientific Research and Development
Journal. This is an
Open Access article
distributed under the
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
INTRODUCTION
Diabetes mellitus (DM) refers to a group of metabolic
diseases in which there are high levels of blood sugar
over prolong period. The common symptoms of
diabetes include polyuria, increased thirst and hunger
(WHO, 2014). It results in aberration in
carbohydrates, fats, and protein metabolism, which
arise due to defects in insulin secretion, and/or actions
(Ejike et al., 2015). DM is currently a very prevalent
disease, especially in Africa (Bos and Agyemang,
2013). Diabetes if left untreated can cause many
complications which include diabetic ketoacidosis,
hyperosmolar hyperglycemic state or death. Other
long term complications includes cardiovascular
diseases, stroke, chronic kidney disease, foot ulcer
and eye damage (WHO, 2013). Globally at the end of
2017, 425 million people had diabetes worldwide
(IDF, 2017); up from an estimated 382 million people
in 2013 (Shi and Hu, 2014). The increase in
prevalence of diabetes accounts for the shifting age
structure of the global population of people living
with the disease with type 2 or DM accounting for
over 90% of cases (Vos et al., 2012). Diabetes occurs
throughout the world but is more common in more
developed countries. The greatest increase in rate has
been seen in low and middle income countries
(LMIC) where more deaths occur (WHO, 2016;
Mathers and Loncar, 2006).The increase in rate in
developing countries follows the trends in
urbanization and lifestyle changes, including
sedentary lifestyles, less physically demanding work
and the global nutrition transition marked by
increased intake of foods that are high energy-dense
but nutrient-poor (often high in sugar and saturated
fats sometimes referred to as “western-style” diet)
(who, 2016; Wild, 2004).
IJTSRD45021
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1381
Diabetes mellitus usually have a serious impact on the
metabolism of carbohydrates and fats in the body, if
they cannot be properly utilized will alter the lipid
profile and antioxidant vitamins, especially vitamin C
and E that fights to remove or restore homeostatic
changed by the hyperglycemic condition in diabetic
cells. Comparing the lipid profile and antioxidant
vitamins of diabetic and non-diabetic individuals will
be useful in guiding future research effects and public
policy formulations and action toward proper
management and cure of the diabetic disease.
MATERIALS AND METHODS
STUDY AREA: The study was conducted at two
tertiary health institutions in Imo- State – Imo- state
University Teaching Hospital Orlu and Federal
Medical Center Owerri. Orlu and Owerri are among
the major towns in Imo State with a combined
population of 3,927,563 according to the 2006 census.
The towns lies within latitude 4o
45’
N and 7o
15’ and
longitude 6o
50’E and 7o
25’E AND COVERS AN
AREA OFABOUT 5100Sq Km.
STUDY POPULATION: Adult subjects (18years
and above) who are patients of the Federal Medical
Center (FMC) Owerri and Imo-State University
Teaching Hospital Orlu were approached and the
goals of the research explained to them, those that
gave their consent were recruited for the study. Those
with any chronic illness, pregnancy or recent delivery
(in women) were excluded. A total of 150 subjects
participated actively in the study.
SAMPLE COLLECTION
Blood samples were collected from subject who have
fasted for at least 12hours (overnight) and used for
the study. The samples were collected under aseptic
condition into Lithium Heparin anticoagulant bottles
and used for the determination of the lipid profile
parameters. Other parameters analysed are vitamins C
and E.
METHODS
Diabetes was diagnosed as fasting blood sugar
concentration of ≥ 7.0mmol/L (126mg/dL), using
Randox glucose reagent (Gluc PAP)RX MONZA GL
364, United Kingdom. Total cholesterol (TC), High
density lipoprotein cholesterol (HDL), Low density
lipoprotein cholesterol (LDL) and triglyceride (TG)
were analyzed using BioSystem Reagents SA.
Barcelona (Spain), Reagent COD11506, COD11523,
COD11579 and COD11529 respectively. Vitamins C
and E were determined using ELISA kits, SMI –
RO1KO2 – EX and MBS728239 respectively.
The subjects were stratified into five different age
groups or ranges i.e. 18 – 29years, 30 – 39years, 40 –
49years, 50 – 59years, 60years and above. Other data
necessary for the research were obtained using a
structured questionnaire.
The ethical clearance for the study was gotten from
Research Ethical Committee of the Abia State
University Uturu and the Ministry of Health Owerri
Imo-State Nigeria.
DATA ANALYSIS
Descriptive statistics were used and data generated
presented as mean ± standard deviation. Also
differences between group means were separated
using one – way analysis of variance (ANOVA) with
significant value at P < 0.05.
RESULTS
The fasting blood sugar levels of the experimental
groups compared to controls, stratified according to
groups and gender showed that the mean fasting
blood sugar concentration were 8.35± 1.1 (mmol/L)
for males, 9.75± 2.0 (mmol/L) for females while the
control was 4.8± 0.44 for both gender. Majority of the
experimental group subjects with diabetes are within
the ages of 40years and above as contained in Table
1.
Table 1: Concentration of FBS of the experimental groups and control (mmol/L)
Ages (years) 18 - 29 30 – 39 40 - 49 50 - 59 60 and above All Control
FMC OWERRI
Male 0 0 0 7.9±0 8.5±0.5 8.2±0.6 4.3±1.9
Female 0 0 10.9± 0 8.3± 0.7 10.7±4.3 10.0±2.6 4.9±0.1
Total 0 0 10.9± 0 8.1± 0.2 9.6±1.1 9.5±2.8 4.6±0.3
IMSUTH ORLU
Male 0 0 9.5±0 8.1±0.2 7.9±0.6 8.5±1.6 5.3±1.7
Female 0 0 9.4±33 10.2±0.0 8.8±2.2 9.5±1.4 4.7±0.0
Total 0 0 9.5±0.1 9.2±1.1 8.4±0.0 9.0±1.1 5.0±0.3
Values are means ±SD of 150 determinations of the subjects FBS from the health institutions at various age
groups. FBS – Fasting blood sugar.
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1382
Table 2: Lipid profile of the experimental groups and control
Parameters TC (mmol/L) TG (mmol/L) LDL (mmol/L) HDL (mmol/L) VLDL(mmol/L)
Group 1(FMC) 8.28±2.62a
2.37± 0.84a
4.58±2.75a
1.43±0.57a
1.46±1.19a
Group2(IMSUTH) 7.98±1.96a
3.10±0.73a
5.22±1.11a
1.55±0.23a
1.87±1.28a
Group3(Control) 5.02±0.97b
1.77±0.60b
1.96±0.61b
1.77±0.69a
1.10±0.60a
Values are means ± S.D. of 150 determinations of subjects’ samples. Mean values with different superscript
alphabets along a column differs significantly (P < 0.05). TC – Total cholesterol, TG – Triglycerides, LDL – Low
density lipoprotein cholesterol, HDL – High density lipoprotein cholesterol, VLDL – Very low density
lipoprotein cholesterol, Group1 – Experimental group at FMC Owerri, Group2 Experimental group at IMSUTH
Orlu. Group3 (Control) – Non diabetic subjects.
Table 3: Concentrations of vitamins C and E of the experimental groups and control
Experimental Groups Vitamin C (mg/dl) Vitamin E (mg/dl)
Group 1 (FMC Owerri) 1.16±0.34a
1.35±0.42a
Group 2 (IMSUTH Orlu) 1.07±0.44a
1.01±0.22a
Group 3 (Control) 1.68±0.07b
2.03±0.19b
Values are means ± S.D. OF 150 determinations. Mean values with different alphabets superscript along a
column differs significantly (P < 0.05). Group1 – Experimental group at FMC Owerri, Group2 Experimental
group at IMSUTH Orlu. Group3 (Control) – Non diabetic subjects.
DISCUSSION
The incidence of diabetes has continued to rise all
over the world even to epidemic proportions
especially in developing countries like Nigeria.
Unlike in developed economies where people60 years
and above are mostly affected, diabetes in this study
is comparatively high in young to middle-aged people
as indicated in table 1 above. These findings are in
line with that of Enang et al., (2014) and Ejike, et al.,
(2015). Hyperglycemia is associated with long term
damage, dysfunction and failure of normal
functioning of many organs including eyes, heart,
kidney, nerve and blood vessels. The concentration of
fasting blood sugar (FBS) was slightly higher in
female subjects than in males as contained in table 1.
This report is in agreement with that or Chinenye, et
al., (2008) and Enang, et al., (2014). This change can
be attributed to the recent trend in urbanization and
lifestyle changes, including a “western style” diet
promoted mostly by the rise in establishment of ‘fast
food’ joints and mechanized lifestyle (Rosenheck,
2008). Other factors that may contribute to this
change include the poor state of healthcare in
developing countries, poverty and poor nutrition. This
study showed significant increases in low density
lipoprotein cholesterol (LDL-C), Total cholesterol
(TC) and Triglyceride (TG) of the experimental
groups from the two study areas compared to the
control. Also decrease in high density lipoprotein
cholesterol (HDL-C) was recorded in the
Experimental Groups 1 and 2 (i.e. the subjects with
diabetes) compared to the controls (see Table 2). This
report is in agreement with that of American Diabetic
Association, which stated that diabetes mellitus is
characterized by lipid abnormalities such as low
density lipoprotein cholesterol (LDL) and total
cholesterol (ADA, 2011; Ronald and Krauss, 2004).
The explanation for this observation is the fact that
excess sugar in a diabetic cell is often converted to
fats (Triglycerides and low density lipoprotein
cholesterol) which are deposited in the blood vessels.
Thus diabetes increases some components of the lipid
profile like low density lipoprotein cholesterol (LDL-
C), total cholesterol (TC) and triglycerides (TG)
while it decreases high density lipoprotein (HDL-C)
(Heidi, 2009). These findings are in accordance with
that of Kayode, et al. 2010.
Human body is continuously being exposed to
different types of agents that result in production of
reactive species called free radicals. These free
radicals by the transfer of their unpaired electrons
cause the oxidation of cellular machinery. Diabetes
comes with increased sugars in tissue and fluids of
the body. These increase results in increased free
radicals which in turn induces oxidative stress,
inflammation and insulin resistance (Ejike, et al.
2015; Watson, et al. 2014). This relationship explains
the complicity of diabetes as contained in this study.
In order to prevent their deleterious effects, body has
endogenous antioxidant system or obtained from diet
that neutralizes such species and keeps the body
homeostasis. Any imbalance between the reactive
species (RS) and antioxidant systems lead to a
condition known as “oxidative stress” and results in
development of pathological conditions including
diabetes and others (Twari, et al. 2013). Oxidative
stress plays a pivotal role in the development of
diabetes and their complications. Some studies reveal
the inference of oxidative stress in pathogengsis by
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1383
alteration in enzymatic systems, lipid peroxidation,
impaired glutathione metabolism and decreased
vitamin C (Ullah, et al.2015; Ferdinando and
Micheal, 2010; Johansen, et al. 2005 and Valko, et al.
2007).
The concentrations of vitamins C and E in the serum
of the experimental subjects with diabetes in this
study were significantly reduced compared to the
controls (non-diabetics). The reduction in vitamin C
could be as a result of the toxicity caused by the
oxidative stress induced by the diabetic conditions.
Concentrations of vitamin E in this report either
decreases or increases in some experimental subjects
of the study. These conflicting reports showed that
diabetes have deleterious effects on vitamin E
concentration in the body, and is in line with the
report of Maritim, et al., 2003 which stated that
vitamin E may either be increased or decreased by
diabetes. Vitamins play important roles in different
biochemical processes. Vitamins C and E act as
antioxidants that detoxify the free radicals.
Alterations in their concentrations are significant
biomarker of oxidative stress (Johansen, et al., 2005;
Valko, et al. 2007).
CONCLUSION
As diabetes is characterized by hyperglycemia, this
study showed that the mean fasting blood sugar (FBS)
concentration were 9.3±1.1 (mmol/L) for males,
9.5±0.5 (mmol/L) for females while the control was
4.8±0.44 (mmol/L) for both sexes. Majority of the
experimental subjects with diabetes are within the
ages of 40years and above unlike compared to
developed world were mostly aged people 60years
and above were affected. Dyslipidemia were higher
among experimental subjects with diabetes compared
to the controls. These abnormalities in lipid profile
include elevated low density lipoprotein cholesterol
(LDL-C) and triglyceride (TG), and reduced high
density lipoprotein cholesterol (HDL-C). The diabetic
conditions in the cell of subjects result in production
of reactive oxygen species (ROS) that causes
oxidative stress. This caused the reduction in
concentration of antioxidant vitamins in the serum of
the experimental groups compared to the control.
Thus oxidative stress plays important roles in the
progression of diabetes and their complications.
Therefore, antioxidants maybe a prospect in the
treatment and management of diabetes. More robust
studies are needed to further confirm these finding
and identify other causes.
LIMITATIONS
The study was limited by the small sample size which
was necessitated by limited funds at our disposal,
unwilliness of people to give their blood due to
cultural belief systems and lack of honoraria paid to
participants.
CONFLICT OF INTREST
None
ACKNOWLEDGEMENTS
We are grateful to the subjects of the study who freely
and willingly participated even without pay and Dr.
Austin Okeji the director of public health and primary
health care Imo State, for his assistance.
REFERENCES
[1] American Diabetes Association (ADA) (2011).
Diagnosis and classification of diabetes
mellitus. Diabetes care. Vol. 34(suppl. 1): S62-
-69.
[2] Bos, M. and Agyemang, C. (2013). Prevalence
and complications of diabetes mellitus in North
African, a systemic review. BMC Public
Health, 13:387.
[3] Chinenye, S., Uloko A. E., Ogbera A. O.,
Ofoegbu E. N., Fasanmade A. A., Fasanmade
O. A., et al. (2012). Profile of Nigerian with
diabetes mellitus – Diabcare Nigerian Study
Group (2008): Result of a multicenter study.
Indian J. Endocrinol. Metab. 16: 558 – 564.
[4] Ejike, E. C. C., Nnamdi K. U., and Nwachukwu
S. O. (2015). Diabetes and prediabetes in adult
Nigerian: prevalence and correlations of blood
glucose concentration with measures of obesity.
African Journal of Biochemistry Research.
9(3): 55 – 60.
[5] Enang, O. E., Out A. A., Essien O. E., Okpara
H., Fasanmade O. A., Ohwovoriole A. E., and
Searle J. (2014). Prevalence of dysglycemia in
Calabar: A cross-sectional study among
residents of Calabar, Nigeria. BMJ Open
Diabetes Res. Care, 2: e000032.
[6] Ferdinando, G. and Micheal B. (2010).
Oxidative stress and diabetic complications.
Circ. Res. 107(9): 1058 – 1070.
[7] Guariguata, L., Whiting D. R., Hambleton I.,
Beagley J., Linnenkamp U. and Shaw J. E.
(2014). Global estimates of diabetes prevalence
for 2013 and projections for 2035. Diabetes
Res. Clin. Pract. 103: 137 – 147.
[8] Heidi, Mochari (2009). Lifestyle Habits for
lipid management. Assessed from:
www.hearthealthtimes.com. On 16/11/2020.
[9] International Diabetes Federation (IDF) (2017).
IDF Diabetes Atlas, 8th
edition. Brussels
Belgium: international Diabetes Federation.
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1384
[10] Johansen, J. S., Alex K. H., David J. R. and
Adviye E. (2005). Oxidative stress and the use
of antioxidants in diabetes: Linking basic
science to clinical practice. Cardiovascular
Diabetology, 2005; 4:5.
[11] Kayoede, J. A., Sola A. O., Mathew A. S.,
Adesola B. O., Ademola I., Adedeji A. T., and
Adelani A. S. (2010). Lipid profile of type 2
diabetic patients at a rural tertiary hospital in
Nigeria. Journal of Diabetes and Endcrinology,
1(4): 46 – 51.
[12] Maritime, A. C., Sanders R. A. and Watkins J.
B. (2003). Diabetes, oxidative and antioxidants:
A review. J. Biochem. Mol. Toxicol. 17(1): 24 –
38.
[13] Mathers C. D. and Loncar D. (2006).
“Projections of global mortality and burden of
disease from 2002 to 2030”. PLoS Med. 3(11):
e442.
[14] Ronald M. K. (2004). Lipids and lipoproteins in
patients with type 2 diabetes. Diabetes Care,
27(6): 1496 – 1504.
[15] Rosenheck, R. (2008). “Fast food consumption
and increased caloric intake: a systemic review
of a trajectory towards weight gain and obesity
risk”. Obes. Review, 9(6): 535 – 47.
[16] Shi, Y. and Hu F. B. (2014). “The global
implication of diabetes and cancer”. Lancet,
383(9933): 1947 – 48.
[17] Tiwari, K. B., Pandey B. K., Abidi B. A. and
Rizvi I. S. (2013). Makers of oxidative stress
during diabetes mellitus. Journal of
biomarkers, vol. 2013, ID383790.
[18] Ullah, A. K., Khan A and Khan I. (2015).
Diabetes mellitus and oxidative stress: A
concise review. Available at:
http//dx.doi.org/10. 1016/j.jsps.2015.03.013.
[19] Valko, M., Leibfritz D., Moncol J, Cronin M.
T., Mazur M. and Telser L. (2007). “Free
radicals and antioxidants in normal
physiological functions and human disease”.
International Journal of Biochemistry and Cell
Biology, 30(1): 44 – 84.
[20] Vos, T., Flaxman A. D., Naghavi M., Lozano
R., Michaud C., Ezzati M., et al. (2012). “Years
lived with disability (YLDs) for1160 sequelae
of 289 diseases and injuries 1990-2020: a
systemic analysis for the global burden of
disease study 2010”. Lancet, 380(9859): 2163 –
96.
[21] Watson, J. D. (2014). Type 2 diabetes as a
redox disease. Lancet, 383: 841 – 843.
[22] World Head Organization (WHO) (2013).
“Diabetes Fact sheet No
312”
[23] World Head Organization (WHO) (2014).
“About diabetes”.
[24] World Head Organization (WHO) (2016).
“Global Report on Diabetes”
[25] Wild, S., Roglic, G., Sicree, R. and King, H.
(2004). “Global prevalence of diabetes:
Estimates for the year 2000 and projections for
2030”. Diabetes care, 27(5): 1047 – 1053.

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Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxidants Vitamins A and C

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 5 Issue 5, July-August 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1380 Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C) Egejuru, Leonard O1 ; Akubugwo, Emmanuel I2 ; Ugorji, Beatrice N3 1,3 Ministry of Health, Owerri, Nigeria 2 Department of Biochemistry, Abia State University, Uturu, Nigeria ABSTRACT Diabetes mellitus affects the metabolism of carbohydrates and fats which if not properly managed will alter the lipid profile and antioxidant vitamins of the body system. However information on the extend and health consequences of these, are scarce in Nigeria. This study compared the lipid profile and some antioxidant vitamins in diabetics and apparently healthy adults were conducted in Imo State Nigeria. Standard protocols were followed for all determination of samples obtained from patients at two major tertiary health institutions in the state. The mean fasting blood sugar (FBS) concentrations of the experimental group were 8.36±1.1mmol/L for males, 9.75±0.5mmol/L for females while the control was 4.8±0.44mmol/L for both sexes. Majority of subjects with diabetes were within the ages of 40years and above. Dyslipidemia was higher among diabetic patients compared to control, while there were significant increases in low density lipoprotein cholesterol (LDL), triglyceride (TG) and reduction in high density lipoprotein cholesterol (HDL) compared to the controls. Also there were significant reductions in antioxidant vitamins C and E of the experimental groups compared to the controls (P > 0.05). Antioxidants maybe a prospect in the treatment/ management of diabetes. More robust studies are needed to further confirm these findings and identify other causes. KEYWORDS: diabetes mellitus, dyslipidemia, antioxidant vitamin, fasting blood sugar How to cite this paper: Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456- 6470, Volume-5 | Issue-5, August 2021, pp.1380-1384, URL: www.ijtsrd.com/papers/ijtsrd45021.pdf Copyright © 2021 by author (s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION Diabetes mellitus (DM) refers to a group of metabolic diseases in which there are high levels of blood sugar over prolong period. The common symptoms of diabetes include polyuria, increased thirst and hunger (WHO, 2014). It results in aberration in carbohydrates, fats, and protein metabolism, which arise due to defects in insulin secretion, and/or actions (Ejike et al., 2015). DM is currently a very prevalent disease, especially in Africa (Bos and Agyemang, 2013). Diabetes if left untreated can cause many complications which include diabetic ketoacidosis, hyperosmolar hyperglycemic state or death. Other long term complications includes cardiovascular diseases, stroke, chronic kidney disease, foot ulcer and eye damage (WHO, 2013). Globally at the end of 2017, 425 million people had diabetes worldwide (IDF, 2017); up from an estimated 382 million people in 2013 (Shi and Hu, 2014). The increase in prevalence of diabetes accounts for the shifting age structure of the global population of people living with the disease with type 2 or DM accounting for over 90% of cases (Vos et al., 2012). Diabetes occurs throughout the world but is more common in more developed countries. The greatest increase in rate has been seen in low and middle income countries (LMIC) where more deaths occur (WHO, 2016; Mathers and Loncar, 2006).The increase in rate in developing countries follows the trends in urbanization and lifestyle changes, including sedentary lifestyles, less physically demanding work and the global nutrition transition marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats sometimes referred to as “western-style” diet) (who, 2016; Wild, 2004). IJTSRD45021
  • 2. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1381 Diabetes mellitus usually have a serious impact on the metabolism of carbohydrates and fats in the body, if they cannot be properly utilized will alter the lipid profile and antioxidant vitamins, especially vitamin C and E that fights to remove or restore homeostatic changed by the hyperglycemic condition in diabetic cells. Comparing the lipid profile and antioxidant vitamins of diabetic and non-diabetic individuals will be useful in guiding future research effects and public policy formulations and action toward proper management and cure of the diabetic disease. MATERIALS AND METHODS STUDY AREA: The study was conducted at two tertiary health institutions in Imo- State – Imo- state University Teaching Hospital Orlu and Federal Medical Center Owerri. Orlu and Owerri are among the major towns in Imo State with a combined population of 3,927,563 according to the 2006 census. The towns lies within latitude 4o 45’ N and 7o 15’ and longitude 6o 50’E and 7o 25’E AND COVERS AN AREA OFABOUT 5100Sq Km. STUDY POPULATION: Adult subjects (18years and above) who are patients of the Federal Medical Center (FMC) Owerri and Imo-State University Teaching Hospital Orlu were approached and the goals of the research explained to them, those that gave their consent were recruited for the study. Those with any chronic illness, pregnancy or recent delivery (in women) were excluded. A total of 150 subjects participated actively in the study. SAMPLE COLLECTION Blood samples were collected from subject who have fasted for at least 12hours (overnight) and used for the study. The samples were collected under aseptic condition into Lithium Heparin anticoagulant bottles and used for the determination of the lipid profile parameters. Other parameters analysed are vitamins C and E. METHODS Diabetes was diagnosed as fasting blood sugar concentration of ≥ 7.0mmol/L (126mg/dL), using Randox glucose reagent (Gluc PAP)RX MONZA GL 364, United Kingdom. Total cholesterol (TC), High density lipoprotein cholesterol (HDL), Low density lipoprotein cholesterol (LDL) and triglyceride (TG) were analyzed using BioSystem Reagents SA. Barcelona (Spain), Reagent COD11506, COD11523, COD11579 and COD11529 respectively. Vitamins C and E were determined using ELISA kits, SMI – RO1KO2 – EX and MBS728239 respectively. The subjects were stratified into five different age groups or ranges i.e. 18 – 29years, 30 – 39years, 40 – 49years, 50 – 59years, 60years and above. Other data necessary for the research were obtained using a structured questionnaire. The ethical clearance for the study was gotten from Research Ethical Committee of the Abia State University Uturu and the Ministry of Health Owerri Imo-State Nigeria. DATA ANALYSIS Descriptive statistics were used and data generated presented as mean ± standard deviation. Also differences between group means were separated using one – way analysis of variance (ANOVA) with significant value at P < 0.05. RESULTS The fasting blood sugar levels of the experimental groups compared to controls, stratified according to groups and gender showed that the mean fasting blood sugar concentration were 8.35± 1.1 (mmol/L) for males, 9.75± 2.0 (mmol/L) for females while the control was 4.8± 0.44 for both gender. Majority of the experimental group subjects with diabetes are within the ages of 40years and above as contained in Table 1. Table 1: Concentration of FBS of the experimental groups and control (mmol/L) Ages (years) 18 - 29 30 – 39 40 - 49 50 - 59 60 and above All Control FMC OWERRI Male 0 0 0 7.9±0 8.5±0.5 8.2±0.6 4.3±1.9 Female 0 0 10.9± 0 8.3± 0.7 10.7±4.3 10.0±2.6 4.9±0.1 Total 0 0 10.9± 0 8.1± 0.2 9.6±1.1 9.5±2.8 4.6±0.3 IMSUTH ORLU Male 0 0 9.5±0 8.1±0.2 7.9±0.6 8.5±1.6 5.3±1.7 Female 0 0 9.4±33 10.2±0.0 8.8±2.2 9.5±1.4 4.7±0.0 Total 0 0 9.5±0.1 9.2±1.1 8.4±0.0 9.0±1.1 5.0±0.3 Values are means ±SD of 150 determinations of the subjects FBS from the health institutions at various age groups. FBS – Fasting blood sugar.
  • 3. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1382 Table 2: Lipid profile of the experimental groups and control Parameters TC (mmol/L) TG (mmol/L) LDL (mmol/L) HDL (mmol/L) VLDL(mmol/L) Group 1(FMC) 8.28±2.62a 2.37± 0.84a 4.58±2.75a 1.43±0.57a 1.46±1.19a Group2(IMSUTH) 7.98±1.96a 3.10±0.73a 5.22±1.11a 1.55±0.23a 1.87±1.28a Group3(Control) 5.02±0.97b 1.77±0.60b 1.96±0.61b 1.77±0.69a 1.10±0.60a Values are means ± S.D. of 150 determinations of subjects’ samples. Mean values with different superscript alphabets along a column differs significantly (P < 0.05). TC – Total cholesterol, TG – Triglycerides, LDL – Low density lipoprotein cholesterol, HDL – High density lipoprotein cholesterol, VLDL – Very low density lipoprotein cholesterol, Group1 – Experimental group at FMC Owerri, Group2 Experimental group at IMSUTH Orlu. Group3 (Control) – Non diabetic subjects. Table 3: Concentrations of vitamins C and E of the experimental groups and control Experimental Groups Vitamin C (mg/dl) Vitamin E (mg/dl) Group 1 (FMC Owerri) 1.16±0.34a 1.35±0.42a Group 2 (IMSUTH Orlu) 1.07±0.44a 1.01±0.22a Group 3 (Control) 1.68±0.07b 2.03±0.19b Values are means ± S.D. OF 150 determinations. Mean values with different alphabets superscript along a column differs significantly (P < 0.05). Group1 – Experimental group at FMC Owerri, Group2 Experimental group at IMSUTH Orlu. Group3 (Control) – Non diabetic subjects. DISCUSSION The incidence of diabetes has continued to rise all over the world even to epidemic proportions especially in developing countries like Nigeria. Unlike in developed economies where people60 years and above are mostly affected, diabetes in this study is comparatively high in young to middle-aged people as indicated in table 1 above. These findings are in line with that of Enang et al., (2014) and Ejike, et al., (2015). Hyperglycemia is associated with long term damage, dysfunction and failure of normal functioning of many organs including eyes, heart, kidney, nerve and blood vessels. The concentration of fasting blood sugar (FBS) was slightly higher in female subjects than in males as contained in table 1. This report is in agreement with that or Chinenye, et al., (2008) and Enang, et al., (2014). This change can be attributed to the recent trend in urbanization and lifestyle changes, including a “western style” diet promoted mostly by the rise in establishment of ‘fast food’ joints and mechanized lifestyle (Rosenheck, 2008). Other factors that may contribute to this change include the poor state of healthcare in developing countries, poverty and poor nutrition. This study showed significant increases in low density lipoprotein cholesterol (LDL-C), Total cholesterol (TC) and Triglyceride (TG) of the experimental groups from the two study areas compared to the control. Also decrease in high density lipoprotein cholesterol (HDL-C) was recorded in the Experimental Groups 1 and 2 (i.e. the subjects with diabetes) compared to the controls (see Table 2). This report is in agreement with that of American Diabetic Association, which stated that diabetes mellitus is characterized by lipid abnormalities such as low density lipoprotein cholesterol (LDL) and total cholesterol (ADA, 2011; Ronald and Krauss, 2004). The explanation for this observation is the fact that excess sugar in a diabetic cell is often converted to fats (Triglycerides and low density lipoprotein cholesterol) which are deposited in the blood vessels. Thus diabetes increases some components of the lipid profile like low density lipoprotein cholesterol (LDL- C), total cholesterol (TC) and triglycerides (TG) while it decreases high density lipoprotein (HDL-C) (Heidi, 2009). These findings are in accordance with that of Kayode, et al. 2010. Human body is continuously being exposed to different types of agents that result in production of reactive species called free radicals. These free radicals by the transfer of their unpaired electrons cause the oxidation of cellular machinery. Diabetes comes with increased sugars in tissue and fluids of the body. These increase results in increased free radicals which in turn induces oxidative stress, inflammation and insulin resistance (Ejike, et al. 2015; Watson, et al. 2014). This relationship explains the complicity of diabetes as contained in this study. In order to prevent their deleterious effects, body has endogenous antioxidant system or obtained from diet that neutralizes such species and keeps the body homeostasis. Any imbalance between the reactive species (RS) and antioxidant systems lead to a condition known as “oxidative stress” and results in development of pathological conditions including diabetes and others (Twari, et al. 2013). Oxidative stress plays a pivotal role in the development of diabetes and their complications. Some studies reveal the inference of oxidative stress in pathogengsis by
  • 4. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1383 alteration in enzymatic systems, lipid peroxidation, impaired glutathione metabolism and decreased vitamin C (Ullah, et al.2015; Ferdinando and Micheal, 2010; Johansen, et al. 2005 and Valko, et al. 2007). The concentrations of vitamins C and E in the serum of the experimental subjects with diabetes in this study were significantly reduced compared to the controls (non-diabetics). The reduction in vitamin C could be as a result of the toxicity caused by the oxidative stress induced by the diabetic conditions. Concentrations of vitamin E in this report either decreases or increases in some experimental subjects of the study. These conflicting reports showed that diabetes have deleterious effects on vitamin E concentration in the body, and is in line with the report of Maritim, et al., 2003 which stated that vitamin E may either be increased or decreased by diabetes. Vitamins play important roles in different biochemical processes. Vitamins C and E act as antioxidants that detoxify the free radicals. Alterations in their concentrations are significant biomarker of oxidative stress (Johansen, et al., 2005; Valko, et al. 2007). CONCLUSION As diabetes is characterized by hyperglycemia, this study showed that the mean fasting blood sugar (FBS) concentration were 9.3±1.1 (mmol/L) for males, 9.5±0.5 (mmol/L) for females while the control was 4.8±0.44 (mmol/L) for both sexes. Majority of the experimental subjects with diabetes are within the ages of 40years and above unlike compared to developed world were mostly aged people 60years and above were affected. Dyslipidemia were higher among experimental subjects with diabetes compared to the controls. These abnormalities in lipid profile include elevated low density lipoprotein cholesterol (LDL-C) and triglyceride (TG), and reduced high density lipoprotein cholesterol (HDL-C). The diabetic conditions in the cell of subjects result in production of reactive oxygen species (ROS) that causes oxidative stress. This caused the reduction in concentration of antioxidant vitamins in the serum of the experimental groups compared to the control. Thus oxidative stress plays important roles in the progression of diabetes and their complications. Therefore, antioxidants maybe a prospect in the treatment and management of diabetes. More robust studies are needed to further confirm these finding and identify other causes. LIMITATIONS The study was limited by the small sample size which was necessitated by limited funds at our disposal, unwilliness of people to give their blood due to cultural belief systems and lack of honoraria paid to participants. CONFLICT OF INTREST None ACKNOWLEDGEMENTS We are grateful to the subjects of the study who freely and willingly participated even without pay and Dr. Austin Okeji the director of public health and primary health care Imo State, for his assistance. REFERENCES [1] American Diabetes Association (ADA) (2011). Diagnosis and classification of diabetes mellitus. Diabetes care. Vol. 34(suppl. 1): S62- -69. [2] Bos, M. and Agyemang, C. (2013). Prevalence and complications of diabetes mellitus in North African, a systemic review. BMC Public Health, 13:387. [3] Chinenye, S., Uloko A. E., Ogbera A. O., Ofoegbu E. N., Fasanmade A. A., Fasanmade O. A., et al. (2012). Profile of Nigerian with diabetes mellitus – Diabcare Nigerian Study Group (2008): Result of a multicenter study. Indian J. Endocrinol. Metab. 16: 558 – 564. [4] Ejike, E. C. C., Nnamdi K. U., and Nwachukwu S. O. (2015). Diabetes and prediabetes in adult Nigerian: prevalence and correlations of blood glucose concentration with measures of obesity. African Journal of Biochemistry Research. 9(3): 55 – 60. [5] Enang, O. E., Out A. A., Essien O. E., Okpara H., Fasanmade O. A., Ohwovoriole A. E., and Searle J. (2014). Prevalence of dysglycemia in Calabar: A cross-sectional study among residents of Calabar, Nigeria. BMJ Open Diabetes Res. Care, 2: e000032. [6] Ferdinando, G. and Micheal B. (2010). Oxidative stress and diabetic complications. Circ. Res. 107(9): 1058 – 1070. [7] Guariguata, L., Whiting D. R., Hambleton I., Beagley J., Linnenkamp U. and Shaw J. E. (2014). Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res. Clin. Pract. 103: 137 – 147. [8] Heidi, Mochari (2009). Lifestyle Habits for lipid management. Assessed from: www.hearthealthtimes.com. On 16/11/2020. [9] International Diabetes Federation (IDF) (2017). IDF Diabetes Atlas, 8th edition. Brussels Belgium: international Diabetes Federation.
  • 5. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD45021 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 1384 [10] Johansen, J. S., Alex K. H., David J. R. and Adviye E. (2005). Oxidative stress and the use of antioxidants in diabetes: Linking basic science to clinical practice. Cardiovascular Diabetology, 2005; 4:5. [11] Kayoede, J. A., Sola A. O., Mathew A. S., Adesola B. O., Ademola I., Adedeji A. T., and Adelani A. S. (2010). Lipid profile of type 2 diabetic patients at a rural tertiary hospital in Nigeria. Journal of Diabetes and Endcrinology, 1(4): 46 – 51. [12] Maritime, A. C., Sanders R. A. and Watkins J. B. (2003). Diabetes, oxidative and antioxidants: A review. J. Biochem. Mol. Toxicol. 17(1): 24 – 38. [13] Mathers C. D. and Loncar D. (2006). “Projections of global mortality and burden of disease from 2002 to 2030”. PLoS Med. 3(11): e442. [14] Ronald M. K. (2004). Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care, 27(6): 1496 – 1504. [15] Rosenheck, R. (2008). “Fast food consumption and increased caloric intake: a systemic review of a trajectory towards weight gain and obesity risk”. Obes. Review, 9(6): 535 – 47. [16] Shi, Y. and Hu F. B. (2014). “The global implication of diabetes and cancer”. Lancet, 383(9933): 1947 – 48. [17] Tiwari, K. B., Pandey B. K., Abidi B. A. and Rizvi I. S. (2013). Makers of oxidative stress during diabetes mellitus. Journal of biomarkers, vol. 2013, ID383790. [18] Ullah, A. K., Khan A and Khan I. (2015). Diabetes mellitus and oxidative stress: A concise review. Available at: http//dx.doi.org/10. 1016/j.jsps.2015.03.013. [19] Valko, M., Leibfritz D., Moncol J, Cronin M. T., Mazur M. and Telser L. (2007). “Free radicals and antioxidants in normal physiological functions and human disease”. International Journal of Biochemistry and Cell Biology, 30(1): 44 – 84. [20] Vos, T., Flaxman A. D., Naghavi M., Lozano R., Michaud C., Ezzati M., et al. (2012). “Years lived with disability (YLDs) for1160 sequelae of 289 diseases and injuries 1990-2020: a systemic analysis for the global burden of disease study 2010”. Lancet, 380(9859): 2163 – 96. [21] Watson, J. D. (2014). Type 2 diabetes as a redox disease. Lancet, 383: 841 – 843. [22] World Head Organization (WHO) (2013). “Diabetes Fact sheet No 312” [23] World Head Organization (WHO) (2014). “About diabetes”. [24] World Head Organization (WHO) (2016). “Global Report on Diabetes” [25] Wild, S., Roglic, G., Sicree, R. and King, H. (2004). “Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030”. Diabetes care, 27(5): 1047 – 1053.