Glycemic status, antioxidant enzyme and lipid peroxidation among patients with diabetes mellitus in Buea Regional Hospital in Cameroon

doi:10.4331/wjbc.v17.i2.118440

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World Journal of Biological Chemistry

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1949-8454

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Control Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Biol Chem. Jun 5, 2026; 17(2): 118440
Published online Jun 5, 2026. doi: 10.4331/wjbc.v17.i2.118440

Glycemic status, antioxidant enzyme and lipid peroxidation among patients with diabetes mellitus in Buea Regional Hospital in Cameroon

Ebot Walter Ojong, Leon Brandon Nyake Mbu Akime, Ayuk Betrand Tambe, Armel Jackson Seukep, Elvis Amih Ofon, Tabe Cletus Akwa, Chugbe Nathaneal Sawah

Ebot Walter Ojong, Leon Brandon Nyake Mbu Akime, Elvis Amih Ofon, Chugbe Nathaneal Sawah, Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea P.O. Box 63, South-West, Cameroon

Ayuk Betrand Tambe, Tabe Cletus Akwa, Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea P.O. Box 63, South-West, Cameroon

Armel Jackson Seukep, Sino-Africa Joint Research Center, Innovation Academy for Drug Discovery and Development, Chinese Academy of Sciences, Shanghai 201203, China

Armel Jackson Seukep, Department of Biomedical Sciences, University of Buea, Buea P.O. Box 63, South-West, Cameroon

Co-first authors: Ebot Walter Ojong and Leon Brandon Nyake Mbu Akime.

Author contributions: Ojong EW, Nyake Mbu Akime LB, and Tambe AB drafted the manuscript; Ojong EW, Nyake Mbu Akime LB, Tambe AB, Seukep AJ, Ofon EA, Akwa TC, and Sawah CN participated in data collection and data and entry; Ojong EW, Tambe AB, Seukep AJ, Ofon EA, and Akwa TC analyzed the data and performed the background literature review for the manuscript; Ojong EW, Tambe AB, and Sawah CN designed and supervised the study; Ojong EW and Nyake Mbu Akime LB contributed equally to this manuscript and are co-first authors. All authors reviewed, edited and approved the final version of the manuscript.

AI contribution statement: Portions of this manuscript were edited using Trinka AI solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.

Institutional review board statement: This study was approved by the Institutional Review Board of the Faculty of Health Sciences, University of Buea (Approval No. 2024/2425-02/UB/SG/IRB/FHS). After assessment of the research protocol, questionnaire, participants’ information leaflet and consent form. Further permission was obtained from the Regional Delegation of Public Health, Buea, South West Region Cameroon (No. P42/MPH//SWR/RDPH/CBPT/613/518) and from the Internal Review Board of the Regional Hospital Buea (No. MPH/SWRDPH/BRH/IRB).

Informed consent statement: A written informed consent was provided by each participant before enrolment into the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data that support the findings of this study are available on request from the corresponding author.

Corresponding author: Ebot Walter Ojong, PhD, Academic Fellow, Lecturer, Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Molyko Quarter, Buea P.O. Box 63, South-West, Cameroon. ebot.ojong@ubuea.cm

Received: January 4, 2026
Revised: February 3, 2026
Accepted: May 21, 2026
Published online: June 5, 2026
Processing time: 154 Days and 16.3 Hours

Abstract

BACKGROUND

Oxidative stress has been suggested to play a role in the pathogenesis of type 2 diabetes mellitus (T2DM) and development of complications by altering antioxidant levels and inducing lipid peroxidation. Although patients with T2DM are reported to be under oxidative stress because of prolonged exposure to hyperglycemia, the influence of glycemic control in diabetes on enhanced free-radical activity is poorly understood.

AIM

To evaluate the levels of malondialdehyde (MDA) - a marker of lipid peroxidation and catalase (CAT) - an antioxidant enzyme in patients with T2DM categorized by glycemic control, and to compare these levels with those of apparently healthy individuals in Buea, Cameroon.

METHODS

A hospital-based case-control study was conducted at Buea Regional Hospital from January 2024 to June 2024 involving patients with T2DM and age-matched healthy controls. Socio-demographic, clinical and anthropometric data were collected using a structured questionnaire. Levels of glucose, lipid profile, CAT and MDA were determined by spectrophotometry. Glycated hemoglobin was measured using ion exchange high performance liquid chromatography method. Data analyses were done using IBM SPSS version 26.0 for Windows. A P ≤ 0.05 was considered statistically significant.

RESULTS

A total of 192 participants (96 patients with T2DM and 96 healthy controls) were recruited in this study. The mean age of the participants was were 47.97 ± 10.3 years with most being males (62.5%). CAT activity and high-density lipoprotein cholesterol levels were higher in control subjects (P < 0.05). The majority of patients with T2DM (80.2%) had a poor glycemic control. CAT activity was lower and MDA was significantly higher in patients with T2DM with poor glycemic control (P < 0.001). Glycated hemoglobin showed a significantly strong positive correlation with MDA levels (r = 0.846, P < 0.001) and a significantly strong negative correlation with CAT activity (r = -0.567, P < 0.001). Additionally, there was a significant negative correlation between CAT activity and MDA (r = -0.568, P < 0.001).

CONCLUSION

The results of this study indicated a significantly higher level of MDA and lower CAT activity in patients with T2DM compared to apparently healthy age-matched and sex-matched controls. Increased lipid peroxidation and decrease antioxidant enzyme activity were associated with poor glycemic control. The correlation between lipid peroxidation, antioxidant activity, and glycemic control highlights the role of oxidative stress in the pathophysiology of T2DM.

Keywords: Type 2 diabetes mellitus; Glycemic control; Lipid peroxidation; Oxidative stress; Antioxidant; Buea

Core Tip: Hyperglycemia in type 2 diabetes mellitus (T2DM) generates free radicals which reduce antioxidant enzyme activities leading to oxidative stress. The influence of glycemic control on enhanced free-radical activity is poorly understood and no study has been conducted in Buea Health District. This hospital-based case-control study evaluated levels of malondialdehyde and catalase in patients with T2DM with different glycemic status and compared them with healthy subjects. We found a higher prevalence of lipid peroxidation and a higher proportion of reduced serum antioxidant activity in patients with T2DM with poor glycemic control. Routine assessment of lipid peroxidation markers and antioxidant enzyme activities in patients with T2DM especially those with poor glycemic control is recommended in improving patient care and mitigating complications.