Sex Differences in the Association Between Disease Complications and Markers of Oxidative Stress in Type 2 Diabetes Mellitus: A Cross‐Sectional Study

Background and Aims: Type 2 diabetes mellitus (T2DM) is often linked to oxidative stress resulting from lipid peroxidation and complications such as diabetic retinopathy, neuropathy, nephropathy, and ketoacidosis (DKA), which may manifest differently based on sex. However, the specific relationship between diabetic complications and markers of oxidative stress in relation to sex remains uncertain. This study seeks to elucidate sex-based variances in the association between oxidative stress markers and diabetic complications among individuals with T2DM in the Ghanaian population. Methods: This study was conducted between July and December 2022 at the Tamale Teaching Hospital. The study involved 55 T2DM patients, comprising: no complications = 13; DKA = 13; neuropathy = 6; nephropathy = 14; and retinopathy = 9. The patients were aged between 20 and 55 years. Single fasting (8-10 h) venous blood samples were collected and analyzed for total cholesterol (TCHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) using an automated biochemistry analyzer and ELISA technique. Results: While no significant sex differences were found in complication prevalence, notable disparities emerged in glycemic and oxidative stress markers. Males with DKA exhibited higher MDA levels compared to females, while females with retinopathy had lower MDA levels than males. Additionally, males with DKA showed higher GSH_Px levels than females, while no significant differences were observed between sexes without complications, and males with DKA and retinopathy tended to have lower HDL-C levels compared to females. Conclusion: While no significant differences in complication prevalence were observed between sexes, our findings revealed notable sex disparities in glycemic and oxidative stress markers. These results indicate the importance of considering sex-specific factors in understanding the pathogenesis and management of diabetic complications.