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Licensed Unlicensed Requires Authentication Published by De Gruyter March 25, 2020

Factors associated with oxidative stress status in pediatric patients with type 1 diabetes mellitus

  • Dragana Kacarevic , Natasa Bogavac-Stanojevic , Vesna Spasojevic-Kalimanovska , Dragana Bojanin , Tatjana Milenkovic , Aleksandra Stefanovic , Marija Mihajlovic , Sanja Vujcic EMAIL logo , Rade Vukovic , Aleksandra Zeljkovic , Sladjana Todorovic , Katarina Mitrovic and Jelena Vekic



Oxidative stress is implicated in both, the onset and the progression of type 1 diabetes mellitus (T1DM). There is accumulated evidence of increased biomarkers of oxidative stress in newly diagnosed, T1DM patients without complications, and in those with advanced disease. In this cross-sectional study, we investigated factors affecting oxidative stress status in pediatric patients with T1DM.


Advanced oxidation protein products (AOPP), prooxidant-antioxidant balance (PAB), total sulfhydryl (SH) groups, and superoxide dismutase (SOD) activity were determined in 170 children and adolescents with T1DM. Principal component analysis was used to investigate clustering of clinical and laboratory variables associated with elevated oxidative stress and reduced antioxidative defense biomarkers.


Factor analysis extracted five factors, interpreted as (1) “weight status factor” including age, BMI, waist and hip circumferences; (2) “proatherogenic factor” that included LDL-cholesterol, non-HDL-cholesterol, and triglycerides; (3) “metabolic control factor” including glucose and HbA1c; (4) “renal marker factor” with positive loading of urinary albumin excretion rate and negative loading of GFR; and (5) “antiatherogenic factor” that included HDL-cholesterol. High AOPP levels were independently predicted by “proatherogenic” (OR: 2.32; 95% CI: 1.44–3.71; p < 0.001), “metabolic control” (OR: 2.24; 95% CI: 1.35–3.73; p < 0.01), and “renal marker” (OR: 1.65; 95% CI: 1.03–2.65; p < 0.05) factors. “Renal marker factor” was a significant predictor of PAB (OR: 0.52; 95% CI: 0.34–0.81; p < 0.01). Regarding antioxidative defense markers, reduced SH groups were predicted by “proatherogenic factor” (OR: 0.56; 95% CI: 0.34–0.94; p < 0.05), while “weight status factor” predicted lower SOD activity (OR: 1.66; 95% CI: 1.03–2.67; p < 0.05).


Cardiometabolic risk factors and renal function are associated with oxidative stress in pediatric T1DM patients.


This work was supported by the grant from the Ministry of Education, Science and Technological Development, Republic of Serbia (Grant number 175035, Funder Id: The authors would like to thank Milica Kostic, MA, for helping with editing the manuscript.

  1. Authors’ contributions: Study concept and design (VSK, JV, TM); acquisition of data (DB, RV, ST, KM); laboratory work (DK, NBS, DB, AS, MM, JV, AZ, SV), data analysis and interpretation (NBS, JV); and drafting of the manuscript (DK). All authors have contributed to data interpretation and critically reviewed the manuscript.

  2. Research funding: Ministry of Education, Science and Technological Development, Republic of Serbia.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Conflict of interest: The authors declare no conflict of interest.


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Received: 2019-11-26
Accepted: 2020-02-18
Published Online: 2020-03-25
Published in Print: 2020-05-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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