Dynamic Thiol/Disulfide Homeostasis as a Complementary Oxidative Stress Marker Across Albuminuria Stages in Type 2 Diabetes Mellitus

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Altuntas A., Aydın B., ERSOY S., EREL O., demirel h., tutum ş.

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, vol.33, no.1, pp.71-77, 2026 (TRDizin)

Abstract

Objective Diabetic nephropathy (DN) remains one of the most serious complications of type 2 diabetes mellitus (T2DM). Traditionally, disease progression has been evaluated through albuminuria, yet increasing evidence highlights the role of oxidative stress and redox imbalance in DN pathogenesis. The present study was designed to evaluate dynamic thiol/disulfide homeostasis across albuminuria stages and to explore its potential role as a complementary systemic oxidative stress marker alongside albuminuria in T2DM. Material and Method A total of 122 individuals were included and categorized into four study groups: 30 healthy participants (Group 1), 31 normoalbuminuric diabetic patients (Group 2), 31 patients with microalbuminuria (Group 3), and 30 patients with macroalbuminuria (Group 4). Plasma thiol/disulfide parameters were measured using the automated method developed by Erel and Neselioglu, while urinary albumin concentrations were determined by immunoturbidimetric assay. Results Progressive decreases in both native and total thiol levels were observed with advancing severity of albuminuria (p<0.001). Disulfide concentrations showed a downward trend in macroalbuminuric patients (p=0.019), although disulfide-related ratios remained largely unchanged across the groups. Correlation analyses identified significant negative associations between thiol concentrations and diabetes duration, HbA1c, as well as CRP levels (p<0.001). Conclusion Dynamic thiol/disulfide balance reflects systemic oxidative stress but cannot fully substitute for albuminuria as a marker of DN. Instead, it appears to provide complementary insight into oxidative mechanisms associated with DN severity in T2DM patients.