EVOLUTION OF OXIDATIVE STRESS MARKERS IN PATIENTS WITH DIABETES MELLITUS AND PULMONARY TUBERCULOSIS DURING TREATMENT

Abstract

Objectives. The association between diabetes mellitus (DM) and pulmonary tuberculosis (TB) represents a major global public health issue. The aim of this study was to evaluate the oxidative status in patients with pulmonary tuberculosis associated with diabetes mellitus by analyzing the dynamics of pro-oxidant markers (malondialdehyde (MDA), protein oxidative peroxidation products (POPP), ceruloplasmin) and antioxidant markers (CUPRAC, catalase, glutathione reductase - GR) during inpatient treatment.

Materials and methods. The study included two groups of patients evaluated before and after hospital treatment: a research group consisting of 59 patients with TB/DM and a control group of 59 patients with pulmonary tuberculosis without diabetes mellitus, hospitalized in the Pneumology 1 Department of the IMSP Institute of Pneumology “Chiril Draganiuc”, Chișinău, during 2019–2024. Patient inclusion was based on the following criteria: confirmed diagnosis of tuberculosis (with or without concomitant diabetes mellitus), predefined age limits, and informed consent signed by the participants.

Results and discussions. The study included 31 female patients (26.3%) and 87 male patients (73.7%). In patients with pulmonary tuberculosis and diabetes mellitus, increased levels of the pro-oxidant markers MDA, POPP, and ceruloplasmin were observed after anti-tuberculosis treatment, reflecting the persistence and intensification of oxidative processes during therapy. The analysis of antioxidant markers revealed decreased catalase and CUPRAC activity associated with increased glutathione reductase levels, changes suggesting impairment of antioxidant defense mechanisms and persistence of oxidative stress.

Conclusions. The association of pulmonary tuberculosis with diabetes mellitus leads to oxidative imbalance and influences disease progression. Evaluation of oxidative stress markers represents an important method for assessing the severity of the pathological process and monitoring treatment efficacy in patients with pulmonary tuberculosis and diabetes mellitus.