Reactive oxygen species and Sestrin-3 in Type 2 diabetes with and without coronary artery disease

Abstract

Objective: To compare serum reactive oxygen species (ROS) and Sestrin-3 concentrations in people with type 2 diabetes (T2D) with and without coronary artery disease (CAD), and to evaluate their diagnostic performance.

Methods: Case-control study of 90 participants (T2D with CAD (n = 50); T2D without CAD (n = 40)) recruited in Baghdad, Iraq. Serum ROS, Sestrin-3, and routine biochemistry were assessed. Between-group comparisons used an independent samples t-test or Mann–Whitney U as appropriate. ROC curves assessed discriminative performance. Multivariable logistic regression evaluated independent associations, adjusted for BMI and HbA1c.

Results: Mean ROS was higher in CAD-T2D than T2D-only (1320.27 ± 123.02 pg/mL vs 988.92 ± 278.26 pg/mL; p = 0.01). Mean Sestrin-3 was higher in CAD-T2D than T2D-only (2.10 ± 0.75 ng/mL vs 1.52 ± 0.59 ng/mL; p = 0.02). HbA1c and BMI did not differ significantly between groups (HbA1c 8.13 ± 1.52 vs 8.26 ± 2.00; p = 0.09; BMI 29.58 ± 3.31 vs 30.66 ± 6.23; p = 0.10). ROC analysis (single ROC per biomarker) indicated discriminatory potential for ROS and Sestrin-3. ROS and Sestrin-3 were significantly higher in T2D+CAD. ROS showed strong discrimination for CAD (AUC≈0.89), while Sestrin-3 demonstrated moderate-to-strong discrimination (AUC≈0.80). In multivariable analysis, both biomarkers remained independently associated with CAD.

Conclusions: In this cohort, ROS and Sestrin-3 concentrations were higher in T2D patients with coexistent CAD compared with T2D alone. These markers show potential for discrimination but require validation in larger, prospectively ascertained cohorts with standardised CAD definition and adjustment for medication and smoking.