Detrimental Effects of Lipid Peroxidation in Type 2 Diabetes: Exploring the Neutralizing Influence of Antioxidants
Open accessAbstract
Lipid peroxidation, including its prominent byproducts such as malondialdehyde (MDA) and 4-hydroxy-2-nonenal (4-HNE), has long been linked with worsened metabolic health in patients with type 2 diabetes (T2D). In fact, patients with T2D already display increased levels of lipids in circulation, including low-density lipoprotein-cholesterol and triglycerides, which are easily attacked by reactive oxygen molecules to give rise to lipid peroxidation. This process severely depletes intracellular antioxidants to cause excess generation of oxidative stress. This consequence mainly drives poor glycemic control and metabolic complications that are implicated in the development of cardiovascular disease. The current review explores the pathological relevance of elevated lipid peroxidation products in T2D, especially highlighting their potential role as biomarkers and therapeutic targets in disease severity. In addition, we briefly explain the implication of some prominent antioxidant enzymes/factors involved in the blockade of lipid peroxidation, including termination reactions that involve the effect of antioxidants, such as catalase, coenzyme Q10, glutathione peroxidase, and superoxide dismutase, as well as vitamins C and E.
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Integrating mechanistic biomarkers such as those related to lipid peroxidation holds potential to improve biological relevance and possibly predictive performance.
“Moreover, integrating mechanistic biomarkers—such as those related to lipid peroxidation—holds potential to improve biological relevance and possibly predictive performance (18–22).”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
Section 3 identifies lipid-peroxidation products as biomarkers, and Section 6 says measuring them in combination helps detect and confirm the severity of oxidative stress. This supports their biological relevance, but the paper does not address whether integrating them improves predictive performance. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOxidative stress and lipid peroxidation are biologically linked to endothelial dysfunction and vascular injury in diabetes.
“Among candidate pathways, oxidative stress and lipid peroxidation deserve attention because they are biologically linked to endothelial dysfunction and vascular injury in diabetes; however, this does not yet justify routine inclusion of such biomarkers in all machine learning models (18–21).”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
Oxidative stress plays a central role in the shared pathophysiology of diabetes and cardiovascular disease, with lipid peroxidation representing one of its major downstream consequences.
“Oxidative stress plays a central role in the shared pathophysiology of diabetes and cardiovascular disease, with lipid peroxidation representing one of its major downstream consequences.”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
Oxidized lipid products and related oxidative stress markers may reflect vascular injury, inflammatory activity, and cardiometabolic dysfunction.
“Studies have shown that oxidized lipid products and related oxidative stress markers may reflect vascular injury, inflammatory activity, and cardiometabolic dysfunction (18–22).”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
Lipid peroxidation markers may serve as mechanistically plausible candidate predictors for cardiovascular complications in diabetes.
“This supports the idea that lipid peroxidation markers may serve as mechanistically plausible candidate predictors; however, the present evidence base remains heterogeneous in marker selection, assay platform, and standardization, and direct comparative evidence against standard clinic-based models is still limited (20–22).”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
The association between lipid peroxidation and diabetic cardiovascular complications has been extensively discussed in the literature.
“The association between lipid peroxidation and diabetic cardiovascular complications has been extensively discussed in the literature (18, 19, 21, 22).”
From AI-driven cardiovascular risk prediction in patients with diabetes: bridging algorithmic innovation to equitable clinical application (2026) · cites this paper as [19]
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- Authors
- Shabalala, S. C., Johnson, R., Basson, A. K., Ziqubu, K., Hlengwa, N., Mthembu, S. X. H., Mabhida, S. E., Mazibuko-Mbeje, S. E., Hanser, S., Cirilli, I., Tiano, L., & Dludla, P. V.
- Affiliations
- South African Medical Research Council (ZA)
- University of Zululand (ZA)
- North-West University (ZA)
- University of Limpopo (ZA)
- Marche Polytechnic University (IT)
- Corresponding author
- Shabalala, Samukelisiwe C.
- Dludla, Phiwayinkosi V.
- ORCID
- Venue
- Antioxidants
- Publisher
- MDPI AG
- Published
- 2022-10-20
- Volume
- 11
- Issue
- 10
- Pages
- 2071
- ISSN
- 2076-3921 (ISSN-L)
- PMC
- PMC9598619
- OpenAlex
- W4306938593
- Cited by
- 102
- References
- 161
- Citations by year
- 2026: 25 · 2025: 36 · 2024: 23 · 2023: 17 · 2018: 1
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Antioxidants (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion, cc-by)
- Funders
- Biomedical Research and Innovation Platform of the South African Medical Research Council (117829 and 141929)
- Topics
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Keywords
- lipid peroxidation, type 2 diabetes, malondialdehyde, 4-hydroxynonenal, oxidative stress, antioxidant enzymes, catalase, coenzyme Q10, glutathione peroxidase, superoxide dismutase, vitamin C, vitamin E, biomarkers, cardiovascular disease, glycemic control, dyslipidemia
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