Changes in total oxidant and antioksidant levels in type ii diabetik pati?ents who underwent coronary artery bypass graft

In coronary artery bypass graft (CABG) surgery; several things such as the surgery technique (cardiopulmonary bypass (CPB), high partial oxygen pressure, surgical trauma), the pathologies the patient has (coronary artery disease, hypertension, diabetes mellitus, renal failure, pulmonary diseases) and many drugs may increase the oxidative stress.In this study, there were a total of 39 patients divided into two subgroups as the ones with type II diabetes (n:14) and the ones without (n:25). Total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were observed in these patients. Blood samples were taken from the patients before the induction of anesthesia (preoperative) and after CPB (intraoperative, postoperative 6th and 24th hours). TOS was increased intraoperatively in both groups. However, in the group with non-diabetics; while the TOS was 4.36±2.0 ?mol H2O2 Equiv/L preoperatively, it increased to 6.6±3.31 ?mol H2O2 Equiv/L and it was a significant difference (p<0.05). In the group with diabetics, comparing to preaoperative period, the intraoperative TOS was not significantly different (4.16±2.53 and 6.43±3.3 ?mol H2O2 Equiv/L respectively). In both groups no significant differences were found in the TOS postoperatively compared to the preoperative period.TAS decreased intraoperatively in both groups compared to the preoperative period levels (0.44±0.18 to 0.34±0.14 mmol trolox Equiv/L in the non-diabetic group (p<0.05), 0.40±0.20 to 0.32±0.08 mmol trolox Equiv/L in the diabetic group). No significant differences were found in the postoperative period compared to the onset.OSI increased intraoperatively in both groups. It went up from 1.12 (0.65-1.45) to 1.6 (1.24-5.70) (median and 25-75% percentile) in the non-diabetic group (p<0.05). In the diabetic group it went from 1.23 (0.77-3.29) to 2.07 (0.94-3.85) (p>0.05). No significant difference was found between the groups. OSI levels decreased in the postoperative period. It decreased 0.54 (0.28-0.87) in the diabetic group (p<0.05). This was significantly lower than the non-diabetic group as well (p<0.05). The reason why the OSI was found lower in diabetic patients at the 24th hour postoperatively than the non-diabetics was considered to be the increase in the antioxidant response.