Association of Prothrombotic and Oxidative Stress Biomarkers With the Risk of Microvascular Dysfunction in Patients...

Background Type 2 diabetes mellitus is a common metabolic disorder associated with progressive vascular complications. Microvascular dysfunction is an important cause of diabetic nephropathy, retinopathy, and neuropathy. Oxidative stress and prothrombotic activity are considered major contributors to vascular injury among diabetic patients. This study aimed to evaluate the association of prothrombotic and oxidative stress biomarkers with microvascular dysfunction risk in patients with type 2 diabetes mellitus. Methods This hospital-based observational cross-sectional study was conducted at Maryam Medicare Hospital, Vehari, Pakistan, from February 2025 to January 2026. A total of 200 patients with type 2 diabetes mellitus were included using consecutive sampling. Patients were divided into low-risk and high-risk microvascular dysfunction groups based on clinical and biochemical assessment. Prothrombotic biomarkers including fibrinogen, D-dimer, and plasminogen activator inhibitor-1 (PAI-1) were measured along with oxidative stress biomarkers including malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione (GSH), and catalase activity. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, New York, United States). Results Patients with high microvascular dysfunction risk showed significantly increased fibrinogen (421.5 ± 72.4 vs 312.8 ± 48.6 mg/dL), D-dimer (458.7 ± 101.5 vs 228.4 ± 62.1 ng/mL), PAI-1 (34.2 ± 8.7 vs 18.7 ± 5.4 ng/mL), and MDA levels (4.86 ± 0.92 vs 2.41 ± 0.58 nmol/mL) compared with the low-risk group (p < 0.001). Antioxidant biomarkers including TAC, SOD, GSH, and catalase were significantly reduced in high-risk patients (p < 0.001). MDA showed the highest predictive value for microvascular dysfunction risk with an area under the curve (AUC) of 0.871. Conclusion Elevated thrombotic and oxidative stress biomarkers were significantly associated with the presence of microvascular complications in patients with type 2 diabetes mellitus. These findings suggest that these biomarkers may reflect the burden of vascular injury and oxidative stress in patients with established diabetic microvascular complications.