Oxidative Stress Level in Patients with Subarachnoid Hemorrhage

Abstract

Background One of the antioxidant mechanisms is the dynamic balance between thiol and disulfide, which, in subarachnoid hemorrhage and other chronic diseases, is disrupted in favor of the latter. The two most commonly used oxidative stress (OS) biochemical markers are the oxidative stress index (OSI) value, which indicates the total oxidant status (TOS) and total antioxidant status (TAS) balance, and the thiol–disulfide (TDS) value, which indicates the total thiol (TT) and native thiol (NT) balance. High OS levels require further investigations. We aimed to investigate the OS level in aneurysmal SAH (aSAH) patients.

methods In this clinical prospective study, blood samples were collected from 50 consecutively treated patients with aSAH and 50 volunteers. Serum TOS, TAS, TT, and NT levels were measured using Erel's method via a spectrophotometer. The Glasgow Coma Scale (GCS) scores, Fisher grades, length of hospital stay (LOS), and the Glasgow Outcome Scale (GOS) scores were recorded. Consequently, the OSI and TDS values were calculated in all participants.

Results A statistically significant difference was observed in the TAS, TOS, OSI, and TDS values between the aSAH patients and the controls. The TT and NT values were significantly lower in aSAH patients than in the controls. A correlation was identified between the OSI values and the GCS scores. Although a correlation was observed between the TDS values and the LOS, no correlation was found between the OSI and the TDS values.

Conclusion The OSI and TDS, which are OS indicators, might serve as the additional objective nominal data to evaluate the treatment efficacy and follow-up for SAH patients. Moreover, decreasing the OSI values and increasing the TT values can be used as improvement indicators in the treated aSAH patients. If we can reduce the OS at the early stage of SAH, it could improve the prognosis by reducing both the morbidity and mortality rates. Further randomized investigations are required to prove the findings in this prospective study.

Keywords

Aneurysmal subarachnoid hemorrhage - oxidative stress - oxidative stress index - thiol-disulfide balance - prognosis

Statement of Authorship

AA was responsible for conceptualization, methodology, software, supervision, formal analysis, literature review, visualization, investigation, writing and review of the original draft, and statistical analysis. İÇ performed the literature review and formal analysis and was involved in writing and reviewing of the original draft. EMG was in responsible for supervision and methodology of the study. MGP, SY, and IY were responsible for validation, whereas OFO was responsible for the methodology. TTD was involved with conceptualization, software, and supervision (TTD is a senior author for the study).

Note

This prospective study was approved by Bezmialem Vakif University ethical board under decision number 2018.876.

Publication History

Received: 18 September 2020

Accepted: 14 May 2021

Article published online:
12 December 2021

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