Oxidative stress and acute-phase response in patients with pressure sores.
OBJECTIVE
We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and alpha-tocopherol levels in patients with pressure sores.


METHODS
The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, alpha1-acid glycoprotein, total iron-binding capacity, ascorbic acid, alpha-tocopherol, and malondialdehyde were measured during the first days of hospitalization.


RESULTS
Albumin concentrations were significantly lower (P < 0.05) and C-reactive protein concentrations were significantly higher (P < 0.05) in patients with pressure sores compared with controls. Concentrations of ascorbic acid and alpha-tocopherol were significantly decreased (P < 0.05) in patients who had pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P < 0.05) compared with control patients. Five of 11 patients (55.56%) with pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 micromol/L). Concentrations of ascorbic acid and alpha-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = -0.44, P < 0.05; r = -0.55, P < 0.01, respectively).


CONCLUSIONS
Patients with pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and alpha-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.
Cordeiro
Maria Bernarda Cavalcanti
MB
Department of Internal Medicine, School Medicine of Triângulo Mineiro, Uberaba, Brazil. mbcfmtm@mednet.com.br
Antonelli
Elida Juliana
EJ
da Cunha
Daniel Ferreira
DF
Júnior
Alceu Afonso Jordão
AA
Júnior
Virmondes Rodrigues
VR
Vannucchi
Helio
H
D000210:Acute-Phase Reaction / Q000378:metabolism*; D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D007501:Iron / Q000097:blood; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D009752:Nutritional Status; D010084:Oxidation-Reduction; D018384:Oxidative Stress / Q000502:physiology; D011014:Pneumonia / Q000378:metabolism; D003668:Pressure Ulcer / Q000378:metabolism*; D012709:Serum Albumin / Q000032:analysis; D024502:alpha-Tocopherol / Q000097:blood*
D000975:Antioxidants; D012709:Serum Albumin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D003404:Creatinine; D007501:Iron; D024502:alpha-Tocopherol; D001205:Ascorbic Acid