Monitoring oxidative stress across worsening Child Pugh class of cirrhosis.
BACKGROUND
Oxidative stress has been increasingly implicated in the pathogenesis and progression of cirrhosis.


OBJECTIVE
We studied oxidative stress in patients with cirrhosis by measuring markers reflecting pro-oxidant (serum malondialdehyde-MDA) and antioxidant factors (RBC catalase-CAT, superoxide dismutase-SOD and blood reduced glutathione-GSH) factors. The level of oxidative stress was also assessed with respect to functional compromise of liver, as determined by Child Turcotte Pugh (CTP) scoring.


METHODS
Case-controlled retrospective study.


METHODS
Twenty-three patients of cirrhosis along with 23 age and sex matched healthy controls were studied. Exclusion criteria were concurrent use of anti-oxidant drugs; co-existing diseases like DM, CKD; alcohol use, gastrointestinal bleed or blood transfusion within previous 2 weeks. Besides routine investigations, MDA, CAT, SOD and GSH levels were measured and compared with controls.


METHODS
Continuous variables were recorded as mean +/- SD; ANOVA-f test, followed by Tukey's test, was used to evaluate the significance of difference (P < 0.05) among groups.


RESULTS
Mean age of patients was 41.04 +/- 12.3 yrs. Patients showed a significant increase in MDA {control 3.31 +/- 0.25 (95% CI 3.21-3.41), Child B 6.30 +/- 0.4 (95% CI 6.03-6.53), Child C 8.05 +/- 0.66 (95% CI 7.29-8.81) nmol/l} and a significant decrease in levels of SOD {control 845.13 +/- 36.44 (95% CI 829.92-860.34), Child B 582.91 +/- 42.12 (95% CI 557.45-608.32), Child C 489.5 +/- 17.66 (95% CI 479.3-499.7) U/gm Hb}, CAT {controls 2.54 +/- 0.22 (95% CI 2.45-2.63), Child B 1.93 +/- 0.23 (95% CI 1.72-2.14), Child C 1.46 +/- 0.10 (95% CI 1.40-1.52) U/ gm Hb} and GSH {controls 6.52 +/- 0.25 (95% CI 6.42-6.52), Child B 3.85 +/- 0.18 (95%CI 3.74-3.96), Child C 2.99 +/- 0.30 (95% CI 2.82-3.16) mmol/ gm Hb}.


CONCLUSIONS
Oxidative stress is associated with the development and progression of cirrhosis.
Bhandari
Sumit
S
Department of Medicine, University College of Medical Sciences and GTB Hospital, New Delhi-110 095, India. sumitbhandari06@gmail.com
Agarwal
Mukul P
MP
Dwivedi
S
S
Banerjee
B D
BD
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers; D016022:Case-Control Studies; D002374:Catalase / Q000097:blood; D016001:Confidence Intervals; D018450:Disease Progression; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000378:metabolism*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D008991:Monitoring, Physiologic; D018384:Oxidative Stress; D012189:Retrospective Studies; D013482:Superoxide Dismutase / Q000097:blood
D015415:Biomarkers; D008315:Malondialdehyde; D002374:Catalase; D013482:Superoxide Dismutase; D005978:Glutathione