title: Serum elements and oxidative status in clinically isolated syndromes: imbalance and predictivity.
abstract: BACKGROUND
  Metals are suspected of being involved in the pathogenesis of various neurologic diseases. We previously found a complex imbalance in serum chemical elements and oxidative status in patients with clinically definite multiple sclerosis (CDMS).
  
  
  OBJECTIVE
  To understand whether this imbalance affects people with clinically isolated syndrome (CIS) and, if so, whether it predicts conversion to CDMS.
  
  
  METHODS
  We studied 22 chemical elements and the oxidative status in 49 patients with CIS, 49 patients with CDMS, and 49 healthy donors (HD). Univariate and multivariate approaches were used to identify profiles for each group. A logistic regression analysis was used to identify the predictive potential of baseline data (elements, oxidative status, and MRI findings) for conversion to CDMS over 36 months.
  
  
  RESULTS
  Several elements and oxidative status values differed significantly among the 3 groups. Discriminant analysis revealed a major contribution of Ca, Fe, Sn, Zn, serum antioxidant capacity, and serum oxidative status, which resulted in distinct profiles (the prediction of group membership was 96% [cross-validated 92%] for HD, 92% [cross-validated 92%] for CDMS, and 90% [cross-validated 86%] for CIS). A weighted combination of element concentrations and oxidative status values, adjusting for all other predictors, would predict a reduction in the risk of conversion to CDMS within 3 years (odds ratio 0.37; 95% confidence interval 0.18-0.76; p = 0.007), thereby proving more effective than MRI at baseline.
  
  
  CONCLUSIONS
  The peculiar imbalance in serum elements and oxidative status that characterizes patients with CIS and may predict conversion to CDMS warrants studies on larger sample sizes.
authors.affiliation: Center for Experimental Neurological Therapies, S. Andrea Hospital, II Faculty of Medicine, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy. giovanni.ristori@uniroma1.it
authors.forename: G
authors.initials: G
authors.lastname: Ristori
authors.forename: S
authors.initials: S
authors.lastname: Brescianini
authors.forename: A
authors.initials: A
authors.lastname: Pino
authors.forename: A
authors.initials: A
authors.lastname: Visconti
authors.forename: D
authors.initials: D
authors.lastname: Vittori
authors.forename: G
authors.initials: G
authors.lastname: Coarelli
authors.forename: R
authors.initials: R
authors.lastname: Cotichini
authors.forename: B
authors.initials: B
authors.lastname: Bocca
authors.forename: G
authors.initials: G
authors.lastname: Forte
authors.forename: C
authors.initials: C
authors.lastname: Pozzilli
authors.forename: I
authors.initials: I
authors.lastname: Pestalozza
authors.forename: M A
authors.initials: MA
authors.lastname: Stazi
authors.forename: A
authors.initials: A
authors.lastname: Alimonti
authors.forename: M
authors.initials: M
authors.lastname: Salvetti
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003711:Demyelinating Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011237:Predictive Value of Tests; D014131:Trace Elements / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014131:Trace Elements