title: Oxidative status in different settings and with different methodological approaches compared by Receiver Operating Characteristic curve analysis.
abstract: OBJECTIVE
  To test the performance of different analytical approaches in highlighting the occurrence of deregulated redox status in various physio-pathological situations.
  
  
  METHODS
  35 light and 61 heavy smokers, 19 chronic renal failure, 59 kidney transplanted patients, and 87 healthy controls were retrospectively considered for the study. Serum oxidative stress and antioxidant status, assessed by spectrophotometric Reactive Oxygen Metabolites (d-ROMs) and Total Antioxidant Capacity (TAC) tests, respectively, were compared with plasma free (F-MDA) and total (T-MDA) malondialdehyde, both quantified by isotope-dilution-gas chromatography-mass spectrometry (ID-GC-MS). Sensitivity, specificity and cut-off points of T-MDA, F-MDA, d-ROMs and TAC were evaluated by both Receiver Operating Characteristic (ROC) analyses and area under the ROC curve (AUC).
  
  
  RESULTS
  Only T-MDA assay showed a clear absence of oxidative stress in controls and significant increase in all patients (AUC 1.00, sensitivity and specificity 100%). Accuracy was good for d-ROMs (AUC 0.87, sensitivity 72.8%, specificity 100%) and F-MDA (AUC 0.82, sensitivity 74.7%, specificity 83.9%), but not high enough for TAC to show in patients impaired antioxidant defense (AUC 0.66, sensitivity 52.0%, specificity 92.9%).
  
  
  CONCLUSIONS
  This study reveals T-MDA as the best marker to detect oxidative stress, shows the ability of d-ROMs to identify modified oxidative status particularly in the presence of high damages, and evidences the poor TAC performance. d-ROMs and TAC assays could be useful for routine purposes; however, for an accurate clinical data evaluation, their comparison versus a "gold standard method" is required.
authors.affiliation: Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milano, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Cighetti
authors.affiliation: Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy; U.O. Ematologia e CTMO, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Bamonti
authors.affiliation: Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milano, Italy.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Aman
authors.affiliation: Unità di Biostatistica, Epidemiologia e Salute Pubblica, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
authors.affiliation: Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy; U.O. Ematologia e CTMO, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: De Giuseppe
authors.affiliation: Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Novembrino
authors.affiliation: Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: de Liso
authors.affiliation: Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Maiavacca
authors.affiliation: Dipartimento di Scienze della Salute, Università degli Studi di Milano, H San Paolo, Milano, Italy. Electronic address: rita.paroni@unimi.it.
authors.forename: Rita
authors.initials: R
authors.lastname: Paroni
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000378:metabolism; D016001:Confidence Intervals; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods*; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D010084:Oxidation-Reduction; D012372:ROC Curve; D018709:Statistics, Nonparametric
chemical_list: D000975:Antioxidants; D008315:Malondialdehyde
keywords: Antioxidant status; Isotope-dilution-gas chromatography–mass spectrometry; Malondialdehyde; Method comparison; Oxidative stress; ROC curve analysis