Monitoring Oxidative Stress Across Worsening Child Pugh Class of Cirrhosis

Context :Oxidative stress has been increasingly implicated in the pathogenesis and progression of cirrhosis.
Aims :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.
Design :Case-controlled retrospective study.
Materials and 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.
Statistical Analysis :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.

Keywords
Humans, cirrhosis, oxidative stress, reactive oxygen species, lipid peroxidation