Gönül AÇIKSARI, Mehmet KOÇAK, Ebuzer AYDIN, Adem ATICI, Hasan BARMAN, Turgut UYGUN, Emre YALÇINKAYA, Yusuf YILMAZ, Oğuz KONAL, Mustafa CALISKAN

Asendan aort dilatasyonunda oksidatif stres ile ilişkili belirteçlerin rolü: malondialdehit ve paraoksonaz-1 aktivitesi

Amaç: Bu çalışmada, oksidatif stres belirteci malondialdehit ve antioksidan enzim paraoksonaz-1 aktivitesi ile asendan aort dilatasyonu olan hastalarda oksidatif ve antioksidatif durum değerlendirildi.Yöntem: Bu kesitsel çalışmaya Ağustos 2020-Aralık 2020 tarihleri arasında asendan aort dilatasyonu olan toplam 56 ardışık hasta (26 erkek, 30 kadın; ort. yaş: 55.3±8.6 yıl; dağılım, 31-67 yıl) ve aort çapı normal olan, yaş ve cinsiyet açısından eşleştirilmiş 33 kontrol (13 erkek, 20 kadın; ort. yaş: 54.5±10.5 yıl; dağılım, 32-67 yıl) dahil edildi. Hastaların tümü transtorasik ekokardiyografi ile değerlendirildi. Paraoksonaz-1 aktivitesi spektrofotometre ile manuel olarak ölçüldü. Malondialdehit, tiyobarbitürik asit testi ile ölçüldü. Asendan aort dilatasyonunun malondialdehit ve paraoksonaz-1 aktivitesi ile olan ilişkisini tespit etmek için korelasyon analizleri yapıldı.Bulgular: Ortalama malondialdehit düzeyleri, kontrol grubuna kıyasla, hasta grubunda anlamlı düzeyde daha yüksek idi (sırasıyla 1.7±0.3 μmoL/mL’ye kıyasla 2.5±1.9 μmoL/mL; p<0.001). Ortalama paraoksonaz-1 aktivitesi, hasta grubunda anlamlı düzeyde daha düşük idi (sırasıyla 30±17.6 U/mL’ye kıyasla 18.5±12.9 U/mL; p<0.002). Serum malondialdehit düzeyleri ve asendan aort çapı arasında pozitif, anlamlı bir ilişki saptandı (r=0.293, p=0.009). Serum paraoksonaz-1 aktivitesi ve asendan aort çapı arasında negatif, anlamlı bir ilişki saptandı (r=-0.364, p=0.001). Malondialdehit düzeyleri ve paraoksonaz-1 aktivitesi, asendan aort dilatasyonunun bağımsız ön gördürücüleri idi.Sonuç: Çalışma sonuçlarımız, lipid peroksidasyonunu gösteren artmış malondialdehit düzeylerinin ve bozulmuş antioksidan savunmasını gösteren azalmış paraoksonaz-1 aktivitesinin, asendan aort dilatasyonunun patofizyolojisinde rol oynayabileceği görüşünü desteklemektedir.

Anahtar Kelimeler:

antioksidan, asendan aort dilatasyonu, malondialdehit, oksidatif stres, paraoksonaz-1.

The role of oxidative stress-related biomarkers in ascending aortic dilatation: malondialdehyde and paraoxonase-1 activity

Aim: This study aimed to evaluate the antioxidative and oxidative status of patients with ascending aortic dilatation using malondialdehyde, an oxidative stress marker, and paraoxonase-1 activity, an antioxidant enzyme.Methods: This cross-sectional study was conducted between August and December 2020. It included 56 consecutive patients (mean age 55.3 ± 8.6 years; range 31 to 67 years; 26 males, 30 females) with ascending aortic dilatation and 33 sex-and age-matched controls (mean age 54.5 ± 10.5 years; range 32 to 67 years; 13 males, 20 females) with normal aortic diameters. All participants were evaluated using transthoracic echocardiography. Malondialdehyde was analyzed using the thiobarbituric acid assay. Paraoxonase-1 activity was measured manually using a spectrophotometer. The relation of ascending aortic dilatation with malondialdehyde levels and paraoxonase-1 activity was identified with correlation analyses.Results: The patient group had significantly higher mean malondialdehyde than the control group (2.5 ± 1.9 μmoL/mL and 1.7 ± 0.3 μmoL/mL, respectively; p < 0.001). The patient group had significantly lower mean activity of paraoxonase-1 than the control group (18.5 ± 12.9 U/mL vs.30 ± 17.6 U/mL, respectively; p < 0.002). Serum malondialdehyde was negatively correlated with ascending aortic diameter (r = 0.293, p = 0.009). A significant negative correlation was found between the activity of serum paraoxonase-1 and ascending aortic diameter (r = -0.364, p = 0.001). Malondialdehyde levels and paraoxonase-1 activity were independent predictors of ascending aortic dilatation.Conclusion: The results are in line with the notion that increased malondialdehyde levels indicate lipid peroxidation, and decreased paraoxonase-1 activity indicates impaired antioxidant defense. Using them may help protect against the pathophysiology of ascending aortic dilatation.

Keywords:

antioxidant, ascending aortic dilatation, malondialdehyde, oxidative stress, paraoxonase-1,

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