A Study on the Role of Oxidative Stress and Prolidase Enzyme in the Clinical Evaluation of Irritable Bowel Syndrome (IBS)

Introduction: Irritable bowel syndrome (IBS), though abenign disorder is highly prevalent and imposes high costand substantial morbidity upon general population. Longconsidered as functional disorder, IBS pathogenesis carries anorganic basis at least in a subset of patients. Altered intestinalimmune response and low grade intestinal inflammation havebeen confirmed as pathophysiology of IBS in few studies.Oxidative stress indicates that there is inflammation and,markers of oxidative stress may be developed as diagnostictool for IBS in future. Study aimed to evaluate oxidativestress in form of total oxidant status (TOS), total anti-oxidantstatus (TAS), oxidative stress index (OSI) and serum prolidaseactivity (SPA) as a marker of intestinal inflammation in IBSpatients and healthy controls.Material and methods: In this case –control study done ata teaching medical institute in north India over a period ofone year, 120 IBS patients (cases) and 40 healthy volunteers(controls) were evaluated for TOS, TAS, OSI and SPA.Patients with IBS were sub-divided into 3 groups (40 each):diarrhea predominant, constipation predominant and mixedtype (IBS-D, C and M respectively). Student t-test, chi-squaretest and ANOVA tests were used for statistical analysis.Results: Mean TOS, TOS/TAS (OSI) and prolidase levelswere significantly higher in IBS group than control with pvalue of <0.001,< 0.001, and <0.01 respectively. Level ofTOS was highest in IBS-D subgroup followed by IBS-M andLowest in IBS-C subgroup showing a significant differencebetween IBS-D and IBS-C, IBS-D and IBS-M and IBS-Mand IBS-C with p values <0.001 for each comparison. OSIwas highest in IBS-D and lowest in IBS-C with significantdifferences between the subgroups (P<0.001). Only IBS-Msubgroup had significantly higher serum prolidase activitywhen compared to controls (p<0.001) IBS-D (P=0.013) andIBS-C (P=0.01). TAS level was significantly higher in controls(P<0.001) than cases. There were significant differencesbetween all four subgroups (p<0.001) except between IBS-Cand IBS-M subgroups (P=0.294).Conclusion: This study observed that there is increasedoxidative stress and decreased antioxidant capacity in patientwith IBS. To support our results further prospective andrandomized controlled trials are necessary.

Serum total oxidant/anti-oxidant status, ischemia-modified albumin and oxidized-low density lipoprotein levels in patients with vitamin D deficiency

Objective Oxidative damage may be responsible for the pathogenesis and complications of many diseases. Vitamin D deficiency has been suggested as a potential mediator of various extra-skeletal pathologies. However, there are limited data on anti-oxidant properties of vitamin D.Materials and methods Forty-one subjects with vitamin D deficiency and 30 healthy controls were enrolled into the study. The levels of total anti-oxidant status (TAS), total oxidant status (TOS), ischemia-modified albumin (IMA), oxidized-low density lipoprotein (ox-LDL), high-sensitivity C-reactive protein (hs-CRP) and fibrinogen were measured in both groups. The measurements were repeated in 17 patients after the replacement of vitamin D.Results Serum IMA and TOS levels were significantly higher (p < 0.001 and p = 0.035, respectively), while TAS levels were significantly lower in patients, compared to controls (p < 0.001). Additionally, fibrinogen was significantly higher in patients than controls (p = 0.003), while ox-LDL and hs-CRP levels were similar between two groups. After the replacement of vitamin D, TAS level significantly increased (p = 0.037), and TOS and fibrinogen levels significantly decreased (p = 0.043 and p = 0.010, respectively). Vitamin D levels were negatively correlated with IMA and fibrinogen levels (r = -0.500, p < 0.001 and r = -0.391, p = 0.002, respectively), although positively correlated with TAS levels (r = 0.430, p < 0.001). No correlation was found between vitamin D levels, and the TOS, ox-LDL and hs-CRP levels.Conclusions In this study, while serum IMA, TOS and fibrinogen levels were increased, TAS levels were seen to be decreased in patients with vitamin D deficiency. These results suggest that oxidative/anti-oxidative balance shifts in favours of oxidative status in vitamin D deficiency.

Adiponectin, total anti-oxidant status, and high sensitivity C-reactive protein in Indonesian men with metabolic syndrome.

Aim: To examine biochemical markers of adiponectin, total anti-oxidant status (TAOS) and high sensitvity C-reactive protein (hsCRP) in individuals with and without metabolic syndrome (MetS). Methods: A cross-sectional study on 36 non-MetS and 36 MetS subjects was undertaken in Jakarta. Measured indicators were adiponectin, TAOS and hsCRP, apart from weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG). Odds ratio (OR) of adiponectin, TAOS and hsCRP were calculated to assess risk for the development of MetS. Median values were determined as cutoffs to define high and low values of each parameter. Relationships between adiponectin, TAOS and hsCRP with WC were analyzed by using Spearman correlation analysis, and the contributions of all indicators to the development of MetS were analyzed by using logistic regression. Results: Adiponectin dan hsCRP differed signifi cantly between non MetS and MetS subjects (4.2 + 1.4 vs 3.1 + 1.0 ug/mL) dan (0.97 + 0.92 vs 3.35 + 3.43 mg/L) (p < 0.01), but no signifi cant difference was found in TAOS (1.24 + 0.1 vs 1.28 + 0.2 mmol/L). Adiponectin associated negatively with WC (rs= -0.436; p < 0.01), while TAOS and hsCRP associated positively with WC (rs= 0.286, p = 0.02 and rs= 0.597, p < 0.01). The odds ratios (ORs) of adiponectin and hsCRP for the development of MetS were 4 (p = 0.01) and ~6,8 (p < 0.01), respectively; while the risk of subjects with adiponectinhs CRP ratio of ≤ 2.31 to develop MetS was 25 times (p < 0.01) those with adiponectin-hsCRP ratio > 2.31. Conclusion: The use of adiponectin-hsCRP ratio increases the predictive power for the occurrence of MetS by 4-6 times the predictive power of adiponectin or hsCRP alone.