Oxidative Stress and Antioxidant Markers in Serum and Red Blood Cell of Patients with Ischemic and Hemorrhagic Stroke: A Case-Control Study

Abstract

Background and Aim: Oxidative stress is a major mechanism involved in stroke pathogenesis. The present study evaluated and compared oxidative stress parameters in patients with ischemic and hemorrhagic stroke (IS and HS) at the time of hospitalization and 1 week after hospitalization. Methods: This was a case-control study with 87 stroke patients (58 IS and 29 HS) as the case and 58 normal individuals as the control group. Sampling was done at the time of hospitalization and after 1 week. The serum total antioxidant capacity (TAC), thiol group, and F2-isoprostan levels were measured using Ferric Reducing Antioxidant Power (FRAP), Elman, and Enzyme Linked Immunosorbent Assay ELISA methods, respectively. Results: At the time of hospitalization, there was no significant difference in TAC and F2-isoprostan levels between the case and control groups (TAC for IS = 852.4 ± 238.9, HS = 1064.1 ± 271.1, and control = 947.6 ± 203.1 µmol/L; P = 0.074), yet, the thiol group levels were significantly lower (P < 0.001) in the case groups (IS and HS) compared to the control group (IS = 360.3 ± 139.8, HS = 357.8 ± 94.4, and control = 568.4 ± 201.4 mmol/L; P < 0.001). At 1 week after the time of hospitalization, the case patients showed a significant increase in thiol levels (IS at p = 0.005; HS at P = 0.02), yet, TAC values decreased (P < 0.015) only in patients with HS compared to levels at the time of hospitalization. There were no significant differences between groups for antioxidant enzymes (SOD, GPx, and CAT) or the National institute of health stroke scale (NIHSS) score of patients at the time of hospitalization and 1 week later, except for superoxide dismutase (SOD), which increased in patients with HS (P = 0.05). Conclusions: The results showed that antioxidant defense status in stroke patients was lower than for the control group. Improving the antioxidant defense system, especially for HS patients by strategies such as natural antioxidant consumption is suggested.