Acute-phase serum superoxide dismutase level as a predictive biomarker for stroke-associated infection

Int J Neurosci. 2020 Feb;130(2):186-192. doi: 10.1080/00207454.2019.1667790. Epub 2019 Nov 7.

Abstract

Background and Purpose: Oxidative stress is involved in the development of infections. However, whether oxidative stress indicators can be used as markers of stroke-associated infection (SAI) is still unclear. The purpose of this study was to test the predictive values of superoxide dismutase (SOD) and malondialdehyde (MDA) levels for SAI incidence.Methods: A total of 45 consecutive patients with ischemic stroke who were admitted to our hospital were enrolled. A prospective study was carried out to observe the occurrence of SAI during the first 7 days after stroke. Accordingly, the patients were divided into SAI and non-SAI groups. The relationship between SOD and MDA serum levels and SAI was analyzed.Results: The patients in the SAI group had significantly higher serum SOD levels than those in the non-SAI group (41.638 ± 3.428 U/ml vs. 36.542 ± 9.114 U/ml, p = 0.033). However, there were no significant differences in MDA levels between the SAI and non-SAI group (p > 0.05). The discriminating ability of serum SOD level for SAI was measured using an ROC curve. Serum level of SOD >38.16 U/ml was useful in diagnosing SAI with a sensitivity of 88% and a specificity of 61%. Kaplan-Meier curves showed that the group with serum SOD level >38.16 U/ml had higher rates of SAI incidence (χ2 = 9.688, p = 0.002; log rank test). Furthermore, Cox regression analysis indicated that a serum SOD level >38.16 U/ml was an independent risk factor for SAI (hazard ratio = 5.836; 95% CI, 1.298-26.244; p = 0.021).Conclusions: Acute-phase serum SOD level could be a predictor of SAI.

Keywords: Stroke; infection; inflammatory response; oxidative stress; superoxide dismutase.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / complications
  • Female
  • Humans
  • Infections / blood*
  • Infections / diagnosis*
  • Infections / etiology
  • Inflammation / blood*
  • Inflammation / etiology
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Oxidative Stress* / physiology
  • Prospective Studies
  • Sensitivity and Specificity
  • Stroke / blood*
  • Stroke / complications
  • Superoxide Dismutase / blood*

Substances

  • Biomarkers
  • Malondialdehyde
  • Superoxide Dismutase