Oxidative stress and acute-phase response in patients with pressure sores

Abstract 

Objective

We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and α-tocopherol levels in patients with pressure sores.

Methods

The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, α₁-acid glycoprotein, total iron-binding capacity, ascorbic acid, α-tocopherol, and malondialdehyde were measured during the first days of hospitalization.

Results

Albumin concentrations were significantly lower (P < 0.05) and C-reactive protein concentrations were significantly higher (P < 0.05) in patients with pressure sores compared with controls. Concentrations of ascorbic acid and α-tocopherol were significantly decreased (P < 0.05) in patients who had pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P < 0.05) compared with control patients. Five of 11 patients (55.56%) with pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 μmol/L). Concentrations of ascorbic acid and α-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = −0.44, P < 0.05; r = −0.55, P < 0.01, respectively).

Conclusion

Patients with pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and α-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.

Key words:  Pressure sores , Acute-phase response , Oxidative stress , Ascorbic acid , α-Tocopherol