Key result
Increased erythrocyte MDA levels and decreased erythrocyte SOD and CAT activities were associated with a 10.32, 10.25, and 5.33 times greater risk for breath-holding spells, respectively.
Why the study?
Breath-holding spells have an unknown pathophysiology, and this study investigated the role of iron deficiency anemia and oxidant/antioxidant balance in affected children compared to healthy controls.
Case-Control (n=96)
Children with breath-holding spells exhibit impaired oxidant/antioxidant balance in favor of oxidants, particularly at the erythrocyte level, regardless of the presence of iron deficiency anemia.
Answers are grounded in this paper and cite their sources.
Erythrocyte oxidative stress markers may flag breath-holding spell risk; case-control data leave open causality and therapeutic implications.
BACKGROUND: Breath-holding spells (BHS) are common non-paroxysmal events with unknown pathophysiology. BHS have been associated not only with iron deficiency anemia (IDA) but also with oxidant/antioxidant imbalance and erythrocyte injury induced by hypoxia. The present study was designed to investigate the contribution of IDA in BHS and the oxidant/antioxidant balance in children with or without IDA in BHS and compare them with healthy controls.Additionally, the study also aimed to examine the effect of the frequency of BHS attacks (mild or severe) on the oxidant/antioxidant balance and to determine the best predictive oxidant and antioxidant markers. MATERIALS AND METHODS: The study included 66 children with BHS aged 6-48 months who had been followed up for a minimum period of one year between 2014 and 2018. A control group of 30 age- and gender-matched healthy children was included in the study. The patient group was divided into 2 groups (IDA and non-IDA) and these groups were compared between each other and also with the control group. The IDA group was divided into subgroups based on the frequency of BHS attacks. Blood samples were obtained within a maximum period of 24 h following the spell. Levels of protein carbonyl, nitrite, nitrate, TOS, TAS, OSI, MDA, enzyme activities of GPx, CAT,enzyme activities of erythrocyte SOD, CAT, and GPx, and the level of MDA were measured. RESULTS: In patients with IDA, the oxidant levels increased while the antioxidant enzyme activities decreased. In all patients, the levels of MDA, carbonyl, TOS, OSI increased and the levels of TAS, activities SOD, and CAT decreased, whereas the enzyme activities of erythrocyte SOD, CAT, GPx decreased significantly compared to those of control group. Increased of erythrocyte MDA levels had 10.32, decreased enzyme activities of erythrocyte SOD levels had a 10.25, and decreased enzyme activities of erythrocyte CAT had a 5.33 times greater risk for spell. CONCLUSION: The results indicated that the oxidant/antioxidant balance in children with BHS was impaired in favor of oxidants at both levels, regardless of the presence of IDA and the increased frequency of BHS attacks per day. Moreover, the presence of IDA was found to be associated with increased oxidative stress in children with BHS, particularly at the erythrocyte level. Erythrocyte level; among the erythrocyte MDA oxidant parameters, erythrocyte SOD and antioxidant parameters, they are the biomarkers that show the best probability of having a BHS attack and an increase in the frequency of apnea attacks.
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Dilber et al. (2021) conducted a case-control in Breath-holding spells (n=96). Breath-holding spells with or without iron deficiency anemia vs. Healthy controls was evaluated on Oxidant and antioxidant markers (MDA, SOD, CAT) (OR 10.32, OR 10.25, OR 5.33). Increased erythrocyte MDA levels and decreased erythrocyte SOD and CAT activities were associated with a 10.32, 10.25, and 5.33 times greater risk for breath-holding spells, respectively.
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