Investigating the Role of Oxidative Stress Parameters in the Spectrum of Preschool Anxiety Disorders

AIM: This study sought to clarify the contribution of oxidative stress to anxiety disorders in preschool-aged children by examining whether serum levels of Nrf2, Keap1, Sestrin-2, Superoxide Dismutase, and GABPa play etiological roles. METHOD: The sample included 65 children aged 3-6 years, comprising 22 children diagnosed with anxiety disorders, 22 with subclinical anxiety, and 21 healthy controls. Anxiety disorders were evaluated using a preschool-age psychiatric assessment. Parents completed the Preschool Anxiety Scale, the Short Temperament Scale for Children, and the CBCL 1.5-5 years forms. Venous blood samples were collected from all participants. Serum levels of Nrf2, Keap1, Sestrin-2, superoxide dismutase, and GABPa were then measured. RESULTS: Nrf2 levels differed significantly among all three groups (p < 0.05), whereas GABPa levels differed significantly only between the anxiety and control groups (p < 0.05). Positive correlations were observed between levels of Nrf2 and GABPa and both the duration and severity of anxiety disorders. Receiver operating characteristic analyses indicated that Nrf2 levels had significant predictive value for the diagnosis of anxiety disorders (p < 0.001), whereas GABPa levels did not reach statistical significance (p = 0.06). CONCLUSIONS: The results identify potential biological markers associated with anxiety disorders in preschool-aged children and suggest that Nrf2 may represent a potential candidate biomarker, pending confirmation in larger, longitudinal studies.