Abstract

Background

It is known that the alteration of antioxidants can been seen in early phase after traumatic brain injury (TBI) in order to block oxidative damage, but little is known about the influence of sex on antioxidant system in patients with TBI. This study investigates whether there are sex differences in these endogenous antioxidant agents during the acute phase after TBI and their association with the disease.

Methods

Serum levels of uric acid (UA), bilirubin, albumin and creatinine were measured in 421 individuals included 157 female TBI patients, 156 male TBI patients and 108 age- and sex-matched controls.

Results

The statistically significant changes were found in UA, bilirubin, albumin and creatinine for both sexes with TBI, but the trend of changes in bilirubin and creatinine was opposite for gender groups. Serum levels of UA, bilirubin, albumin and creatinine were associated with the severity of TBI patients for both sexes. Male patient subgroups with elevated UA, albumin and creatinine had higher frequency of regaining consciousness in a month. Moreover, addition of UA and creatinine to the established clinical model had significantly improved the predictive performance over using clinical model alone in male patients with TBI. However, no similar findings were observed on female TBI patients.

Conclusion

Our results suggest sex-based differences in the serum endogenous antioxidant response to TBI. Use of serum UA and creatinine could help in the outcome prediction of male patients with TBI in combination with other prognostic factors.

中文翻译：

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创伤性脑损伤后急性期尿酸、胆红素、白蛋白和肌酐的抗氧化状态：性别特异性特征

摘要

背景

已知在创伤性脑损伤（TBI）后早期可以看到抗氧化剂的改变以阻止氧化损伤，但对性别对TBI患者抗氧化系统的影响知之甚少。这项研究调查了这些内源性抗氧化剂在 TBI 后的急性期是否存在性别差异及其与疾病的关联。

方法

测量了 421 名个体的尿酸 (UA)、胆红素、白蛋白和肌酐的血清水平，包括 157 名女性 TBI 患者、156 名男性 TBI 患者和 108 名年龄和性别匹配的对照。

结果

两性脑外伤患者的UA、胆红素、白蛋白和肌酐均有统计学意义的变化，但各性别组胆红素和肌酐的变化趋势相反。UA、胆红素、白蛋白和肌酐的血清水平与两性 TBI 患者的严重程度相关。UA、白蛋白和肌酐升高的男性患者亚组在一个月内恢复意识的频率更高。此外，与单独使用临床模型相比，在已建立的临床模型中加入 UA 和肌酐显着提高了男性 TBI 患者的预测性能。然而，在女性 TBI 患者中没有观察到类似的发现。

结论

我们的研究结果表明血清对 TBI 的内源性抗氧化反应存在性别差异。使用血清 UA 和肌酐结合其他预后因素有助于预测男性 TBI 患者的结果。