The Role of Biochemical Markers of Oxidative Damage in The Progression of Coronary Heart Disease Among Residents of Kirkuk City

Authors

  • Iman Noori Mahmood Mahdi Department of Chemistry, College of Science, University of Kirkuk, Kirkuk, Iraq

DOI:

https://doi.org/10.51699/cajmns.v7i2.3169

Keywords:

Coronary Heart Disease, Oxidative Stress, Malondialdehyde, Glutathione Peroxidase, Antioxidants

Abstract

Coronary heart disease (CHD) still accounted for a large proportion of all-cause mortality, oxidative stress has been proven to play an important role in the pathogenesis of CHD besides the traditional lipid abnormality. Objective: This work was oriented to the study of oxidative stress biomarkers in CHD patients versus healthy subjects and to investigate the association between these parameters with demographic and clinical variables in Kirkuk City residents in the north of Iraq. A case-control study was conducted on 60 CHD patients (30 males, 30 females; age ranged 40–69 years) and 30 apparently healthy controls (15 males, 15 females; age ranged 40–67 years); all were non-smokers, non-alcoholics, and without hypertension or diabetes. Venous blood samples were taken to estimate malondialdehyde (MDA), glutathione peroxidase (GPx) activity and levels of vitamin C and ceruloplasmin. The independent t test and two-way ANOVA were involved in the statistical analysis. Results: In CHD patients, all OS markers were significantly raised compared with controls, and in patients MDA was significantly higher (4.87 ± 1.23 nmol/mL) than in controls (2.15 ± 0.67 nmol/mL)). Antioxidant defenses were equally severely impaired: GPx activity was decreased (28.64 ± 6.71 U/L vs.58 ± 8.45 U/L), as well as vitamin C levels (0.58 ± 0.21 mg/dl vs. 1.26 ± 0.34 mg/dl) and ceruloplasmin concentrations (28. 93 ± 5.67 mg/dl vs. 41.75 ± 7.82 mg/dl). Gendered analysis showed male patients had greater oxidative imbalance than females. Age stratification showed progressive increase of MDA and decrease of antioxidants with age. Body mass index (BMI) correlated significantly positively with MDA and negatively with antioxidant parameters. Our results indicate an extreme disruption of the oxidant-antioxidant equilibrium in CHD patients with increased lipid peroxidation and impaired antioxidant defense, which indicates that these biomarkers may be of value as additional tools in the risk stratification and follow-up of the disease.

References

G. A. Roth et al., "Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study," J. Am. Coll. Cardiol., vol. 76, no. 25, pp. 2982-3021, Dec. 2020.

P. Libby et al., "Atherosclerosis," Nat. Rev. Dis. Primers, vol. 5, no. 1, p. 56, Aug. 2019.

U. Förstermann, N. Xia, and H. Li, "Roles of vascular oxidative stress and nitric oxide in the pathogenesis of atherosclerosis," Circ. Res., vol. 120, no. 4, pp. 713-735, Feb. 2017.

D. Steinberg and J. L. Witztum, "Oxidized low-density lipoprotein and atherosclerosis," Arterioscler. Thromb. Vasc. Biol., vol. 30, no. 12, pp. 2311-2316, Dec. 2010.

I. G. Zainal, "Study the profile of some antioxidant markers in diabetic mellitus and non-diabetic patients with cardiovascular disease," Med. J. Babylon, vol. 19, no. 4, pp. 653-658, Oct. 2022.

D. A. Mahmoud and S. S. Saleh, "Determination of the level of homocysteine and antioxidants in the blood serum of women with gestational diabetes," Solid State Technol., vol. 64, no. 1, pp. 1129-1135, Jan. 2021.

E. Lubos, J. Loscalzo, and D. E. Handy, "Glutathione peroxidase-1 in health and disease: from molecular mechanisms to therapeutic opportunities," Antioxid. Redox Signal., vol. 15, no. 7, pp. 1957-1997, Oct. 2011.

S. J. Padayatty and M. Levine, "Vitamin C: the known and the unknown and Goldilocks," Oral Dis., vol. 22, no. 6, pp. 463-493, Sep. 2016.

N. Shukla, J. Maher, J. Masters, G. D. Angelini, and J. Y. Jeremy, "Does oxidative stress change ceruloplasmin from a protective to a vasculopathic factor?," Atherosclerosis, vol. 187, no. 2, pp. 238-250, Aug. 2006.

GBD 2017 Risk Factor Collaborators, "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017," Lancet, vol. 392, no. 10159, pp. 1923-1994, Nov. 2018.

M. Myszko, J. Bychowski, E. Skrzydlewska, and W. Łuczaj, "The dual role of oxidative stress in atherosclerosis and coronary artery disease: pathological mechanisms and diagnostic potential," Antioxidants, vol. 14, no. 3, p. 275, Mar. 2025.

J. A. Buege and S. D. Aust, "Microsomal lipid peroxidation," Methods Enzymol., vol. 52, pp. 302-310, 1978.

D. E. Paglia and W. N. Valentine, "Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase," J. Lab. Clin. Med., vol. 70, no. 1, pp. 158-169, Jul. 1967.

S. T. Omaye, J. D. Turnbull, and H. E. Sauberlich, "Selected methods for the determination of ascorbic acid in animal cells, tissues, and fluids," Methods Enzymol., vol. 62, pp. 3-11, 1979.

K. H. Schosinsky, H. P. Lehmann, and M. F. Beeler, "Measurement of ceruloplasmin from its oxidase activity in serum by use of o-dianisidine dihydrochloride," Clin. Chem., vol. 20, no. 12, pp. 1556-1563, Dec. 1974.

F. Milani et al., "Oxidative stress and DNA damage biomarkers in heart failure: a systematic review and meta-analysis," Antioxidants, vol. 14, no. 10, p. 1249, Oct. 2025.

A. Iboleon-Jimenez et al., "Mitochondria, sex, and cardiovascular disease: a complex interplay," Int. J. Mol. Sci., vol. 26, no. 18, p. 8971, Sep. 2025.

I. Liguori et al., "Oxidative stress, aging, and diseases," Clin. Interv. Aging, vol. 13, pp. 757-772, Apr. 2018.

J. F. Keaney Jr. et al., "Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study," Arterioscler. Thromb. Vasc. Biol., vol. 23, no. 3, pp. 434-439, Mar. 2003.

M. Karakayali et al., "Serum malondialdehyde levels at admission as a predictor of inhospital mortality in patients with acute coronary syndrome," Coron. Artery Dis., vol. 36, no. 3, pp. 211-217, May 2025.

W. Zhang et al., "Elevated serum glutathione peroxidase levels reducing the risk of acute upper gastrointestinal bleeding combined with acute coronary syndrome: evidence from observational, interventional, and Mendelian randomization studies," Int. J. Cardiol. Cardiovasc. Risk Prev., vol. 26, p. 200471, Sep. 2025.

H. J. Forman and H. Zhang, "Targeting oxidative stress in disease: promise and limitations of antioxidant therapy," Nat. Rev. Drug Discov., vol. 20, no. 9, pp. 689-709, Sep. 2021.

A. Toffalini et al., "Association of low vitamin C concentrations and low consumption of fresh fruit and vegetables with cardiovascular disease in type 2 diabetes," BMC Nutr., vol. 11, no. 1, p. 68, May 2025.

M. B. Morelli et al., "Vitamin C and cardiovascular disease: an update," Antioxidants, vol. 9, no. 12, p. 1227, Dec. 2020.

A. P. Arenas de Larriva et al., "Ceruloplasmin and coronary heart disease—a systematic review," Nutrients, vol. 12, no. 10, p. 3215, Oct. 2020.

H. Wazir et al., "Serum ceruloplasmin as a risk predictor in cardiovascular disease: a systematic review," J. Cardiovasc. Dev. Dis., vol. 12, no. 2, p. 45, Feb. 2025.

A. Maleki et al., "Gender differences in oxidative stress markers among patients with metabolic syndrome," Diabetol. Metab. Syndr., vol. 13, no. 1, p. 52, May 2021.

I. Liguori et al., "Oxidative stress, aging, and diseases," Clin. Interv. Aging, vol. 13, pp. 757-772, Apr. 2018.

W. H. Son, Y. S. Kwak, and M. S. Ha, "Circuit training on oxidative stress and arterial health: a health promotion perspective for obese adult men," Front. Public Health, vol. 13, p. 1562193, Mar. 2025.

R. A. Pinho et al., "Oxidative stress and inflammatory markers in cardiovascular diseases: the role of diet and physical exercise," Curr. Pharm. Des., vol. 25, no. 28, pp. 3044-3057, 2019.

P. Fiorino et al., "The intricate relationship between oxidative stress, inflammation, and atherosclerosis," Oxid. Med. Cell. Longev., vol. 2020, p. 5296571, 2020.

H. N. Siti, Y. Kamisah, and J. Kamsiah, "The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease," Vascul. Pharmacol., vol. 71, pp. 40-56, Aug. 2015.

K. Cervantes Gracia, D. Llanas-Cornejo, and H. Husi, "CVD and oxidative stress," J. Clin. Med., vol. 6, no. 2, p. 22, Feb. 2017.

F. He and L. Zuo, "Redox roles of reactive oxygen species in cardiovascular diseases," Int. J. Mol. Sci., vol. 16, no. 11, pp. 27770-27780, Nov. 2015.

N. R. Madamanchi, A. Vendrov, and M. S. Runge, "Oxidative stress and vascular disease," Arterioscler. Thromb. Vasc. Biol., vol. 25, no. 1, pp. 29-38, Jan. 2005.

Downloads

Published

2026-03-19

How to Cite

Mahdi, I. N. M. (2026). The Role of Biochemical Markers of Oxidative Damage in The Progression of Coronary Heart Disease Among Residents of Kirkuk City. Central Asian Journal of Medical and Natural Science, 7(2), 347–382. https://doi.org/10.51699/cajmns.v7i2.3169

Issue

Section

Articles