Aral Armagan, Avcı Bahattin, Kesim Neriman, Şimşek Oğuzhan
Child and Adolescent Mental Health and Diseases, Izmir City Hospital, İzmir, Türkiye.
Medical Biochemistry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye.
Noro Psikiyatr Ars. 2025 Aug 13;62(3):264-269. doi: 10.29399/npa.28937. eCollection 2025.
Anxiety disorders (AD) constitute a significant part of mental health problems; however, their pathogenesis remains not fully elucidated. The balance between the oxidative and antioxidative systems are disrupted in children with AD. The total oxidant/antioxidant status (TOS/TAS) and thiol/disulphide homeostasis (TDH) show oxidative stress through different mechanisms. To date, research in this context has tended to focus on adults rather than children. Despite this, understanding oxidative stress in pediatric populations is increasingly emphasized. Therefore, this research aims to investigate TOS/TAS and TDH in children with AD.
The study included 40 treatment-naive children with AD and 40 healthy controls matched by age and sex. Sociodemographic data and The Screen for Child Anxiety-Related Emotional Disorders (SCARED) were used for assessment.
The results showed that TOS and the Oxidative Stress Index (OSI) were elevated, and TAS was reduced in children with AD compared to controls. However, when evaluated in terms of TDH, there was no significant difference. Logistic regression analysis identified TOS as a significant predictor of AD (p=0.027; OR=5.49, 95% CI: 1.21-24.84). Although dynamic-disulphide level improved the model's predictive accuracy, they did not reach statistical significance (p=0.063).
These findings suggest a potential oxidative dysfunction in AD. The study highlights the potential utility of TOS as a robust biomarker for distinguishing pediatric AD from HC. Furthermore, the absence of significant changes in TDH suggests that oxidative stress in pediatric AD may primarily involve alternative pathways. This may involve a complex interplay of DNA damage, lipid peroxidation, and protein oxidation processes contributing to the oxidative stress observed in AD. To explore the potential for using oxidative stress markers as novel targets for treatment and diagnostic tools for AD, prospective, large-scale, randomized trials are required.
焦虑症（AD）是心理健康问题的重要组成部分；然而，其发病机制仍未完全阐明。AD患儿的氧化系统与抗氧化系统之间的平衡被打破。总氧化剂/抗氧化剂状态（TOS/TAS）和硫醇/二硫化物稳态（TDH）通过不同机制显示氧化应激。迄今为止，这方面的研究倾向于关注成人而非儿童。尽管如此，对儿童群体氧化应激的理解正日益受到重视。因此，本研究旨在调查AD患儿的TOS/TAS和TDH。
该研究纳入了40名未经治疗的AD患儿以及40名年龄和性别匹配的健康对照。使用社会人口统计学数据和儿童焦虑相关情绪障碍筛查量表（SCARED）进行评估。
结果显示，与对照组相比，AD患儿的TOS和氧化应激指数（OSI）升高，TAS降低。然而，就TDH进行评估时，没有显著差异。逻辑回归分析确定TOS是AD的显著预测因子（p = 0.027；OR = 5.49，95% CI：1.21 - 24.84）。尽管动态二硫化物水平提高了模型的预测准确性，但未达到统计学意义（p = 0.063）。
这些发现表明AD中存在潜在的氧化功能障碍。该研究强调了TOS作为区分儿童AD与健康对照（HC）的强大生物标志物的潜在效用。此外，TDH无显著变化表明儿童AD中的氧化应激可能主要涉及其他途径。这可能涉及DNA损伤、脂质过氧化和蛋白质氧化过程的复杂相互作用，导致AD中观察到的氧化应激。为了探索将氧化应激标志物用作AD治疗和诊断工具新靶点的潜力，需要进行前瞻性、大规模、随机试验。
