Development of a Plasma Biomarker to Test Oxidative Stress in Frail Elders with Traumatic Injury

Abstract

Background: Physically injured elder adults present challenges in the emergent injury phase. Oxidative stress contributes to cellular deterioration, resulting in decreases in physiological reserve. Imbalance of oxidative stress pathways lead to damage and drive the aging process and frailty. Goals of this study were to determine if a new plasma biomarker of oxidative stress is related to: 1) oxidation reduction status in patients who have experienced traumatic injury as well as healthy community dwellers, 2) outcomes of patients who have experienced trauma, 3) frailty measured by established frailty scales in healthy community dwellers. Methods: Prospective study included 1) trauma patients ≥65 admitted to Level I trauma center 2) age, gender matched healthy, community-dwelling participants. Plasma samples tested in duplicate for capacity oxidative reductive potential (cORP, μC; antioxidant reserve), and static oxidative reductive potential (sORP, mV; the current state of oxidative stress). Frailty assessments were performed in healthy participants using established frailty scales. ORP measurements were analyzed using correlation analyses. Univariate analysis analyzed cORP and sORP for differences by the variables gender, age, smoking, diabetes, statin use, vitamin use and any alcohol use in both the injured and healthy populations. Results: 186 subjects included in study (N=93 for both groups). Trauma groups's cORP values were significantly lower in patients with diabetes (p<0.05) and patients that smoked (p<0.01). Similarly the healthy group's cORP was significantly lower for those who smoked and those with diabetes (p<0.05). Non-vitamin use in the healthy group was related to lower cORP values (p<0.05). Trauma patients who smoked and those with diabetes exhibited higher sORP values (p<0.05). In the healthy group, sORP did not differ when considering the variables. No12significant differences were found based on gender, statin or alcohol use for either group. Significant correlation was found for both sORP and cORP with CSHA Clinical Frailty Scale in the healthy group. Conclusion: Findings suggest that the variables of smoking and diabetes are contributory to frailty trajectory. Data suggest the capacity to tolerate oxidative stress, measured by cORP, is lower in aged individuals that smoke or are diabetic and contributes to frailty as a result of oxidative damage.