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Serum Malondialdehyde Levels in Hypertensive Patients: A Non-invasive Marker of Oxidative Stress. A Systematic Review and Meta-analysis

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Abstract

Introduction

Previous analyses have reported a higher malondialdehyde (MDA) serum level in hypertensive patients (HTs) compared to normotensive subjects (NTs).

Aim

We performed a systematic review and meta-analysis of these studies to offer a comprehensive information on this issue.

Methods

The PubMed, EMBASE and Web of Science databases were analysed to locate English-language articles published from January 1, 2000 up to January 1 2021. Studies were identified using the following MeSH terms: “Malondialdehyde” AND “Arterial hypertension”. The difference of MDA serum levels between HTs and NTs was expressed as standardized mean difference (SMD) with 95% CI using a random-effect model.

Results

A total of of 4102 patients (2158 HTs and 1944 NTs, mean age 52.7 and 48.0 years, respectively) were included in 17 studies. Pooled mean MDA serum levels in HTs and NTs were 4.91 [standard error (SE): 0.34, 95% CI 4.23–5.59)] and 3.43 [SE 0.15, 95% CI 3.18–3.78] nmol/L, respectively. The SMD between HTs and NTs was 3.23 nmol/L (95% CI 2.54–3.92; Z-score for overall effect: 9.17, p < 0.0001, I2 = 98.6%). Egger’s test resulted significant at p = 0.009 while Begg’s test was not, p = 0.11. Subsequent adjustment via the trim-and-fill method did not predict a new model (studies trimmed = 0). Meta-regression analysis found no correlations either between SMD and age (p = 0.95) or BMI (p = 0.96) but a significant one considering the latitude of the study site as moderator variable (p = 0.001).

Conclusions

Among patients with HTs, serum MDA appears to have the greatest potential as non-invasive biomarkers of oxidative stress and endothelial dysfunction (ED).

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Authors and Affiliations

  1. Section of Internal and Cardio-Respiraotry Medicine, Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy

    Marco Zuin, Elenonora Capatti & Giovanni Zuliani

  2. University Hospital of Ferrara Arcispedale Sant’Anna, Ferrara, Emilia Romagna, Italy

    Marco Zuin, Elenonora Capatti & Giovanni Zuliani

  3. Department of Medical and Surgical Science, University of Bologna, Bologna, Italy

    Claudio Borghi

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  1. Marco Zuin
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Contributions

MZ contributed to the study conception and design. Literature search was performed by MZ and EC and AD. Data collection and analysis were performed by MZ and GZ. The first draft of the manuscript was written by MZ and all authors commented on previous versions of the manuscript. CB critically revised the manuscript. All authors read and approved the final manuscript

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Correspondence to Marco Zuin.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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40292_2022_514_MOESM2_ESM.jpg

Funnel plots for the pooled estimation of the mean serum malondialdehyde levels in hypertensive patients (Panel A) and normotensive subjects (Panel B) (JPG 84 KB)

40292_2022_514_MOESM3_ESM.jpg

Funnel plots for the comparison of serum malondialdehyde levels between hypertensive patients and normotensive subjects (JPG 41 KB)

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Zuin, M., Capatti, E., Borghi, C. et al. Serum Malondialdehyde Levels in Hypertensive Patients: A Non-invasive Marker of Oxidative Stress. A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 29, 263–273 (2022). https://doi.org/10.1007/s40292-022-00514-9

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