The Clinical Role of the Thiol-Disulfide Balance as an Oxidative Stress Indicator in Patients with Obesity

Yıl 2025, Cilt: 15 Sayı: 3, 218 - 226, 30.09.2025

Soner Yeşilyurt , Osman Erinç , Türker Demirtakan , Almila Şenat , Esra Fırat Oğuz , Nihat Mujdat Hokenek , Özcan Erel

https://doi.org/10.31832/smj.1698739

Öz

Objectives: Thiol-disulfide measurements will assess obesity-related oxidative stress.
Methods: A prospective observational study was done at two tertiary care centers. The participants were divided into three distinct categories based on their body mass index (BMI): The control group (Group 1) consisted of 116 individuals with a BMI ranging from 18 to 25 kg/m², while the overweight group (Group 2, n = 89) included those with a BMI between 25 and 30 kg/m². The obese group (Group 3, n = 39) comprised individuals with a BMI of 30 kg/m² or greater. This approach primarily utilizes the disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio as key metrics. All patients' demographics, waist circumference, hip circumference, height, weight, hemoglobin, hematocrit, white blood cell count, glucose, C-reactive protein, disulfide, native-thiol (NT), total-thiol (TT), lipid hydroperoxide radical (LOOH), and absolute ischemia-modified-albumin (ABSO) levels were recorded on calculations and records were made for disulfide to native and total thiol ratios.
Results: Thiol-disulfide equilibrium differed between the three groups. NT concentrations averaged 368.87 mmol/L across all individuals and were significantly higher in the normal-weight cohort (BMI 18-25 kg/m2) at 380.60 mmol/L, compared to overweight and obese populations (p<0.001). TT concentrations were higher in normal-weight individuals, with an average of 426.36±54.48 mmol/L, compared to 405.41±52.14 and 391.07±46.45 in overweight and obese individuals, respectively (p<0.001).
Conclusions: Reduced native and total thiol levels, along with altered disulfide concentrations in obese individuals, serve as indicators of oxidative stress.

Anahtar Kelimeler

thiol disulfide balance , inflammatory markers , oxidative stress , obesity

Kaynakça

• World Health Organization (2024) Obesity and overweight.
• World Health Organization (2014) Global status report on noncommunicable diseases 2014.
• Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015-2016. NCHS Data Brief. 2017;(288):1-8.
• Global Nutrition Target Collaborators. Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2025;404(10471):2543-2583.
• Finkelstein EA, Khavjou OA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563-570.
• World Health Organization (2020). WHO guidelines on physical activity and sedentary behaviour.
• Freigang R, Geier AK, Schmid GL, Frese T, Klement A, Unverzagt S. Misclassification of self-reported body mass index categories. Dtsch Arztebl Int. 2020;117(15):253-260.
• American College of Cardiology, American Heart Association (2020) 2020 AHA/ACC guideline on the assessment of cardiovascular risk. Available from: https://www.jacc.org/doi/full/10.1016/j.jacc.2020.09.018
• Sies H. Oxidative stress: A concept in redox biology and medicine. Redox Biol. 2015;4:180-183.
• Ahmed B, Sultana R, Greene MW. Adipose tissue and insulin resistance in obese. Biomed Pharmacother. 2021;137:111315.
• Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006 Dec 14;444(7121):860-867.
• Bosch-Sierra N, Grau-Del Valle C, Hermenejildo J, Hermo-Argibay A, Salazar JD, Garrido M, et al. The impact of weight loss on inflammation, oxidative stress, and mitochondrial function in subjects with obesity. Antioxidants (Basel). 2024;13(7):870.
• Kanikowska D, Kanikowska A, Swora-Cwynar E, Grzymisławski M, Sato M, Bręborowicz A, et al. Moderate caloric restriction partially improved oxidative stress markers in obese humans. Antioxidants (Basel). 2021;10(7):1018.
• Jones DP. Redox theory of aging. Redox Biol. 2015;5:71-79.
• Turell L, Radi R, Alvarez B. The thiol pool in human plasma: The central contribution of albumin to redox processes. Free Radic Biol Med. 2013;65:244-253.
• Winterbourn CC. Are free radicals involved in thiol-based redox signaling? Free Radic Biol Med. 2015;80:164-170.
• D'Alessandro A, Di Felice G, Manco M, Pastore A, Pezzi S, Mariani M, et al. Study of the association between thiols and oxidative stress markers in children with obesity. Nutrients. 2022;14(17):3637.
• Keaney JF Jr, Larson MG, Vasan RS, Wilson PW, Lipinska I, Corey D, et al. Framingham Study. Obesity and systemic oxidative stress: Clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol. 2003;23(3):434-439.
• Shevtsova A, Gordiienko I, Tkachenko V, Ushakova G. Ischemia-modified albumin: Origins and clinical implications. Dis Markers. 2021;2021:9945424.
• Ayala A, Muñoz MF, Arguelles S. Lipid peroxidation: Production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev. 2014;2014:360438.
• Sulekova M, H. The role of oxidative stress and thiol-disulfide balance in obesity and metabolic disorders. Obes Rev. 2022:23(5):e13456.
• Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. Reviewers of the AACE/ACE obesity clinical practice guidelines. Endocr Pract. 2016;22(7):842-884.
• Erel O, Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem. 2014;47(18):326-332.
• Resano-Barrio P, Alfaro E, Solano-Pérez E, Coso C, Cubillos-Zapata C, Díaz-García E, et al. On Behalf of The Spanish Sleep Network. Analysis of the ischemia-modified albumin as a potential biomarker for cardiovascular damage in obstructive sleep apnea patients with acute coronary syndrome. Int J Mol Sci. 2023;24(10):9019.
• Xie Y, Wu Z, Qin Z, Wu B, Lv X, Wei F, et al. Methods of lipidomic analysis: Extraction, derivatization, separation, and identification of lipids. Adv Exp Med Biol. 2021;1280:173-187.
• Feelisch M, Cortese-Krott MM, Santolini J, Wootton SA, Jackson AA. Systems redox biology in health and disease. EXCLI J. 2022;21:623-646.
• Oklu E, Alhan M, Erdal E (2023) The role of thiol/disulfide balance in obesity: A clinical study. J Obes Res. 2023;45(2):123-130.
• Elmas B, Karacan M, Dervisoglu P, Kösecik M, Isguven SP, Bal C. Dynamic thiol/disulfide homeostasis as a novel indicator of oxidative stress in obese children and its relationship with inflammatory-cardiovascular markers. Anatol J Cardiol. 2017;18(5):361-369.
• Fernández-Sánchez A, Madrigal-Santillán E, Bautista M, Esquivel-Soto J, Morales-González A, Esquivel-Chirino C, et al. Inflammation, oxidative stress, and obesity. Int J Mol Sci. 2011;12(5):3117-3132.
• Carbone S, Del Buono MG, Ozemek C, Lavie CJ. The association between circulating C-reactive protein levels and both epicardial and visceral fat depots in women meeting metabolic syndrome criteria. J Clin Med. 2019;8(11):1838.
• van Wijk DF, Boekholdt SM, Arsenault BJ, Ahmadi-Abhari S, Wareham NJ, Stroes ES, et al. C-Reactive protein identifies low-risk metabolically healthy obese persons: The european prospective investigation of cancer-norfolk prospective population study. J Am Heart Assoc. 2016;5(6):e002823.
• Li X, Morel JD, Benegiamo G, Poisson J, Bachmann A, Rapin A, et al. Genetic and dietary modulators of the inflammatory response in the gastrointestinal tract of the BXD mouse genetic reference population. Elife. 2023;12:RP87569.
• Mengen E, Ucakturk SA, Kocaay P, Kaymaz O, Neselioglu S, Erel ÖO. The significance of thiol/disulfide homeostasis and ischemia-modified albumin levels in assessing oxidative stress in obese children and adolescents. J Clin Res Pediatr Endocrinol. 2020;12(1):45-54.
• Elkan H, Karateke F, Taskin S, Celik H, Yuksekyayla B, Uzunkoy A. Comparison of preoperative and postoperative serum thiol/disulfide levels in patients undergoing laparoscopic sleeve gastrectomy for morbid obesity. Eur Rev Med Pharmacol Sci. 2024;28(2):757-762.
• De Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: Meta-regression analysis of prospective studies. Eur Heart J. 2007;28(7):850-856.
• Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021;143(21):e984-e1010.
• Bluher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009;117(6):241-250.
• Piva SJ, Duarte MM, Da Cruz IB, Coelho AC, Moreira AP, Tonello R, et al. Ischemia-modified albumin as an oxidative stress biomarker in obesity. Clin Biochem. 2011;44(4):345-347.
• Mehmetoglu I, Kurban S, Yerlikaya FH, Polat H. Obesity is an independent determinant of ischemia-modified albumin. Obes Facts. 2012;5(5):700-709.