Plasma level of malondialdehyde in the cases of acute paraquat intoxication

Abstract

Background, material, and methods. To assess plasma malondialdehyde (MDA) level as a clinical marker in acute paraquat (PQ) intoxication, we sequentially investigated 74 patients (40 males and 34 females, aged 49.9 ± 16.2 years), all of whom ingested PQ as a means of suicide from July to December 2008. Results. The baseline level of MDA (10.8 ± 3.5 μM) had no correlation with plasma PQ levels of 22.1 ± 48.7μg/mL (median: 1.9, range <0.01–228.5) or with volume of PQ ingested. However, the following parameters were significantly different between survivors and nonsurvivors: the amount of PQ ingestion, plasma PQ levels, basal MDA levels, WBC, hemoglobin, hematocrit, platelet counts, albumin, BUN, creatinine, potassium, amylase, and arterial blood gas analysis (pH, pCO₂, ).The nonsurvivors' baseline MDA (11.4 ± 3.8 vs. 9.8 ± 2.8, p = 0.040) was higher than the survivors. However, the baseline level was not a predictor of mortality in the univariate and the multivariate binary logistic analyses. Among the patients whose MDA levels were measured sequentially, 58.3% of the patients (35 out of 60) showed fluctuating MDA levels, 25% (n = 15) showed steady decreases, with only 16.6% (n = 10) showing steady increases in MDA levels during the observation period. These findings imply the presence of active MDA metabolism and/or that the half-life of MDA is very short in the human body. Conclusion. Both cross-sectional and sequential measurements of plasma MDA do not provide reliable information on outcome in patients with acute PQ intoxication.

Keywords:

• Paraquat
• MDA
• Clinical markers
• Lipid peroxidation
• ROS