# Effect of Oxidative Stress Intensity on Inflammatory, Bone Turnover, and Haemostasis Biomarkers in Patients with Spinal Osteoarthritis

## TL;DR

This study explores how oxidative stress affects inflammation, bone turnover, and blood clotting in spinal osteoarthritis patients.

## Contribution

The study identifies PAB and D-dimer as potential biomarkers for disease severity and thrombotic risk in spinal osteoarthritis.

## Key findings

- High oxidative stress (PAB ≥ 100 U/L) correlates with elevated fibrinogen, ESR, and shortened PT/aPTT.
- Elevated D-dimer levels are strongly associated with increased ESR, IL-6, and ALP in spinal osteoarthritis patients.
- Patients with grade V disc degeneration are more likely to have elevated D-dimer levels than those with grade IV.

## Abstract

Osteoarthritis is associated with chronic inflammation, which contributes to a hypercoagulable state. Oxidative stress may further disrupt homeostatic balance, thereby promoting thrombotic events. This study evaluated the association between biomarkers of oxidative stress, inflammation, haemostasis, and bone metabolism in patients with spinal osteoarthritis. A total of 48 patients were included. The levels of inflammatory, bone turnover, haematological, and coagulation biomarkers were determined using standard laboratory methods. Redox status was assessed via prooxidant–antioxidant balance (PAB) and superoxide dismutase (SOD) activity. Patients with elevated PAB showed significantly higher erythrocyte sedimentation rate (ESR) (p = 0.005), alkaline phosphatase (ALP) (p = 0.003) and fibrinogen levels (p = 0.006) and platelet count (p = 0.040), along with lower 25-OH vitamin D levels (p = 0.045) and shortened PT (p = 0.008) and aPTT (p = 0.017). In low oxidative stress states (PAB < 100 U/L), significant correlations were observed among redox, coagulation, and bone turnover markers, whereas in high oxidative stress (PAB ≥ 100 U/L), it was characterised by predominant associations between redox and bone turnover biomarkers. Patients with grade V disc degeneration had a significantly higher probability of elevated D-dimer levels compared to those with grade IV (OR = 5.440; p = 0.009). In addition, elevated D-dimer levels were associated with increased ESR (p = 0.015), IL-6 (p = 0.016) and ALP levels (p = 0.034). The associations between biomarkers of redox status, inflammation, coagulation and bone turnover are influenced by the extent of oxidative stress. Our results suggest that PAB and D-dimer may serve as potential biomarkers for disease severity and thrombotic risk. Further studies are needed to confirm these preliminary findings.