EFFECTS OF ANGIOTENSIN RECEPTOR ANTAGONISTS ON OXIDATIVE STRESS RESPONSE, AUTOANTIBODIES AND INFLAMMATORY FACTORS

Yanqun Hu^{1, #}, YingYing Zheng^{2, #}, Yunguang Cen^{1, #}, Taihao Wang¹, Jiejun Zhang¹, Xiaoling Chen², Liumei Luo³, Xiaohong Zhan¹, Xintao Zhou¹, Bin Li^{3, *}

¹Department of Geriatrics Center, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China - ²Department of Clinical Laboratory, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China - ³Department of Nursing, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China - ⁴Department of Science and Education, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China

Introduction: To investigate the effects of angiotensin receptor antagonists on the oxidative stress response and the levels of autoantibodies, serum TNF-α, IL-6 and IL-8 in elderly patients at high risk of falls. 

Materials and methods: 86 elderly patients treated in the geriatric department of our hospital from April 2021 to December 2021 were selected, and could be divided into a control group and an observation group of 43 patients each according to whether they had a history of falls within one year. Twenty-five patients treated with angiotensin receptor antagonists were included in the treatment group and were closely followed up for up to 2 months and, for each follow-up visit, indicators such as the patient's degree of disease activity were recorded in detail. Serum IL-6, IL-8, TNF-α levels, oxidative stress levels and the relationship between oxidative stress indicators, inflammatory factor levels and RAS indicators in the treatment group and the observation group were compared between the two groups. 

Results: The results showed that the serum MDA and AOPP levels were lower in the observation group than in the control group; while the serum SOD levels were higher in the observation group than in the control group; the serum TNF-α, IL-6 and IL-8 levels were higher in the observation group than in the control group; the serum CAT and T-AOC levels were higher in the control group than in the observation group, while the ROS and AT1RaAbs levels were lower than in the observation group; the differences were all statistically significant (all P<0.05). The differences were statistically significant (all P<0.05). When the best cut-off value of AT1RaAbs assay was 0.705 mg/L, the AUC for predicting falls was 0.961; the 95% confidence interval was 0.933-0.991, which had a good diagnostic value with a sensitivity of 82.2% and specificity of 91.0%, respectively. The Pearson test assessed the relationship between angiotensin receptor antagonists and indicators of oxidative stress, inflammatory factors and RAS in elderly patients at high risk of falls and found that: angiotensin receptor antagonists were positively correlated with oxidative stress indicators MDA, AOPP and antibodies CAT and T-AOC, with SOD levels and levels of inflammatory factors TNF-α, IL-6 and IL-8, as well as with ROS and AT1Ra. and ROS and AT1RaAbs were negatively correlated. 

Conclusion: AT1RaAbs is a good diagnostic predictor of high-risk falls in the elderly, and ARBs can significantly improve oxidative stress, inflammatory factor levels, and inhibit the activation of AT1RaAbs in patients, making it an effective drug for preventing high-risk falls in the elderly.