Study of the antioxidant status in patients with secondary lymphedema of the lower extremities under conservative treatment

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Aim. To assess the antioxidant status in patients with secondary lymphedema of the lower extremities who undergo different types of conservative treatment.

Methods. The study included 90 patients with secondary lymphedema of the lower extremities and 30 healthy volunteers. Group 1 participants (n=30) received compression therapy and Vitamin E at a dose of 400 IU/day, group 2 participants (n=30) compression therapy and a micronized purified flavonoid fraction 1000 mg/day, group 3 (n=30) compression therapy alone. Group 4 (n=30) comprised healthy volunteers. The level of malondialdehyde, the activity of superoxide dismutase, glutathione peroxidase, catalase, and the level of non-protein thiols (SH-groups) were determined at inclusion in the study and then after 1 and 3 months.

Results. In patients with secondary lymphedema, the initial level of glutathione peroxidase was higher by 768.22%, catalase — by 420.5%, malondialdehyde — by 60%, and the level of SH-groups was lower by 65,71% compared with the group of volunteers. In the first group, there was a significant decrease of 36.1% in the level of superoxide dismutase and a significant increase of 89.9% in the level of glutathione peroxidase at the end of therapy when compared with the level after 1 month. In the second group, catalase level significantly increased — by 33.3%, superoxide dismutase by 17.6%, and glutathione peroxidase by 61.3% compared to baseline values. The biochemical indicators of the endothelium significantly increased when using a combination of micronized purified flavonoid fraction and elastic compression in comparison with elastic compression alone and a combination with Vitamin E. In the third group, there were no significant differences in the levels of biochemical indicators of endothelial function.

Conclusion. Increased formation of lipid peroxidation products along with a decrease in the activity of antioxidant systems was revealed in patients with lower extremity secondary lymphedema compared with healthy volunteers; the most effective therapy aimed at correcting endothelial cell dysfunction is the use of micronized purified flavonoid fraction and elastic compression.

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Roman E. Kalinin

Ryazan State Medical University

ORCID iD: 0000-0002-0817-9573
SPIN-code: 5009-2318
ResearcherId: M-1554-2016
Russian Federation, Ryazan, Russian

Igor A. Suchkov

Ryazan State Medical University

ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662
ResearcherId: M-1180-2016
Russian Federation, Ryazan, Russian

Denis A. Maksaev

Ryazan State Medical University

Author for correspondence.
ORCID iD: 0000-0003-3299-8832
SPIN-code: 9962-2923
Russian Federation, Ryazan, Russian

Yulia V. Abalenikhina

Ryazan State Medical University

ORCID iD: 0000-0003-0427-0967
SPIN-code: 4496-9027
ResearcherId: L-8965-2018
Russian Federation, Ryazan, Russian


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© 2021 Kalinin R.E., Suchkov I.A., Maksaev D.A., Abalenikhina Y.V.

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