Association of antioxidant markers (SOD, GSH, NO, Catalase) with ischemic stroke severity and recovery outcomes

Background: This randomised controlled trial aimed to investigate the relationship between antioxidant markers (Superoxide Dismutase [SOD], Glutathione [GSH], Catalase, and Nitric Oxide [NO]) and the severity of ischemic stroke in affected individuals. Methods: A single-blind randomised controlled trial was conducted from June 2022 to November 2024, including 364 patients aged 45-80 years diagnosed with ischemic stroke. Participants were randomly divided into two groups: Group A (n=193) received standard stroke rehabilitation therapy, while Group B (n=171) received additional antioxidant support. Serum levels of SOD, GSH, Catalase, and NO were measured. Stroke severity was evaluated using the modified Rankin Scale (mRS) and NIH Stroke Scale (NIHSS), with follow-up assessments at 2, 4, and 6 months post-treatment. Results: Among the 364 participants, 203 (55.7%) were male, and 161 (44.3%) were female, with a mean age of 67.3±12.2 years. Serum SOD levels were higher in the experimental group (16.3±3.7 U/mL) compared to the control group (12.5±4.1 U/mL, p=0.014). GSH levels were also significantly higher in the experimental group (178±31 mmol/L) than in the control group (145±26 mmol/L, p=0.032). NO levels were higher in the experimental group (42.1±8.6 mmol/L) than in the control group (35.4±7.3 mmol/L, p=0.021). Catalase levels were 52.3±11.1 U/mL in the experimental group and 49.6±10.2 U/mL in the control group, with no significant difference between the groups (p=0.213). Significant inverse correlations were found between SOD, GSH, and NO levels and stroke severity (p<0.05), but catalase showed no such correlation (p=0.513). Conclusions: This study identified a significant relationship between higher levels of SOD, GSH, and NO and improved stroke recovery, whereas catalase did not exhibit a meaningful association with stroke severity or functional outcomes. These findings highlight the potential role of specific antioxidant markers in stroke prognosis and recovery while suggesting that catalase may not play a critical role in ischemic stroke outcomes.