Features of lipid peroxidation in patients with autoimmune thyroiditis under wartime conditions, Особливості перекисного окиснення ліпідів у хворих на автоімунний тиреоїдит за умов воєнного часу

<jats:p>Background. Oxidative stress plays a crucial role in the pathogenesis of autoimmune thyroiditis (AIT) and may be further intensified by chronic psycho-emotional stress, particularly under wartime conditions. Aim of the study was to investigate the features of lipid peroxidation in patients with autoimmune thyroiditis with different levels of situational anxiety in wartime conditions. Materials and methods. The study included 81 patients with AIT and 22 healthy controls. Patients were stratified into groups with moderate and high situational anxiety according to the State-Trait Anxiety Inventory. Concentrations of primary (acyl hydroperoxides) and secondary (malondialdehyde) lipid peroxidation markers were measured, along with activity of key antioxidant enzymes: superoxide dismutase (SOD), glutathione peroxidase, catalase in plasma and erythrocytes, xanthine oxidase, and total reduced SH-groups. Results. The findings indicate a combined impact of autoimmune inflammation and stress-related factors on free radical oxidation processes. A systemic oxidative imbalance was detected in AIT patients even in the euthyroid state. Compared to controls, all AIT groups exhibi­ted significantly elevated levels of both primary (1.8-fold) and secon­dary (1.2-fold) lipid peroxidation markers, irrespective of an­xiety le­vel. A 1.3-fold reduction in SOD activity was observed in both AIT groups, while suppression of glutathione peroxidase was more pronounced in patients with high situational anxiety (1.9-fold), indicating depletion of essential enzymatic components of the antioxidant defense system. The 1.3-fold increase in xanthine oxidase activity observed in AIT may represent a compensatory response to decreased SOD activity. In addition, catalase activity was markedly elevated in plasma (1.63-fold in the moderate anxiety group and 2.1-fold in the high anxiety group) and in erythrocytes (1.3-fold in both AIT groups), which can be interpreted as a compensatory mechanism for hydrogen peroxide detoxification. The unchanged levels of reduced SH-groups in AIT suggest preservation of the thiol-based antioxidant reserve. Conclusions. AIT is associated with systemic oxidative imba­lance, while psycho-emotional factors such as high situational anxiety further exacerbate glutathione peroxidase suppression. These findings emphasize the importance of a comprehensive patient management that integrates psychotherapy with interventions aimed at supporting antioxidant defense mechanisms.</jats:p>