Pro-oxidant–antioxidant balance (PAB) as a prognostic index in assessing the cardiovascular risk factors: A narrative review

The imbalance between pro-oxidants and antioxidants in favour of high levels of pro-oxidants may result in several chronic diseases, including CVD and complications associated with its risk factors such as metabolic syndrome and diabetes mellitus. Increased production of reactive oxygen species (ROS) implicated in the pathogenesis of CVD, and it is probably mediated in part by the oxidative modification of lipoproteins like LDL and HDL. Oxidation of LDL results in endothelial dysfunction and plays a vital role in the atherogenic process and vascular diseases. Moreover, ROS play a critical role in endothelial dysfunction, vascular smooth muscle cell remodelling, and monocyte migration, initiation of inflammation, and development of metabolic disorders. The pro-oxidant-antioxidant balance (PAB) assay is a relatively simple, rapid, and cheap technique that attempts to assess pro and antioxidant activities in a single assay. Since it strives to provide an integrated value for the concentration of pro-oxidants and antioxidants, the PAB assay is calibrated based on different proportions of hydrogen peroxide and uric acid. It serves as an appropriate standard for detecting the capacity of the pro-and antioxidant present in biological fluids. A high serum PAB may be expected to be associated with an increased ROS production that would cause the oxidation of bio-molecules and cellular injury. Serum PAB as a prognostic index in assessing the risk of atherosclerosis and inflammation process was known. This review summarized the association of serum PAB with CVD and its traditional risk factors. •PAB assay is a relatively simple, rapid, and cheap technique for assessing pro and antioxidant activities in a single assay.•A significant correlation between BMI and PAB was presented in rheumatoid arthritis.•Serum PAB may be of value as a prognostic index in assessing the risk of atherosclerosis and inflammation process.•PAB could be considered as an independent risk factor for cardiovascular events and cardiac death.