Biochemical Assessment of Oxidative Stress, Antioxidant Status, and Lipid Profile in Pulmonary and Abdominal Tuberculosis Patients Receiving Anti-Tubercular Therapy

Background: Tuberculosis (TB) remains a significant global health burden, particularly in developing countries like Pakistan. Beyond its infectious nature, TB is associated with increased oxidative stress and metabolic alterations. However, limited data exist on the biochemical response to anti-tubercular therapy (ATT) in both pulmonary and abdominal TB cases. Therefore, this study aimed to evaluate the effect of ATT on oxidative stress markers, antioxidant enzymes, and lipid profiles in patients with pulmonary and abdominal TB. Methods: A prospective observational study was conducted over a 12-month period (March 2023 to February 2024) on 83 patients with pulmonary or abdominal tuberculosis at multiple tertiary care hospitals across Pakistan. Patients were recruited using a non-probability purposive sampling technique. Blood samples were collected at baseline (before treatment) and after two months of standard ATT. Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total antioxidant capacity (TAC), and lipid profile parameters were analyzed. Data were analyzed using SPSS version 26, and paired sample and independent t-tests were applied with a significance level set at p < 0.05. Results: Among the 83 tuberculosis patients enrolled, 47 (56.6%) were males and 36 (43.4%) females, with 47 (56.6%) having pulmonary TB and 36 (43.4%) abdominal TB. Significant reductions in oxidative stress markers were observed post-treatment: MDA decreased from 5.26 ± 1.31 to 2.79 ± 1.01 and NO from 4.82 ± 1.00 to 3.95 ± 1.02 (p < 0.001 for both). Antioxidant enzymes showed marked improvement: SOD increased from 2.02 ± 0.65 to 3.28 ± 0.87, CAT from 2.54 ± 0.99 to 4.46 ± 1.00, GPx from 1.91 ± 0.57 to 3.08 ± 0.72, and TAC from 0.94 ± 0.31 to 1.62 ± 0.32 (all p < 0.001). Lipid markers also improved, with total cholesterol rising from 127.71 ± 18.18 to 154.53 ± 19.75, LDL from 71.27 ± 15.05 to 88.05 ± 16.61, HDL from 31.59 ± 5.95 to 39.54 ± 7.23, TG from 107.98 ± 19.84 to 122.97 ± 20.15, and VLDL from 22.35 ± 3.81 to 25.69 ± 4.62 (all p < 0.001). No significant differences were found in these biochemical changes between pulmonary and abdominal TB groups (p > 0.05). Conclusion: Anti-tubercular therapy leads to a marked reduction in oxidative stress and improvement in antioxidant and lipid profiles in both pulmonary and abdominal TB patients. These findings highlight the systemic impact of TB and underscore the biochemical recovery that follows treatment.