Aim Cardiovascular complications are a major cause of mortality in methamphetamine use disorder (MUD), with oxidative stress and lipid dysregulation playing central roles. This study aimed to evaluate within-subject changes in oxidative stress markers and atherogenic lipid ratios by comparing the same patients’ values during chronic use and after transitioning to early remission. Methods Twenty-seven male patients diagnosed with MUD according to DSM-5-TR criteria, and 27 age-matched healthy controls were included. Patients were assessed at two points: during the chronic use phase (day 1) and again after a confirmed early remission period (following three months of abstinence). Clinical data were recorded, along with serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, Atherogenic Index of Plasma (AIP), Castelli Risk Index I (CRI-I), and Castelli Risk Index II (CRI-II), as well as oxidative stress markers malondialdehyde (MDA), oxidized LDL (OxLDL), myeloperoxidase (MPO), and catalase (CAT). MDA, OxLDL, MPO, and CAT were measured using an enzyme-linked immunosorbent assay. Results Compared to their chronic use phase, patients in early remission exhibited significantly lower levels of serum TC (p = 0.002), LDL-C (p = 0.007), MDA (p = 0.042), and OxLDL (p = 0.032), as well as reduced AIP (p = 0.04), CRI-I (p = 0.006), and CRI-II (p = 0.009). However, MDA and OxLDL remained significantly higher than those observed in healthy controls. Although CAT levels increased during remission (p = 0.486), they were still lower than in the control group (p < 0.01). Positive correlations were found between weekly methamphetamine use and MDA, OxLDL, and MPO levels (r = 0.737, r = 0.683, r = 0.658). In early remission, CAT levels positively correlated with MDA, OxLDL, and MPO levels (r = 0.800, r = 0.927, r = 0.971) and CRI-II was positively correlated with MDA (r = 0.386) and with MPO (r = 0.419, p < 0.05). Linear regression analyses showed that weekly methamphetamine use was a significant predictor of MDA levels (p < 0.05), while generalized estimating equations analysis revealed remission time as a significant negative predictor of MDA change (p < 0.001). Conclusion The associations between oxidative stress markers and atherogenic indices suggest that MUD may be associated with elevated cardiovascular risk, even during early remission. Although these parameters improve with abstinence, they do not fully normalize, underscoring the need for continued monitoring and targeted antioxidant or lipid-based interventions.

Cardiovascular Risk in Methamphetamine Use Disorder: Longitudinal Changes in Oxidative Stress and Atherogenic Lipid Profiles During Early Remission

期刊论文
发表日期：

2026年4月13日

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Fatih Gur,
Filiz Kulacaoglu,
Yusuf Ezel Yildirim,
Hacer Eroglu Icli

摘要

Aim

Cardiovascular complications are a major cause of mortality in methamphetamine use disorder (MUD), with oxidative stress and lipid dysregulation playing central roles. This study aimed to evaluate within-subject changes in oxidative stress markers and atherogenic lipid ratios by comparing the same patients’ values during chronic use and after transitioning to early remission.

Methods

Twenty-seven male patients diagnosed with MUD according to DSM-5-TR criteria, and 27 age-matched healthy controls were included. Patients were assessed at two points: during the chronic use phase (day 1) and again after a confirmed early remission period (following three months of abstinence). Clinical data were recorded, along with serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, Atherogenic Index of Plasma (AIP), Castelli Risk Index I (CRI-I), and Castelli Risk Index II (CRI-II), as well as oxidative stress markers malondialdehyde (MDA), oxidized LDL (OxLDL), myeloperoxidase (MPO), and catalase (CAT). MDA, OxLDL, MPO, and CAT were measured using an enzyme-linked immunosorbent assay.

Results

Compared to their chronic use phase, patients in early remission exhibited significantly lower levels of serum TC (p = 0.002), LDL-C (p = 0.007), MDA (p = 0.042), and OxLDL (p = 0.032), as well as reduced AIP (p = 0.04), CRI-I (p = 0.006), and CRI-II (p = 0.009). However, MDA and OxLDL remained significantly higher than those observed in healthy controls. Although CAT levels increased during remission (p = 0.486), they were still lower than in the control group (p < 0.01). Positive correlations were found between weekly methamphetamine use and MDA, OxLDL, and MPO levels (r = 0.737, r = 0.683, r = 0.658). In early remission, CAT levels positively correlated with MDA, OxLDL, and MPO levels (r = 0.800, r = 0.927, r = 0.971) and CRI-II was positively correlated with MDA (r = 0.386) and with MPO (r = 0.419, p < 0.05). Linear regression analyses showed that weekly methamphetamine use was a significant predictor of MDA levels (p < 0.05), while generalized estimating equations analysis revealed remission time as a significant negative predictor of MDA change (p < 0.001).

Conclusion

The associations between oxidative stress markers and atherogenic indices suggest that MUD may be associated with elevated cardiovascular risk, even during early remission. Although these parameters improve with abstinence, they do not fully normalize, underscoring the need for continued monitoring and targeted antioxidant or lipid-based interventions.