SUN-257 Point-of-Care Oxidative Stress Profiling Reveals Distinct Inflammatory Subgroups in Subjects with Cardiometabolic Risks

Abstract Disclosure: R. Dalan: None. A.T. Alves: LarmorBIO. L. Shirley: None. C. Ying Jie: None. M.J. McPhaul: LarmorBIO. R. Rohr: LarmorBIO. B.O. Boehm: LarmorBIO. Oxidative stress plays a crucial role in the pathogenesis of cardiometabolic diseases, yet existing biomarkers lack the sensitivity and specificity required for routine clinical use. Building on previously established baseline values obtained through real-time monitoring of oxidative stress via microscale nuclear magnetic resonance (µNMR) in healthy subjects1, we investigated POCT oxidative stress testing in subjects (n=350) with cardiometabolic risks from the Predict to Prevent (P2P) prospective study in Singapore. This study was designed to better pinpoint drivers of macro- and microvascular disease progression in subjects afflicted with obesity, hypertension, dyslipidemia, type 2 diabetes mellitus as well as chronic kidney disease (44% Stage 1 [eGFR >90 mL/min/1.73m²] and 48% Stage 2 [eGFR 60-89 mL/min/1.73m²]). Conventional glycemic and inflammatory biomarkers were measured alongside µNMR oxidative stress levels. Subjects with cardiometabolic risks showed significantly elevated oxidative stress levels compared to healthy controls (2.55 ± 1.6 vs. 2.06 ± 0.35, SD 0.26 vs. 0.07, p<0.0001), representing on average a 23.8% increase. This marked elevation of oxidative stress level adds a new dimension in the risk matrix of subjects afflicted by cardiometabolic risks. Additionally, the marker demonstrated significant positive correlations with established cardiometabolic risk markers (glycated hemoglobin, HbA1c: r=0.26, p<0.0001; high-sensitivity C-reactive protein, hsCRP: r=0.28, p<0.0001; fasting glucose, r=0.28, p<0.0001; albumin-creatinine ratio, r=0.15, p<0.01; skin autofluorescence estimating non-invasively advanced glycation end products using AGE reader technology r=0.16, p<0.01; and pulse wave velocity as a marker of arterial stiffness, r=0.13, p<0.05). When stratified by hsCRP levels into low (0-1 mg/L), moderate (1-3 mg/L), and high (3-12 mg/L) subgroups, significantly distinct differences in oxidative stress profiles were observed across all three groups (p<0.0001, one-way ANOVA with Tukey's multiple comparisons test). Critically, oxidative stress identified a subpopulation of potentially at-risk individuals, even when their hsCRP levels are low. These findings demonstrate that µNMR-monitored oxidative stress provides an innovative quantitative assessment of cardiometabolic health status adding a new dimension in the risk matrix in these subjects. In subjects with cardiometabolic risks POCT-based oxidative stress monitoring allows the identification of subphenotypes and will therefore provide additional personalized information in the most needed timely manner guiding prevention, treatment and long-term follow-up.1-Peng, W.K., Chen, L., Boehm, B.O. et al. npj Aging Mech Dis 6, 11 (2020).https://doi.org/10.1038/s41514-020-00049-0 Presentation: Sunday, July 13, 2025