23 DOI: https://doi.org/10.1016/j.jgeb.2026.100842 English eng Ali B. Roomi Contributor <div class="abstract author" id="as0005" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Background</h3><div class="u-margin-s-bottom" id="sp0080" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Maintenance hemodialysis (HD) is accompanied by persistent inflammation, oxidative stress, and disturbances of the intestinal barrier.</div></div><div class="abstract author" id="as0010" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Objective</h3><div class="u-margin-s-bottom" id="sp0085" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">To compare serum zonulin concentrations between patients receiving maintenance HD and healthy controls and to evaluate their associations with interleukin-6 (IL-6), malondialdehyde (MDA), and total antioxidant status (TAS).</div></div><div class="abstract author" id="as0015" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Methods</h3><div class="u-margin-s-bottom" id="sp0090" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">This comparative cross-sectional study included 180 participants: 90 patients with end-stage renal disease receiving maintenance HD and 90 age- and sex-comparable healthy controls. Predialysis blood samples were analyzed for serum zonulin, IL-6, and MDA by enzyme-linked immunosorbent assay and for TAS by a colorimetric assay. Group differences were evaluated using independent-samples <em style="margin: 0px; padding: 0px;">t</em>-tests, associations using Pearson's correlation, and adjusted relationships using multivariable linear regression.</div></div><div class="abstract author" id="as0020" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Results</h3><div class="u-margin-s-bottom" id="sp0095" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Compared with controls, the HD group had higher serum zonulin, IL-6, MDA, urea, creatinine, and phosphorus concentrations and lower TAS, albumin, calcium, and hemoglobin values (all <em style="margin: 0px; padding: 0px;">P</em> < 0.001). Within the HD group, zonulin correlated positively with IL-6 (<em style="margin: 0px; padding: 0px;">r</em> = 0.644, <em style="margin: 0px; padding: 0px;">P</em> < 0.001) and MDA (<em style="margin: 0px; padding: 0px;">r</em> = 0.782, <em style="margin: 0px; padding: 0px;">P</em> < 0.001) and inversely with TAS (<em style="margin: 0px; padding: 0px;">r</em> = −0.392, <em style="margin: 0px; padding: 0px;">P</em> < 0.001). After covariate adjustment, zonulin remained associated with IL-6 (B = 0.982, β = 0.577, <em style="margin: 0px; padding: 0px;">P</em> < 0.001), MDA (B = 36.76, β = 0.597, <em style="margin: 0px; padding: 0px;">P</em> < 0.001), and TAS (B = −0.018, β = −0.345, <em style="margin: 0px; padding: 0px;">P</em> = 0.021).</div></div><div class="abstract author" id="as0025" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0030" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Conclusion</h3><div class="u-margin-s-bottom" id="sp0100" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Serum zonulin was elevated in patients receiving maintenance HD and was independently associated with inflammatory and oxidative-stress biomarkers. These cross-sectional findings support an association but do not establish that altered intestinal permeability causes inflammatory-oxidative imbalance or that serum zonulin is ready for clinical use.</div></div> Elsevier September 2026 pdf Journal of Genetic Engineering and Biotechnology Serum zonulin levels and their association with inflammatory and oxidative stress biomarkers in patients undergoing maintenance hemodialysis mixed material Elsevier