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ArticleThe Eurasian journal of medicine2026

Peripheral Nitrosative Stress in Pediatric Anxiety Disorders: Elevated Serum Nitric Oxide Levels.

Merve Okuyucu, Mehmet Fatih Ceylan, Selma Tural Hesapçıoğlu, Seda Kafalı, Salim Neşelioğlu, Özcan Erel

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Article in The Eurasian journal of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Merve OkuyucuDepartment of Child and Adolescent Psychiatry, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Türkiye.
Mehmet Fatih CeylanDepartment of Child and Adolescent Psychiatry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye.
Selma Tural HesapçıoğluDepartment of Child and Adolescent Psychiatry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye.
Seda KafalıDepartment of Child and Adolescent Psychiatry, Kırıkkale Yuksek İhtisas Hospital, Kırıkkale, Türkiye.
Salim NeşelioğluDepartment of Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye.
Özcan ErelDepartment of Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe developing pediatric brain is vulnerable to nitrosative stress. This study investigated serum nitric oxide (NO), inducible nitric oxide synthase (iNOS), and S-nitrosothiols (SNOs) as peripheral biomarkers in children with anxiety disorders (ADs) and their associations with symptom severity.

methodsEighty-one participants aged 7-17 years were enrolled, including 40 drug-naive participants with ADs and 41 age- and sex-matched healthy controls (HCs). Diagnoses were established using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5- Turkish version (K-SADS-PL-DSM-5-T). Symptom severity was assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Clinical Global Impression-Severity (CGI-S) Scale. Data were analyzed using between-group comparisons, correlation analyses, covariance analyses (MANCOVA/ ANCOVA), controlling for age, sex, and body mass index (BMI), and receiver operating characteristic (ROC) analysis.

resultsSerum NO levels were significantly higher in the AD group compared with HCs (P = .028), whereas iNOS and SNO levels did not differ (P > .05). In adjusted analyses controlling for age, sex, and BMI, NO remained significantly higher, and iNOS and SNO levels were also significantly higher in the AD group. No marker (NO, iNOS, SNOs) correlated significantly with anxiety severity (all P > .05). Receiver operating characteristic analysis indicated modest diagnostic accuracy for NO (area under the curve (AUC) = 0.629, 95% CI: 0.506-0.752, P = .046), while iNOS and SNOs were not significant.

conclusionElevated NO, alongside adjusted increases in iNOS and SNO, supports altered peripheral nitrosative signaling in pediatric ADs. Nitric oxide showed modest discriminative value. Cite this article as: Okuyucu M, Ceylan MF, Hesapçıoğlu ST, Kafalı S, Neşelioğlu S, Erel Ö. Peripheral nitrosative stress in pediatric anxiety disorders: elevated serum nitric oxide levels. Eurasian J Med. 2026, 58(4), 1235, doi:10.5152/eurasianjmed.2026.251235.

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PMID42381294
PMCPMC13324883

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