10.1136/bmj.m3684 130 ShimanoH.SatoR
We wish to emphasise, however, that the present study did not measure any direct marker of hepatic or systemic oxidative stresssuch as the GSH/GSSG ratio, malondialdehyde, F2-isoprostanes, or 8-hydroxy-2-deoxyguanosineand the observed clinical pattern is equally compatible with several non-redox explanations: differential reversibility of the underlying precipitating event between phenotypes, differential intensity of concurrent standard-of-care interventions in the sicker subgroup (infection control, alcohol abstinence, diuretic optimisation, nutritional support), and statistical regression toward the mean in patients with the highest baseline biochemical values
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