Ischemia-modified Albumin Levels Research Articles

Is ischemic modified albumin a marker in osteomyelitis patients?

Abstract
 Objective: To compare the levels of ischemia modified albumin between osteomyelitis patients and healthy controls.
 Method: The cross-sectional prospective study was conducted at Van Yüzüncü Y?l University, Van, Turkey, from May 2018 to May 2019, and comprised inpatients diagnosed with osteomyelitis, and healthy controls. Serum IMA concentrations were determined spectrophotometrically at 470nm wavelength. Serum ischemia modified albumin levels were measured and compared between the patients and the controls. Data was analysed using SPSS 20.
 Results: Of the 77 subjects, 37(48%) were patients and 40(52%) were controls. Serum ischemia modified albumin level in patients was significantly higher than controls (p<0.05). There was a significant correlation between ischemia modified albumin and C-reactive protein levels (p<0.05).
 Conclusion: Serum ischemia modified albumin level in patients was significantly higher than controls (p<0.05).
 Key Words: Osteomiyelitis, Ischemia-modified albumin, Receiving operation curve, Biomarker, C-reactive protein.
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SerumIschemia-Modified Albumin Levels, Myeloperoxidase Activity and Peripheral Blood Mononuclear cells inAutism Spectrum Disorder (ASD).

Genetic, neurobiological, neurochemical, environmental factors and their interactions contribute to autism phenotypes. Blood from 48 (age range: 4-17) autism spectrum disorder diagnosed patients (ASD) and 38 age- and gender-matched healthy control subjects was analyzed for numbers of neutrophils, lymphocytes, monocytes, albumin, serum Ischemia-Modified Albumin (IMA) levels and myeloperoxidase activity. The serum IMA levels, myeloperoxidase activity and peripheral blood mononuclear cells count were significantly higher in ASD cases than in the control subjects. There were no significant differences in albumin levels between the patient and control groups. These results suggest that the immune system, oxidative stress and myeloperoxidase activity may be activated in ASD. There is a clinical benefit from the early detection of ASD using myeloperoxidase activity, IMA levels and monocyte counts.

Assessment of serum Ischemia Modified Albumin (IMA) Levels in Acute Rheumatic Fever

Introduction : Rheumatic fever (RF) is an autoimmune, multiorgan inflammatory disease. The patients develop carditis (50-78%), arthritis (35-88%), chorea (2-19%), erythema marginatum (< 6%) and subcutaneous nodules (< 1-13%). Ischemia modified albumin or cobalt binding albumin is one of new biomarker for inflammation and oxidative stress. Various previous studies indicate that acute rheumatic fever is associated with oxidative stress and inflammation. In the present study, we examined IMA, CRP, ESR and albumin levels in acute rheumatic fever.Material and method: This case control study was conductedbetween April 2017 to March 2018 in pediatrics department of Malda Medical College and Hospital. Study group composed of 42 children aged 5-18 years suffering from acute rheumatic fever diagnosed by modified jones criteria and they compared with 50 healthy age and sex match control. The IMA levels were compared among groups, and the association to acute phase reactants were investigated.Results: Values ofserumischemia modified albumin, ESR and C Reactive Protein were significantly higher in cases compared to control group (p value ≤0.001). But no significant differencewas found between values of serum albumin in cases compared to control group. Positive correlation was found between cases serum IMA and ESR, C-Reactive protein.Conclusion: Serumischemia modified albumin were significantly higher in children with acute rheumatic fever compared to control group, so IMA could be used as a biomarker in diagnosis of ARF. However, further multicenter and larger case studies are needed to provide stronger evidence.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 222-225

Usefulness of ischemia-modified albumin in the diagnosis of sepsis/septic shock in the emergency department.

ObjectiveNo studies have evaluated the diagnostic value of ischemia-modified albumin (IMA) for the early detection of sepsis/septic shock in patients presenting to the emergency department (ED). We aimed to assess the usefulness of IMA in diagnosing sepsis/septic shock in the ED.MethodsThis retrospective, observational study analyzed IMA, lactate, high sensitivity C-reactive protein, and procalcitonin levels measured within 1 hour of ED arrival. Patients with suspected infection meeting at least two systemic inflammatory response syndrome criteria were included and classified into the infection, sepsis, and septic shock groups using Sepsis-3 definitions. Areas under the receiver operating characteristic curves (AUCs) with 95% confidence intervals (CIs) and multivariate logistic regression were used to determine diagnostic performance.ResultsThis study included 300 adult patients. The AUC (95% CI) of IMA levels (cut-off ≥85.5 U/mL vs. ≥87.5 U/mL) was higher for the diagnosis of sepsis than for that of septic shock (0.729 [0.667–0.791] vs. 0.681 [0.613–0.824]) and was higher than the AUC of procalcitonin levels (cut-off ≥1.58 ng/mL, 0.678 [0.613–0.742]) for the diagnosis of sepsis. When IMA and lactate levels were combined, the AUCs were 0.815 (0.762–0.867) and 0.806 (0.754–0.858) for the diagnosis of sepsis and septic shock, respectively. IMA levels independently predicted sepsis (odds ratio, 1.05; 95% CI, 1.00–1.09; P=0.029) and septic shock (odds ratio, 1.07; 95% CI, 1.02–1.11; P=0.002).ConclusionOur findings indicate that IMA levels are a useful biomarker for diagnosing sepsis/ septic shock early, and their combination with lactate levels can enhance the predictive power for early diagnosis of sepsis/septic shock in the ED.

Dynamic thiol disulfide homeostasis in painters as indices of oxidative stress

ABSTRACT This study was designed to determine thiol-disulfide homeostasis as indices of oxidative stress in painters by using a novel and automated colorimetric measurement method. Male painters (n = 117) were separated into three groups according to duration of work; group 1 (<5 years), group 2 (5–14 years) and group 3 (≥15 years). Hippuric acid, trichloroacetic acid (TCA), and phenol in urine was determined. Catalase activity and ischemia-modified albumin (IMA) levels were also assessed. Disulfide/Native Thiol and Disulfide/Total Thiol of group 2 and group 3 were significantly higher than those of group 1 (p < 0.001). A positive correlation was observed between urinary phenol and disulfide/native thiol (r = 0.214, p = 0.035), IMA (r = 0.305, p = 0.002), disulfide (r = 0.209, p = 0.040), and duration of work (r = 0.341, p < 0.001). The newly developed automated colorimetric method used in our study proposes a promising, practical and daily applicable test for evaluating oxidative status of painters.

Ischemia-Modified Albumin Levels and Thiol-Disulphide Homeostasis in Diabetic Macular Edema in Patients with Diabetes Mellitus Type 2

ABSTRACT Purpose It was aimed to assess the role of thiol-disulphide homeostasis and ischemia-modified albumin (IMA) level in the development of diabetic macular edema (DME) in patients with diabetes mellitus type 2 (T2DM). Materials and Methods Sixty-six study patients were divided into two groups. Group I included 43 patients with T2DM and DME, and Group 2 included 23 patients with T2DM without eye involvement. A novel colorimetric method was used to assess thiol-disulphide homeostasis. Between the two groups IMA, total anti-oxidant, and total oxidant levels were measured and compared. Results In Group 1, total and native thiol levels and disulphide levels were lower compared to Group 2 (p = .025, p < .001 and p = .013, respectively). Disulphide/native thiol, disulphide/total thiol ratios and native thiol/total thiol were similar between the groups. Total anti-oxidant level (TAL) reduced whereas total oxidant level (TOL) increased in Group 1 compared to Group 2 (p = .001, p = .002, respectively). Albumin level decreased, whereas IMA level increased in Group 1 compared to Group 2 (p < .001 for both). Conclusions The disruption in thiol/disulphide homeostasis, increased IMA and oxidative stress have an impact on the development of diabetic macular edema.

Anemia in pregnancy: it’s effect on oxidative stress and cardiac parameters

Objective We aimed to evaluate the changes in cardiac functions by echocardiography and oxidative stress markers in pregnant women with iron deficiency anemia.Method A total of 100 patients (pregnant women with IDA n = 34, healthy pregnant women n = 33, non-pregnant control group n = 33) were enrolled. Demographic data, serum thiol-disulfide and ischemia modified albumin levels, and echocardiographic parameters were compared.Results Native thiol (NT) (p < .001) and Total Thiol (TT) (p < .001) levels as antioxidant markers; left ventricular ejection fraction (LVEF) (p < .001), tricuspid annular plane systolic excursion (TAPSE) (p < .001) were significantly decreased in the IDA group compared to healthy pregnant women and non-pregnant controls. Adjusted IMA ratios were significantly increased in the IDA group (p =.001). A significant negative correlation was determined between adjusted IMA and LVEF (r = −0,4226; p =.016), a significant positive correlation was determined between thiol levels and TAPSE (r = 0.361; p =.041) in IDA group, no correlation was observed in healthy pregnant women and healthy non-pregnant control group.Conclusion Anemia in pregnanc may trigger oxidative stress and increased OS may be related to changes in cardiac functions. The possible cardiovascular impact should be considered in pregnant women with anemia and clinicians should not neglect to refer these patients to cardiology in clinical practise.

Is ischemia modified albumin a good marker in acute exacerbation of chronic obstructive pulmonary disease?

Objectives: Our aim is to compare the Ischemia modified albumin (IMA) in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) with a high oxidative and inflammatory biologic marker like C-reactive protein (CRP) and to investigate its employability in AECOPD and the relationship between arterial blood gas and pulmonary function parameters. Methods: Forty-six patients diagnosed with acute exacerbation of COPD between March 2015 - September 2016 at Ufuk University School of Medicine were included. The 1st and 5th days of IMA and CRP levels were measured. Also, IMA levels were given in absorbance units (ABSU). Results: Total 46 patients of COPD, 13 (28.3%) were females and 33 (71.76%) were males. The mean age of the patients was 71.39 ± 10.04 years. The 1st and 5th day values of IMA, ABSU and CRP were 1.08 ± 0.33 and 0.49 ± 0.24; 1.06 ± 0.34 and 0.49 ± 0.26; and 29.25 (3.10-288.00) and 6.35 (0.30-149.00), respectively (p &amp;lt; 0.001). No significant correlation was determined between IMA and CRP. Also, no correlation were determined between the parameters of arterial blood gas and pulmonary function. Conclusions: Although IMA values showed significant increase during acute exacerbation of COPD and decreased after treatment, CRP still appeared more effective in evaluating the exacerbation status and following up of the treatment of patients with COPD.

Evaluation of Ischemia-Modified Albumin and Fibrinogen in Relation with High-Sensitive C-reactive Protein in Diabetic Foot Ulcers

Context: Diabetic foot ulcer (DFU) is one of the most dreaded complication of diabetes which often affects the morbidity and mortality of a diabetic. Biomarkers are required for follow-up of these patients to prevent further complications to the affected limb. Aim: The aim of this study is to evaluate ischemia-modified albumin (IMA), fibrinogen in relation with high sensitive-C-reactive protein (hs-CRP) in patients with DFUs. Methods: a hospital-based cross-sectional study was carried out among 30 patients with DFU admitted in the surgery department of tertiary care teaching hospital. The duration of the study was 2 months. Serum IMA, hs-CRP, and plasma fibrinogen levels were measured. Results: The present study has demonstrated that IMA levels (P &lt; 0.05) and fibrinogen levels (P &lt; 0.05) are statistically significantly elevated in patients with DFU and had significant correlation with albumin and hs-CRP (P &lt; 0.05). Conclusions: The use of IMA, hs-CRP, and fibrinogen may be incorporated during the follow-up of type 2 diabetes mellitus patients and may probably prevent the development of DFU and also possibly prevent lower limb amputation. Further studies with a larger number of patients with DFU are necessary to reach a definitive judgment.

Oxidant and antioxidant balance in children with bacteremia.

There is a crucial balance between oxidant and antioxidant defense mechanisms. We aimed to evaluate the role of the balance of these systems in children with bloodstream infection. We analyzed prospectively oxidant and antioxidant stress parameters from serum samples of children with BSI besides demographic and clinical data of children. Serum levels of the total antioxidant status (TAS), total oxidant status (TOS), albumin, plasma thiol, disulphide, catalase (CAT), myeloperoxidase (MPO), ischemia-modified albumin (IMA) levels, ferroxidase and arylesterase (ARES) activity were evaluated in both patients and healthy controls. A total of 113 children were evaluated, 50 of them had bacteremia and the remaining 63 were healthy subjects. The median TOS values were 18.5 μmol H2O2/L and 13.1 μmol H2O2/L in patient and control groups, respectively with a statistically significant difference between groups. The mean serum IMA levels were 0.8 ± 0.1 absorbance unit (ABSU) in patients and 0.5 ± 0.09 ABSU in control, the difference between groups was statistically significant. The native thiol, total thiol levels and the disulphide levels were significantly lower in the patient group as compared with the control group. The myeloperoxidase level was 136 U/L in patients and 107 in controls with a statistically significant difference between groups. TOS, IMA, MPO, and particularly plasma thiols seem good candidates for accurate diagnosis of bacteremia in children.

Helicobacter pylori ve tiyol-disülfid homeostazı arasındaki ilişki: Prospektif, gözlemsel bir çalışma

Aim: Helicobacter pylori (HP) infection causes inflammation and oxidative stress at a cellular level. In the present study, we aimed to evaluate the possible relationship between HP and thiol-disulfide homeostasis (TDH), a novel indicator of oxidative stress.Methods: Medical data of a total of 53 patients admitted with persistent dyspepsia and undergoing gastroscopy were evaluated prospectively. The patients were divided into two groups, based on the result of gastric biopsy, as HP-positive (+) and HP-negative (-). Demographic data, ferric-reducing ability of plasma (FRAP), ischemia-modified albumin (IMA), native thiol, total thiol, disulfide, and malondialdehyde (MDA) levels of the patients were recorded and compared between the two groups.Results: The native thiol (451.03 mmol/L vs. 407.03mmol/L, p=0.005) and total thiol (493.20 mmol/L vs. 456.40 mmol/L, p=0.027) levels were significantly higher in the HP (+) group than in the HP (-) group. The disulfide levels and disulfide/native thiol, disulfide/total thiol and native thiol/total thiol ratios were similar between the HP (+) and HP (-) groups. Although the FRAP was lower in the HP (+) group than in the HP (-) group, this difference was not statistically significant (0.94 mmol/L vs. 1.10 mmol/L). No statistically significant difference was found between the groups in the IMA and MDA levels. Conclusion: In this study, oxidative status of HP patients was evaluated in several different methods. Among them, only elevated native thiol and total thiol levels were found in HP-induced gastritis. There is a need for further studies involving a larger number of patients and a subgroup analysis to examine whether elevated serum thiol-disulfide levels in HP infection suggest an antioxidant or pro-oxidant status.

Oxidative stress parameters in patients with ascending aortic dilatation

Background/aimThis study aimed to determine plasma thiol, disulphide, and serum ischemia-modified albumin (IMA) levels and ferroxidase activity in patients with ascending aorta dilatation (AAD) in comparison to those without AAD and to evaluate the predictive value of these oxidative stress parameters for AAD.Materials and methods This study was designed as a cross-sectional study of 184 patients who applied to our cardiology clinic. Our study population consisted of patients with AAD (n = 85) and without AAD (n = 99). A spectrophotometric method was used to determine plasma thiol, disulphide, and serum IMA levels and ferroxidase activity.Results The native thiol and the total thiol levels were significantly higher in the control group than the AAD group (P < 0.001), whereas the disulphide and IMA levels and the ferroxidase activity were similar between the groups. The native thiol and the total thiol levels were inversely and significantly correlated with ascending aortic diameter (r = –0.38, P < 0.001; r = –0.39, P < 0.001; respectively). The left ventricle mass and the total thiol levels were independent predictors of ascending aortic diameter (β= 0.223, P = 0.02; β= –0.340, P < 0.001; respectively).Conclusion Among oxidative stress parameters including thiols, disulphide, IMA, and ferroxidase activity, only the lower total thiol levels appear to confer a high risk for AAD development. Along with the proven diagnostic imaging methods, thiol levels may be helpful to diagnose and stratify patients with AAD.

Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy.

BackgroundBirth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney.PurposeThis study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE).MethodsSixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzymelinked immunosorbent assay of a cord blood sample collected within 30 minutes after birth.ResultsCord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001).Conclusion IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

The relationship between oxidative stress and preeclampsia. The serum ischemia-modified albumin levels and thiol/disulfide homeostasis

Objective:Preeclampsia (PE) is a dangerous complication of pregnancy and still a major cause of maternal-fetal morbidity and mortality. Its etiology remains largely unknown, but researchers have suggested oxidative stress-mediated inflammation for the same. The purpose of this study is to investigate the relationship between oxidative stress and PE as well as the usability of oxidative stress indicators such as serum ischemia-modified albumin (IMA) levels and thiol/disulfide balance in the prediction of PE.Materials and Methods:The study included 47 pregnant women with PE and 57 healthy pregnant women. We measured their serum IMA, native thiol, total thiol, and disulfide levels. Additionally, we determined the optimal cutoff values via the receiver operating characteristic curve analysis.Results:There were no differences between the two groups with respect to the maternal age, body mass index, gravida, and parity. The native and total thiol levels were found to be low when the disulfide and IMA levels were high in the patients with PE (p<0.05). When the IMA level was corrected by the albumin level (IMAR), the significant difference between the two groups disappeared. We also found that the native and total thiol concentrations were correlated with the systolic and diastolic blood pressures. The optimal cut-off values calculated for the prediction of PE were as follows: 178.45 µmol/L (with sensitivity of 72% and specificity of 83%) for native thiol, 232.55 µ mol/L (with a sensitivity of 75% and specificity of 85%) for total thiol, and 29.05 µmol/L (with sensitivity of 65% and specificity of 72%) for disulfide.Conclusion:The balance of thiol/disulfide may play a role in the pathogenesis of PE and could be used as a biological marker for PE.

Assessment of ADMA, IMA, and Vitamin A and E Levels in Patients with Acne Vulgaris.

Acne vulgaris is a common skin disease in adolescents known to be associated with oxidative stress. However, the number of studies in which oxidative stress and antioxidants are evaluated together is limited. In this study, we aimed to investigate L-arginine/nitric oxide (NO) pathway metabolites, ischemia-modified albumin (IMA), and vitamin A and E levels in patients with acne and its association with disease severity. Ninety patients with acne and 30 healthy adults were included in the study. The serum levels ofL-arjinin, L-arginine metabolites, IMA, and vitamins A and E measured in the patient and control groups. Asymmetric dimethylarginine (ADMA), LNG -monomethyl-L-arginine (L-NMMA) and symmetric dimethylarginine (SDMA), and IMA levels were significantly higher in the patients with acne than in the control group (P˂.05). The L-arginine/ADMA ratio and citrulline and vitamin A levels were significantly lower in patients with acne than those of the controls (P˂.05). ADMA and IMA plasma levels were increased in parallel with the disease severity (P˂.05). L-arginine/ADMA ratio, L-arginine, citrulline, and vitamin A plasma levels decreased as the disease became severe (P˂.05). Although L-arginine and vitamin E levels were lower in the patient group compared to the control group, the difference was not statistically significant (P˃.05). These results suggest that IMA and L-arginine-NO pathway associated with ischemia and oxidative stress may play an important role in the pathogenesis and progression of acne vulgaris.

The effect of laparoscopic and open surgery on oxidative DNA damage and IL-37 in children with acute appendicitis.

Although laparoscopic appendectomy (LA) is considered to be minimally invasive compared with open appendectomy (OA), there are few studies showing this in terms of cytokines and oxidative stress markers. LA and OA techniques have been compared in terms of different conditions such as operation time and complication rate. Here, we compared how oxidative DNA damage and some cytokines levels change in relation to LA and OA. This study was performed in children diagnosed with acute appendicitis in our hospital. The study was conducted on 30 children with acute appendicitis in each group. Oxidative DNA damage and malondialdehyde levels were determined by high-performance liquid chromatography, and interleukin-1β, interleukin-37, ischaemia-modified albumin and total thiol levels were determined by enzyme-linked immunosorbent assays. There was a dramatic decrease in ischaemia-modified albumin (IMA) levels after LA. However, there were no statistically significant differences in pre- and postoperative IMA levels in the OA group. Oxidative DNA damage and malondialdehyde levels were low significantly according to preoperative levels after the LA and OA. Total thiol levels were high in children who underwent LA while they were low after OA. In addition, postoperative interleukin-1β levels were low in both groups. Furthermore, IL-37 levels postoperatively were low in the LA group, while there was no significant change in the OA group. LA had a more positive effect on oxidative DNA damage, IL-1β and IL-37 than the OA. In addition, surgical stress was reduced with LA.

Correlation between ischemia-modified albumin level and coronary collateral circulation

ObjectiveTo investigate the correlation between ischemia-modified albumin (IMA) levels and coronary collateral circulation (CCC) in patients with chronic total occlusive (CTO).MethodsCoronary angiography was performed in the Department of Cardiology, Zhongnan Hospital of Wuhan University from 2017 to 08 to 2019–02 to identify 128 patients with CTO lesions in at least one major coronary artery. According to the Rentrop evaluation criteria, the degree of CCC formation was divided into the poor CCC formation group (Rentrop0–1 grade,n = 69) and the good CCC formation group (Rentrop2–3 grade,n = 59). The IMA level of the patients was measured using an albumin-cobalt binding assay. The general data, routine blood panel, total bilirubin (TBIL), blood lipids, uric acid (UA), left ventricular ejection fraction (LVEF) and other indicators of the patients were recorded and analyzed while assessing the patients’ blood vessel occlusion.ResultsThe proportion of platelet count and diabetes in the poor CCC group was higher than that in the good CCC group (P < 0.05). The ratio of ischemia-modified albumin and total bilirubin in the poor CCC group was lower than that in the good CCC group (P < 0.05). Multivariate logistic regression analysis showed that ischemia-modified albumin was positively correlated with CCC formation [OR = 1.190,95% CI (1.092–1.297),P < 0.001], while diabetes was negatively correlated with CCC formation [OR = 0.285,95% CI (0.094–0.864), P < 0.05]. Ischemic modified albumin predicted good formation of CCC according to the ROC curve, and the area under the ROC curve was 0.769(95% CI,0.686–0.851, P<0.001); the optimal cut-off value was 63.35 KU/L, and the sensitivity was 71.2%,specificity is 71%.ConclusionThe IMA level is closely related to good formation of CCC. Higher IMA levels can be used as an effective predictor of good CCC formation in patients with CTO.

Assessment of thiol/disulphide homoeostasis and ischaemia-modified albumin and their relationship with disease severity in children with chronic urticaria

Background The pathogenesis chronic urticaria (CU) hasn't been fully understood. In recent years, it has been shown that thiol-disulphide homoeostasis, as an antioxidant system, plays important roles in both healthy individuals and various diseases. In different ischaemia-reperfusion states, high oxidative stress causes ischaemia-modified albumin (IMA) generation. Aim To investigate thiol/disulphide balance and IMA level in children with CU and their association with disease severity. Methods Thirty children with CU and 20 healthy children as controls, aged 1–18 years, were included in this cross-sectional study. In all subjects, total thiol, native thiol, disulphide levels and IMA levels were measured in plasma by spectrophotometry. Disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated. The disease severity was rated by Urticaria Activity Score (UAS). Results In the children with CU, the levels of native thiol (375.56 ± 56.22 μmol/L) and total thiol (415.69 ± 54.75 μmol/L) were significantly lower than the control group (475.20 ± 71.87 and 511.20 ± 73.73 μmol/L, respectively) (p = 0.000, p = 0.000). The ratio of native/total thiol * 100 was lower in patients than the control group (p = 0.002). IMA was significantly higher in the patient group than control group (p = 0.000). No significant correlation was found between UAS and thiol/disulphide homoeostasis (p > 0.05). The disulphide levels, disulphide/native thiol and disulphide/total thiol levels were found to be higher in patients with positive family history for autoimmune disorders than those without (p < 0.05). Conclusion In children with CU, impaired thiol/disulphide homoeostasis and increased IMA suggest that oxidative stress may play role in the disease pathogenesis.

Does Subclinical Hypothyroidism Affect Dynamic Thiol / Disulfide Homeostasis and İschemia-modified Albumin Levels in Children?

To determine the effects of subclinical hypothyroidism on oxidative stress in children. A cross-sectional study. Department of Paediatrics, Paediatric Endocrinology, and General Outpatient Clinics, Kirikkale University, School of Medicine, from May 2017 to October 2018. This study included 92 subjects aged between 2 and 18 years. The subjects were divided into two groups. Forty-seven children with subclinical hypothyroidism and 45 healthy controls were evaluated. In order to evaluate oxidative damage, native thiol, total thiol, disulfides, their ratios, and ischemia-modified albumin (IMA) levels were compared between the two groups. The relationship between TSH and IMA levels was assessed. Age and gender were not significantly different in the two groups. Native thiol, total thiol, disulfides and their ratios were similar in the two groups. Ischemia-modified albumin levels were significantly higher in the patient group than the controls (p<0.001). There was no correlation between TSH and IMA levels in the patient group (r=0.069 p=0.645). Subclinical hypothyroidism may be related to the impairment of IMA, and have a neutral effect on thiol/disulfide balance. Further research is needed to explain the effects of oxidative stress in subclinical hypothyroidism. Key Words: Subclinical hypothyroidism, Childhood, Oxidative stress.

Prognostic Value of Inflammation Parameters in Patients With Non-ST Elevation Acute Coronary Syndromes.

Inflammation parameters can predict the severity of coronary artery disease and predict long-term mortality. However, there is no study in which these parameters were evaluated together. We compared the prognostic values of inflammation parameters in predicting long-term mortality in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Consecutive patients with NSTE-ACS (n = 170) were included in the study. Monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), total cholesterol/HDL-C ratio (TC/HDL-C), triglyceride /HDL-C ratio (TG/HDL-C), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, and ischemia-modified albumin (IMA) were measured. Total antioxidant status and TOS variables were significant independent predictors of mortality. When 1.17 value is taken as a cutoff point of TAS values, the sensitivity (70.0%) and specificity (77.39%) values calculated for this value indicate that TAS variable has a predictive value on mortality. Monocyte/high-density lipoprotein cholesterol ratio, LMR, NLR, PLR, TC/HDL-C, TG/HDL-C, TOS, and IMA levels could not be used alone in the diagnosis, severity assessment, and predicting future mortality of NSTE-ACS. Only TAS levels had a predictive value on mortality.