Ischemia-modified Albumin Values Research Articles

Evaluation of the ischemia modified albumin levels in familial Mediterranean fever patients.

Familial Mediterranean fever (FMF) is an autoimmune disease with periodic fever attacks recurring with mutations in the MEFV gene and chronic inflammation. The new molecule which is formed as a result of the chemical changes made by oxidative free radicals in the albumin molecule during ischemic events is called ischemia modified albumin (IMA). The aim of this study is to evaluate the IMA levels as a predictor of the cardiovascular risk factor in FMF patients in the attack-free period and to evaluate the relationship between IMA and inflammation markers. Forty FMF patients without any additional disease, non-smokers, and in their attacks-free period, 40 ankylosing spondylitis patients whose disease activity criteria is less than 4 from Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and 39 healthy adults were included in the cross-sectional analytical research. The value of IMA was statistically significantly higher in the AS group compared to the control group (p = 0.01). The positive correlations between IMA and ESR, LDL, total cholesterol, triglyceride, CRP, and fibrinogen were statistically significantly determined in FMF patients (respectively; r = 0.594; p < 0.001, r = 0.382; p = 0.015, r = 0.335; p = 0.034, r = 0.363; p = 0.021, r = 0.597; p < 0.001, r = 0.656; p < 0.001). The positive correlations between IMA and ESR, CRP were found in AS patients (respectively; r = 0.383; p = 0.015, r = 0.382; p = 0.015). IMA can be used as a predictor similar to cardiovascular risk factors and it is a precious marker for inflammation. The use of IMA in these fields and the multi-centred and comparative studies about predictability of it may contribute to science.

Evaluation of Serum Ischemia Modified Albumin in Patients With COVID-19 Pneumonia: A Case-Control Study.

Introduction: Various biomarkers are used when evaluating the hospitalization needs of patients diagnosed with Coronavirus disease (COVID-19). Ischemia-modified albumin (IMA) is a biomarker that causes blood levels to increase as a result of hypoxia and acidosis. We think that an increase in IMA in the blood may be caused by hypoxia stemming from lung damage. This study aimed to compare the mean/median of the blood IMA value in patients with pneumonia due to COVID-19 infection with a control group.Methods: The case group included patients with COVID-19 pneumonia detected by lung imaging and a positive COVID test. Demographic information of the case group, the severity of pneumonia, and their PCR test results were recorded in the data set.Findings: A total of 150 people, 90 of whom were in the case group and 60 of whom were in the control group, participated in the study. No statistically significant differences were found between the blood IMA levels of the case group and the control group. When the blood IMA levels of the case group were compared according to pneumonia severity, no statistically significant differences were found between the mild-moderate and severe pneumonia groups.Conclusion: Blood IMA levels are not a diagnostic biomarker for patients with COVID-19 pneumonia and are not helpful in predicting the severity of pneumonia.

Evaluation of thiol/disulfide hemostasis and serum Ischemia modified albumin as oxidative stress biomarkers in systemic lupus erythematosus patients: Relationship with major organ involvement and disease activity.

We aimed to compare thiol/disulfide hemostasis and serum ischemia-modified albumin (IMA) levels, which are indicators of oxidative stress (OS), in patients with systemic lupus erythematosus (SLE), with the healthy control (HC) group and to evaluate the relationship of these parameters with disease activity and major organ involvement. Eighty-four SLE patients and 96 HCs were included in this study. The disease activity of SLE patients was calculated using The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Patients with SLEDAI-2K ≤ 5 were classified as low disease activity (LDA) and those with SLEDAI-2K > 6 as high disease activity (HDA). Thiol/disulfide hemostasis was evaluated using a new automated method and natural thiol (NT), total thiol (TT), disulfide (SS) levels, SS/NT, SS/TT, NT/TT ratios, and serum IMA levels were recorded. NT and TT levels were significantly lower (490.11 ± 123.61 vs 536.96 ± 86.05, p = 0.003) (532.56 ± 125.80 vs 565.72 ± 89.82, p = 0.046), SS level (21.22 ± 11.75 vs 13.37 ± 9.31, p < 0.001) was higher, and SS/TT (4.64 ± 2.93 vs 2.52 ± 1.82, p < 0.001) and SS/NT (4.12 ± 2.33 vs 2.35 ± 1.59, p < 0.001) ratios were significantly higher in SLE patients compared to HCs. IMA values were not different between the two groups (p = 0.920). NT (449.84 ± 136.98 vs 520.32 ± 104.11, p = 0.012) and TT levels (492.01 ± 138.45±562.97 ± 107.09, p = 0.013) were significantly lower and serum IMA levels (0.802 ± 0.089 vs 0.764 ± 0.040, p = 0.023) were significantly higher in SLE patients with HDA than in LDA patients. There was a weak negative correlation between NT (r = -0.284, p=0.009) (r = -0.291, p = 0.007) and TT levels (r = -0.281, p = 0.010) (r = -0.289, p = 0.008) and a weak positive correlation between IMA levels (r = 0.279, p = 0.011) (r = 0.263, p = 0.016) and SLEDAI-2K, and major organ involvement. It is thought that thiol/disulfide hemostasis and IMA levels may be used as ideal biomarkers of OS in SLE patients and may reflect the disease activity and major organ involvement.

Ischemia-Modified Albumin (IMA) levels in ectopic pregnancy and early pregnancy loss.

IMA is a novel marker to consider in ischemic conditions. The initial stages of pregnancy represent a physiological ischemic status. IMA levels may be changed when there is suspicion of early pregnancy complications because of increased oxidative stress. We aimed to determine and compare IMA values in cases of ectopic and healthy pregnancies as well as early pregnancy loss. This prospective case control study population (n = 91) consisted of early pregnancy loss (n = 28), ectopic pregnancy (n = 28), and an intracavitary early healthy pregnancy (n = 35). The serum IMA levels were compared in these groups. Demographic parameters were similar and there was no significant difference between the three groups in terms of serum IMA concentrations. We suggested that IMA cannot be used clinically for the diagnosis and follow up of early pregnancy complications during the first five to six gestational weeks.

Serum IMA and LP-PLA2 Levels in Patients with Coronary Heart Disease and Their Correlation with the Degree of Myocardial Ischaemia and Their Diagnostic Value.

Purpose To measure serum levels of ischaemia-modified albumin (IMA) and lipoprotein-associated phospholipase A2 (LP-PLA2) in patients with coronary heart disease (CHD) and to analyse their correlation with the degree of myocardial ischaemia and their diagnostic value. Methods A sample of 150 patients diagnosed with CHD by coronary angiography in our hospital from March 2019 to September 2021 was taken as the CHD group. The patients were divided into acute myocardial infarction (AMI) group (n = 52), unstable angina pectoris (UAP) group (n = 54), and stable angina pectoris (SAP) group (n = 44) according to the degree of myocardial ischaemia, and then 50 healthy physical examination patients were selected as the health group during the same period. Serum C-reactive protein (CRP), interleukin-6 (IL-6), IMA, and LP-PLA2 levels were measured in each group separately. Multiple ordered logistic regression was used to analyse the factors influencing the degree of myocardial ischaemia in patients with CHD. Pearson correlation was used to analyse the correlation between serum IMA, LP-PLA2 levels and serum CRP, IL-6 levels in CHD patients. The diagnostic value of IMA alone, LP-PLA2 alone, and in combination for CHD was analysed using receiver operating characteristic (ROC) curves. Results In terms of serum CRP, IL-6, IMA, and LP-PLA2 levels, the CHD group was higher than the health group, the AMI and UAP groups were higher than the SAP and health groups, and the AMI group was higher than the UAP group (P < 0.05). Multiple ordered logistic regression analysis showed that serum CRP, IL-6, IMA, and LP-PLA2 levels were all independent influences on the degree of myocardial ischaemia in patients with CHD (P < 0.05). Pearson correlation analysis showed a positive correlation between serum IMA, LP-PLA2 levels and serum CRP, IL-6 levels in CHD patients (P < 0.001). The area under curve (AUC) for serum IMA levels to predict myocardial ischaemia in patients with CHD was 0.754 (95% CI: 0.684–0.825), with a sensitivity of 61.3% and specificity of 84.0% when the best cut-off value was 0.453; the AUC for serum LP-PLA2 levels to predict myocardial ischaemia in patients with CHD was 0.747 (95% CI: 0.681–0.813), with a sensitivity of 62.0% and specificity of 82.0% when the optimal cut-off value was 0.440; and the AUC of IMA + LP-PLA2 for predicting myocardial ischaemia in patients with CHD was 0.892 (95% CI: 0.847–0.938), with a sensitivity of 86.7% and specificity of 80.0% when the optimal cut-off value was 0.667. The specificity was 80.0%. Conclusions Serum IMA and LP-PLA2 levels are elevated in patients with CHD. Serum IMA and LP-PLA2 levels are closely related to the degree of myocardial ischaemia and its inflammatory level, and the combination of IMA + LP-PLA2 can improve the diagnosis efficacy of myocardial ischaemia in CHD patients.

The clinical value of IMA and SCUBE1 in the diagnosis of acute appendicitis in children

Objectives. This study aims to show the clinical value of ischemia-modified albumin (IMA) and Signal Peptide, Complementary C1r/C1s, Uegf and Bmp1–Epidermal Growth Factor Like Domain Containing 1 (SCUBE1) protein in pediatric appendicitis. Methods. Eighty-one pediatric patients hospitalized in the pediatric surgery ward with acute appendicitis and a control group of 62 pediatric patients with unspecific abdominal pain were included in this prospective case-control study. Thirty-nine patients whose pathology specimens confirmed acute appendicitis made up the final appendicitis group. Results. Patients with appendicitis had higher IMA (p&lt;0.001) and SCUBE1 (p&lt;0.001) levels than the control group. In receiver operating characteristic (ROC) analysis, areas under the curve (AUC) were 0.991 (sensitivity=97.4%, specifity=100%, positive likelihood ratio (+LR) infinity, negative likelihood ratio (-LR)=0.03, positive predictive values (+PV)=100%, negative predictive value (-PV)=98.3% for IMA and 0.803 (sensitivity = 89.7%, specificity =64.5%, +LR=2.53, -LR=0.16, +PV=61.4%, -PV=90.9%) for SCUBE1. Conclusions. The present study shows that IMA may be a reliable marker for a more accurate diagnosis of appendicitis. SCUBE1 can be used to exclude diagnosis if used in combination with other laboratory and clinical data.

Correlation of Serum CysC, IMA, and LP-PLA2 Levels With Type 2 Diabetes Mellitus Patients With Lower Extremity Atherosclerotic Occlusive Disease.

ObjectiveTo investigate the serum level of cystatin C (CysC), ischemia-modified albumin (IMA), and lipoprotein-associated phospholipase A2 (LP-PLA2) in patients with type 2 diabetes mellitus (T2DM) and with lower extremity atherosclerotic occlusive disease (LEASOD) and their correlation.MethodsFrom March 2017 to December 2019, 110 patients with T2DM with LEASOD, who were treated in our hospital, were selected as the observation group. One hundred ten healthy persons who received medical examination in our hospital during the same period were selected as the control group. Serum CysC, IMA, LP-PLA2, and ankle-brachial index (ABI) were detected in each group. According to the ABI index, the observation group was divided into three subgroups, namely, the mild group (n = 45), the moderate group (n = 42), and the severe group (n = 23). Pearson correlation analysis was used to analyze the relationship between serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD and their condition. The receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of serum CysC, IMA, and LP-PLA2 levels in patients with T2DM with LEASOD.ResultsThe serum levels of CysC, IMA, and LP-PLA2 in the observation group were higher than those in the control group (p < 0.05). The serum levels of CysC, IMA, and LP-PLA2 in the severe and the moderate group were higher than those in the mild group, and the serum levels of CysC, IMA, and LP-PLA2 in the severe group were higher than those in the moderate group (p < 0.05). Pearson correlation analysis showed that CysC, IMA, and LP-PLA2 levels were all negatively correlated with ABI (r = −0.802, r = −0.757, r = −0.764, p < 0.001). The ROC curve results showed that the area under the curve (AUC) of serum CysC in the diagnosis of T2DM with LEASOD was 0.806, and the best cut-off value was 1.74 mg/L. The AUC of serum IMA for diagnosis of T2DM with LEASOD was 0.772, and the best cut-off value was 92.58 g/L. The AUC of serum LP-PLA2 in the diagnosis of T2DM with LEASOD was 0.781, and the best cut-off value was 544.86 ng/L. The AUC of the three combined diagnoses of T2DM with LEASOD was 0.863.ConclusionSerum levels of CysC, IMA, and LP-PLA2 were increased in patients with T2DM with LEASOD. Serum CysC, IMA, and LP-PLA2 are closely related to the severity of the disease. The higher the serum levels of CysC, IMA, and LP-PLA2, the more serious the degree of lower extremity arteriosclerosis occlusion, which can be used as an important serum marker to monitor the severity of T2DM with LEASOD. The combined detection of serum CysC, IMA, and LP-PLA2 has good diagnostic value for patients with T2DM with LEASOD.

Diagnostic Value of Ischemia-Modified Albumin in Terms of Acute Coronary Syndromes in Chronic Renal Patients Admitted to Emergency Department with Chest Pain and/or Equivalent Symptoms

Diagnostic Value of Ischemia-Modified Albumin in Terms of Acute Coronary Syndromes in Chronic Renal Patients Admitted to Emergency Department with Chest Pain and/or Equivalent Symptoms

Association of Maternal Serum Ischemia Modified Albumin (IMA) with Placental Histopathological Changes and Fetomaternal Outcome: A Prospective Case Control Study in Normotensive and Pre-eclamptic Women.

Ischemia and oxidative stress leads to generation of hydroxyl free radicals and modification of 'N-terminus' of human serum albumin. This modified albumin molecule, known as Ischemia Modified Albumin (IMA), is elevated in early stages of ischemia. It has recently been approved by US Food and Drug Administration (US FDA) for its clinical use, as early marker of myocardial ischemia in cardiology. IMA is a novel marker of ischemia and is elevated in other clinical conditions associated with ischemia like pulmonary embolism, uncontrolled type II diabetes mellitus, acute decompensated heart failure, preeclampsia, recurrent pregnancy losses and IUGR. Role of IMA in birth asphyxia in perinatology is of current interest and needs further research. A prospective case control study was conducted in a tertiary center in North India for one year. Total 80 pregnant women between 34 and 40weeks were recruited and allocated in two groups. Case group comprised of 40 pre-eclamptic pregnant women and control group comprised of 40 normotensive pregnant women. Comparison and association of maternal serum IMA levels with fetomaternal outcome and number and types of placental histopathological changes was done in two groups. In preeclampsia group mean serum IMA (115.23 ± 49.51) was significantly higher as compared to the normotensive group (79.21 ± 14.35). The optimum cut off value of IMA to detect a case was 94.5IU/ml (sensitivity 65%, specificity 87.5%, PPV 83.9%, NPV 71.4% and diagnostic accuracy of 76.3). Pre-eclamptic women, had significantly higher incidence of PTVD, lower fetal birth weight and placental histopathological changes as compared to normotensive group. 83.8% of the women with raised IMA levels were pre-eclamptic. Raised IMA levels were significantly associated with higher incidence of PTVD, birth weight ≤ 2kg and hypoxic histopathological lesions of chorangiosis, intervillous fibrin and hyalinization. Determination of maternal serum IMA levels early in pregnancy can predict preeclampsia and avoid future severe preeclampsia related complications. It might be useful to optimize both maternal and fetal/neonatal outcomes.

Thiol/disulphide balance and ischemia modified albumin levels in relapsed brucellosis patients

Objectives: In the study, it was aimed to determine the Thiol/Disulphide profile in patients with relapsed brucellosis and the relationship between Ischemia Modified Albumin (IMA) Levels and Thiol/Disulphide profile. Methods: Native thiol, Total thiol, Disulphide, Disulphide/Native thiol, Disulphide/Total thiol, IMA levels were measured in forty patients with relapsed brucellosis and healthy control group by using the newly developed method in this cross-sectional study. Results: There was no statistically significant difference in patients with relapse brucellosis despite the fact that it was lower than total thiol control group (p &amp;gt; 0.05). Disulphide was detected high in patients with brucellosis but no statistically significant difference was found (p &amp;gt; 0.05). Native thiol and total thiol ratios of disulphide were found to be statistically higher in patients with relapsed brucellosis (p &amp;lt; 0.05). In addition, the ratio of native thiol and native thiol to total thiol was statistically lower than the control group (p &amp;lt; 0.05). The levels of IMA were statistically significant in patients with relapsed brucellosis compared to the control group (p &amp;lt;0.05). There was a statistically significant positive correlation between IMA values and Disulphide and Disulphide/Native thiol, Disulphide/Total thiol, Native thiol/Total thiol ratios (r=0.514, r=0.527, r=0.527, r=0.527; respectively). Conclusions: It is known that the response of brucellosis treatment can be followed up with oxidative stress markers and it can also be used as a relapse indicator in our study.

The value of ischemia modified albumin level for predicting in-hospital mortality in patients with acute aortic dissection

Objective: To investigate the value of ischemia modified albumin (IMA) level for predicting in-hospital mortality in patients with acute aortic dissection (AAD). Methods: A total of 195 patients with AAD from the Department of Cardio-Vascular Surgery of Affiliated Hospital of North Sichuan Medical College from January 2017 to November 2019 were consecutively collected, with 126 males and 69 females. Based on whether they died during hospitalization or not, these patients were divided into 2 groups: survival group and mortality group. The baseline data and IMA levels at admission of the two groups were recorded. Univariate logistic regression analysis was used to identify the independent risk factors, and multivariate logistic regression analysis was further performed on variables with statistical significance in univariate analysis. The area under the receiver operating characteristic (ROC) curve was calculated to determine the value of IMA for predicting in-hospital mortality in patients with AAD. Results: Forty-two AAD patients died and 153 survived, and the mortality rate was 21.5%. Logistic regression analysis showed that age (OR=2.143,95%CI:1.247-4.826,P=0.011), Stanford type A (OR=6.751,95%CI:3.189-14.291,P<0.001), drug therapy (OR=5.133,95%CI:2.463-10.700,P<0.001), IMA level (OR=4.452,95%CI:2.231-8.953,P=0.004) were independent risk factors for in-hospital mortality in patients with AAD, however surgery was a protective factor (OR=0.195,95%CI:0.093-0.406,P<0.001). The area under the ROC curve for IMA level in predicting in-hospital mortality with AAD was 0.838 (95%CI: 0.774-0.901, P<0.001), with a cut-off value of 86.55 U/ml, and the sensitivity and specificity were 83.3% and 75.2%, respectively. Conclusions: IMA may serve as a simple risk assessment indicator for patients with AAD. IMA level at admission is an independent predictor of in-hospital mortality. For patients with higher IMA level, early surgical intervention should be performed.

The Use of Ischemia Modified Albumin as a Predictive and Prognostic Biomarker in Patients with Non–Acetaminophen-Induced Acute Liver Failure

Background: King College criteria (KCC) and Model for End-Stage Liver Disease (MELD) score are the most commonly used criteria in the follow-up of patients with acute liver failure (ALF). However, these criteria cannot always predict prognosis and the need for liver transplantation (LT). Aim: This study aimed to investigate to usability of ischemia modified albumin (IMA) and IMA/albumin ratio (IMAR) values in the follow-up of ALF patients. Methods: IMA and IMAR values of 23 ALF patients and 43 healthy volunteers were measured. Then IMA and IMAR values were compared with KCC and MELD score to predict LT requirement and prognosis in ALF patients. Results: IMA and IMAR values were significantly higher in ALF patients compared healthy volunteers (p=0.001, p=0.001; respectively). IMA and IMAR values predicted LT requirement in ALF patients such as KCC and MELD (≥30) score (p=0.006, p=0.04, p=0.001, p=0.03; respectively). IMA values were found to better than KCC in predicting mortality (p=0.008, p=0.02; respectively). MELD (≥30) score failed to predict mortality (p=0.44). Conclusion: IMA and IMAR values can be used as diagnostic biomarkers in ALF patients. IMA is a better prognostic biomarker in the follow-up of ALF patients.

The predictive value of ischemia-modified albumin in the diagnosis of acute appendicitis: A prospective case-control study.

Surgical planning is critical for ongoing treatment and prognosis of the disease's course after an appendicitis diag-nosis. Ischemia-modified albumin (IMA) has been used as a biomarker for a variety of ischemia-related disorders in the past. The aim of this study is to determine the IMA level in patients with AA and to evaluate its predictive significance. A total of 139 participants were enrolled in the trial. After diagnosis and before surgery, the amount of plasma IMA was tested. Patients diagnosed with appendicitis in Group 1 (n=97) and volunteer surgical patients not diagnosed with appendicitis in Group 2 (n=42) were compared as the final diagnostic criterion. The data of 139 patients with a mean age of 36.15 were evaluated statistically. IMA values were analyzed in both groups. The mean IMA of all patients was 0.74±0.16 AbsU. When the two groups were compared, it was seen that IMA was statistically higher in Group 1 than in the control group. While the area under the curve for IMA was 0.670, the sensitivity for the cutoff value of 0.715 was 68%, the specificity was 62%. Our study shows that IMA values provide significant results in predicting acute appendicitis.

Maternal Serum and Fetal Cord Blood Concentrations of Thiol/ Disulfide and Ischemia-Modified Albumin as Predictors of Neural Tube Defects.

To investigate the predictive role of thiol/ disulfide homeostasis and Ischemia-modified albumin (IMA) levels for NTDs. A total of 71 pregnant women (31 with NTD and 42 healthy controls) were enrolled in this study. This prospective case-control study included pregnant women with NTDs as the study group and randomly selected age-matched pregnant women with healthy fetuses as the control group. The two groups were compared on the basis of thiol/disulfide and IMA levels in the maternal and fetal samples. No statistically significant difference in native thiol, total thiol, disulfide, and calculated ratios was observed between the groups. However, maternal IMA values were significantly higher in the study group. The IMA was proven to be a predictor with a sensitivity of 77.4% and specificity of 100% for NTDs at a cut-off value of 1.32. The examination of the maternal levels of IMA may be useful in the detection of NTDs.

Ischemia-modified albumin as a novel marker for diagnosis of necrotizing enterocolitis in newborn infants

Background: Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency. Ischemia-modified albumin (IMA) is a marker of oxidative stress and ischemia. Its role in early diagnosis of NEC has been little investigated so far. Aim: The objective of our research was to study the role of serum IMA in diagnosis of NEC in newborn infants. Material and methods: The study was carried out on 80 neonates; 40 with NEC and 40 controls, subjected to serum IMA dosage with ELISA. Results: There was a highly statistically significant increase in IMA in both preterm (60.59 ± 34.97 U/ml) and full-term infants with NEC (60.50 ± 29.88 U/ml) compared to their controls (11.28 ± 3.09 U/ml; 5.34 ± 1.88 U/ml). The positive predictive value of IMA in preterm and full-term with NEC was 100% and 94.74%, while the negative predictive value was 80% and 90.48%, respectively. There was a statistically significant increase in serum level of IMA in stage II NEC compared to stage I NEC as well as in non-survivor cases. Significant positive correlation between serum IMA level and duration of recovery from NEC was detected. Conclusions: IMA is a sensitive marker for diagnosis of NEC in full-term and preterm infants and can predict severity of NEC and death.

Investigation of Thiol/Disulfide Homeostasis and Ischemia-Modified Albumin Levels in Children with Wilson Disease

Background The aim of the present study was to assess thiol/disulfide homeostasis (TDH) parameters and ischemia-modified albumin (IMA) levels in children with Wilson Disease (WD) and to compare them to healthy controls. Methods: Based on the inclusion and exclusion criteria, fifteen children with WD and twenty-nine healthy children were enrolled, and serum thiol/disulfide and IMA levels were compared between groups. Results: The mean values of native and total thiols were significantly lower in the WD group than in the control group. The mean value of disulfide was significantly higher in the WD group than in the control group. The mean percentages of disulfide/total thiol and native thiol/total thiol were higher in the WD group than in the control group. The IMA value was also higher in the WD group than in the control group. Conclusion: The present study demonstrating altered thiol/disulfide parameters indicates increased oxidative stress in children with WD.

Study of ischemia modified albumin (IMA) as a biomarker in hypertensive retinopathy.

BackgroundHypertension (HTN) is one of the leading causes of morbidity and mortality worldwide. A prompt diagnosis and treatment of hypertensive retinopathy (HR), the leading complication of HTN is pivotal for a better visual outcome. Increased blood pressure on its own cannot fully clarify the development of retinal alterations, therefore an additional pathogenetic mechanism, such as oxidative stress, might be inquired.The aim of the study was to evaluate the changes in the level of ischemia modified albumin (IMA) in the serum and tears of HR patients in order to establish the predictive value of IMA for the HR progression.MethodsSerum and tear samples for the measurement of IMA were collected from 90 patients detected primarily with HR, who were not taking any antihypertensive or other drug that could influence the results of the study, divided according to the Keith-Wagener classification into GI – 36 patients with HR grade I, GII – 35 with HR grade II and GIII – 19 with HR grade III. Serum and tear IMA levels were assessed using the Co2+ binding method and expressed as median and interquartile range. Kruskal-Wallis and Mann-Whitney nonparametric tests were used to compare the groups and the Spearman correlation coefficient was calculated (SPSS 23.0), with p<0.05 being statistically significant.ResultsThe groups showed a statistically significant difference in serum IMA (p=0.006), the values increasing in parallel with the progression of HR. The serum IMA level in GII increased compared to GI (+3%; 239.06 μM/L (IQR 75.58) vs 231.77 μM/L (IQR 104.09), p=1.00), as well as in GIII patients compared to GII (+17%; 277.67 μM/L (IQR 88.72) vs 239.06 μM/L (IQR 75.58), p=0.04). There were no differences in IMA content (p=0.160), between groups in the tears. No correlations were found between serum and tear IMA levels (p=0.134), but serum IMA showed a significant moderate strength, positive correlation with the degree of HR (r=0.307, p=0.003).ConclusionA progressive enhancement in serum IMA level as HR advanced was identified. Thereby, the results suggest the potential relevance of serum IMA as a sensitive and early biomarker useful for grading and optimal treatment of the patients with HR.

Usefulness of ischemia-modified albumin for assessment of the effects of small ventricular septal defects on the pulmonary vascular bed.

Pulmonary vascular damage may be associated with oxidative stress in congenital heart diseases. We investigated whether small ventricular septal defects have an effect on the pulmonary bed. This prospective cohort study included 100 patients with small ventricular septal defects and 75 healthy controls. Ischemia-modified albumin, high-sensitivity C-reactive protein, and various cardiovascular parameters were assessed in both groups. The mean ischemia-modified albumin level was significantly higher in patients with small ventricular septal defects (0.62 ± 0.17 absorbance units) than in the control group (0.51 ± 0.09 absorbance units; p < 0.001). The mean high-sensitivity C-reactive protein level was significantly higher in the ventricular septal defects group (3.72 ± 1.57) than in the control group (2.45 ± 0.89; p < 0.001). The ischemia-modified albumin levels in patients with left ventricular internal diameter end diastole and end sistole and main pulmonary artery z-scores ≥ 2 were significantly higher than patients whose z-scores were <2. The ischemia-modified albumin and high-sensitivity C-reactive protein levels were positively correlated in the small ventricular septal defects group (rho = 0.742, p < 0.001). Receiver operating characteristic analyses showed that at the optimal cut-off value of ischemia-modified albumin for the prediction of pulmonary involvement was 0.55 absorbance units with a sensitivity of 60%, specificity of 62% (area under the curve = 0.690, p < 0.001). We demonstrated the presence of oxidative stress and higher ischemia-modified albumin levels in small ventricular septal defects, suggesting that ischemia-modified albumin might be a useful biomarker for evaluating the effects of small ventricular septal defects on the pulmonary bed.

Oxidative imbalance in autoimmune liver disease: evaluation of oxidant-antioxidant status and ischemia-modified albumin

Objective: Current study evaluated the utility of total antioxidant status (TAS), oxidative stress index (OSI), total oxidant status (TOS), ischemia-modified albumin (IMA), and ischemia-modified albumin ratio (IMAR) as markers in autoimmune liver disease (AILD).&#x0D; Material and Methods: The study included a total of 66 AILD patients, 22 with autoimmune hepatitis (AIH), 32 with primary biliary cholangitis (PBC), and 12 with AIH/PBC overlap syndrome, and 49 healthy controls. Serum TAS, TOS, IMA, albumin (Alb), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil), and 25-hydroxyvitamin D (25[OH]D) were analyzed. OSI was calculated as TOS/TAS and IMAR was derived from IMA and Alb.&#x0D; Results: Serum TAS, OSI, TOS, IMA, and IMAR values were found to be significantly higher in the AILD group compared to controls (p=0.004,

Altered thiol/disulfide homeostasis and ischemia-modified albumin levels in children with irritable bowel syndrome.

In this study, we assessed thiol/disulfide homeostasis (TDH) parameters and ischemia-modified albumin (IMA) levels in children with irritable bowel syndrome (IBS) compared with healthy children. Fifty-six children with IBS and 53 healthy children were included in the study after assessment of inclusion and exclusion criteria. Plasma thiol/disulfide and IMA levels were compared between children with and without IBS. The mean values of native thiol, total thiol, and disulfide were 343.779 138.654μmol/L, 365.398 ± 140.148μmol/L, and 23.190 ± 4.978μmol/L, respectively, in the IBS group and 409.908 ± 69.288μmol/L, 433.481 ± 76.891μmol/L, and 20.090 ± 4.252μmol/L, respectively, in the control group. Native thiol and total thiol values were significantly reduced in the IBS group compared with the control group. The mean IMA values were 0.835 ± 0.083 (g/L) and 0.778 ± 0.072 in the IBS and control groups, respectively. The IMA value was significantly increased in the IBS group. Impaired thiol/disulfide homeostasis and increased IMA levels can be considered etiological factors in children with IBS.