Ischemia-modified Albumin Levels Research Articles

Oxidant and Antioxidant Balance in Children with Community-Acquired Pneumonia

Abstract Objective The balance between oxidant and antioxidant defense mechanisms is crucial. In this article, we aimed to evaluate the role of this balance in community-acquired pneumonia (CAP) in children. Methods We analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic data of children with CAP and compared them with healthy controls. Serum total antioxidant status (TAS) and total oxidant status (TOS) were evaluated and compared between the groups, along with levels of ischemia-modified albumin (IMA), antioxidant enzymes, nonenzymatic antioxidant factors, and plasma thiol. Results Of 160 children evaluated, 106 had CAP (54 outpatients and 52 inpatients), and the other 54 were healthy (control group). Total thiol and native thiol levels were significantly lower in the inpatient group compared with the outpatient group (p = 0.004 and p = 0.005, respectively). Serum IMA differed significantly among the groups (p = 0.001), with inpatients showing the highest level. A positive correlation was found between serum IMA and C-reactive protein levels in patients with pneumonia (r = 0.351; p = 0.001). Conclusion Parameters that provide information about antioxidant capacity may be useful in the diagnosis and prognosis of pneumonia. Our results suggest that plasma thiol levels and IMA may be good candidate biomarkers to predict hospitalization for CAP in children.

Ischemia-Modified Albumin: Origins and Clinical Implications.

Albumin is one of the most abundant proteins in the body of mammals: about 40% of its pool is located in the intravascular space and the remainder is found in the interstitial space. The content of this multifunctional protein in blood is about 60-65% of total plasma proteins. A decrease in its synthesis or changes of functional activity can destabilize oncotic blood pressure, cause a violation of transporting hormones, fatty acids, metals, and drugs. Albumin properties change under ischemic attacks associated with oxidative stress, production of reactive oxygen species, and acidosis. Under these conditions, ischemia-modified albumin (IMA) is generated that has a reduced metal-binding capacity, especially for transition metals, such as copper, nickel, and cobalt. The method of determining the cobalt-binding capability of HSA was initially proposed to evaluate IMA level and then licensed as an ACB test for routine clinical analysis for myocardial ischemia. Subsequent studies have shown the viability of the ACB test in diagnosing other diseases associated with the development of oxidative stress. This review examines recent data on IMA generation mechanisms, describes principles, advantages, and limitations of methods for evaluation of IMA levels, and provides detailed analysis of its use in diagnostic and monitoring therapeutic efficacy in different diseases.

Oxidant and antioxidant balance in patients with COVID-19.

BackgroundA crucial balance exists between oxidant and antioxidant mechanisms in the functional immune system. We aimed to evaluate the contributions of balance between these systems to coronavirus disease 2019 (COVID‐19), a devastating pandemic caused by viral infection.MethodWe analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic characteristics of children and adults with COVID‐19 and compared them against the values of healthy controls. Serum native thiol (NT), total thiol (TT), disulfide, total antioxidant status, total oxidant status, and ischemia‐modified albumin levels were evaluated and compared between groups.ResultsA total of 79 children and 74 adults were evaluated in the present study, including 46 children and 40 adults with COVID‐19, 33 healthy children, and 34 healthy adults. TT, NT, and disulfide levels were significantly lower in the adult COVID‐19 group than in all other groups (p = .001, p = .001, and p = .005, respectively). Additionally, TT and NT levels were significantly lower in both pediatric and adult COVID‐19 cases with severe disease course than mild/moderate course. TT and NT levels were identified as predictors for the diagnosis of the adult COVID‐19 cases and as independent predictors for disease severity in both children and adults with COVID‐19.ConclusionParameters that reveal the oxidant and antioxidant capacity, including TT and NT, appear to be good candidates for the accurate prediction of the clinical course among patients with COVID‐19.

The role of thiol-disulfide and ischemia-modified albumin levels in the diagnosis of childhood appendicitis

Aim: The accurate diagnosis of acute appendicitis can be achieved by a combination of evaluation of clinical symptoms, physical examination findings and history taking, but is still challenging for the clinician. Some biochemical markers have been evaluated for the purpose of increasing the diagnostic accuracy rate for appendicitis. In this study, our aim is to evaluate the diagnostic value of thiol-disulfide levels and IMA, in pediatric patients with suspected acute appendicitis. 
 Materials And Methods:
 The children (1-17 years age) who were admitted to our clinic for suspected acute appendicitis between March 2017 and September 2017 were evaluated. A total of 238 children are enrolled in the study; 119 were operated for suspected acute appendicitis and the 119 children who did not have appendicitis constituted the control group. Serum levels of native thiol (-SH), total thiol (SH + SS), dynamic disulfide (SS), dynamic disulfide (SS)/total thiol (SH + SS) ratio, albumin, ischemic modified albumin (IMA) and WBC levels were obtained and compared within groups. 
 Results: 
 The mean age of the patients was 10.9 years (±3.7, 3-17 years) and 9.1 years (±3.7, 1-17 years) in the operation and the control groups, respectively. The SH, SH+SS, SS and albumin levels and SS/SH+SS ratio were significantly lower and IMA levels were significantly higher in the operation group than the control group. Among the operated patients, IMA and dynamic disulfide levels were significantly higher and WBC levels were significantly lower in patients with non-perforated appendicitis than patients with perforated appendicitis. A significant decrease in serum levels of IMA was observed in the postoperative 1st day when compared with the preoperative values.
 Conclusion:
 Measuring the IMA levels with thiol/disulfide homeostasis may increase the diagnostic accuracy rate when evaluating the patients with suspected appendicitis. However, it appears that these evaluations fail to distinguish the patients with perforated and non-perforated appendicitis, thus further studies are necessary.

Comparison of lesion level and ischemic modified albumin in peripheral artery disease

Aim: Research is ongoing to discover biomarkers that can be used to monitor disease progression and predict prognosis in peripheral artery disease (PAD). Ischemia-modified albumin (IMA) is known to predict the risk for PAD. The aim of this study was to investigate whether serum IMA levels were associated with PAD lesions and ankle-brachial index (ABI) values, and to determine the accuracy of IMA levels in predicting PAD prognosis.
 Material and Method: Seventy-three patients with PAD who applied to our hospital between July and September 2018 were included in the study. The lesion levels of patients with an ankle-brachial index (ABI) value lower than or equal to 0.9 were determined by computed tomography angiography (CTA). Patients were grouped according to their lesion levels and Fontaine classification. Serum IMA concentrations were measured and compared with regard to lesion levels and ABI values.
 Results: Sixty-five of the patients (89%) were male. The mean age of the patients was 62.2 ± 8.8 (43–77) years. The mean serum IMA level was 25.9 ± 26.7 (10–218) ng/ml. Serum IMA levels were found to be lower in patients with bilateral iliac artery lesions (p = 0.040). There was no statistically significant relationship between other parameters and serum IMA levels (p >0.05 for all).
 Conclusion: There is a need for biomarkers that can predict lesion level and prognosis in patients with PAD. Although no statistically significant relationship was found between lesion level and serum IMA concentrations in this study, further studies involving a higher number of patients may provide more informative data on this subject.

An evaluation of ischaemia-modified albumin levels in the development of diabetic foot ulcer.

This study investigated the status of serum ischaemia-modified albumin (IMA) levels in the development of diabetic foot ulcer (DFU) in patients with diabetes mellitus (DM) and in predicting ulcer formation and ulcer grading. Thirty patients with DM, 30 with DFU and 30 healthy controls were included in the study. All participants' demographic characteristics and serum IMA, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) levels and DFU infection grades were recorded. Nine (30%) patients with DFU were grade 2 according to the grading of International Working Group of the Diabetic Foot, 14 (46.7%) were grade 3 and seven (23.3%) were grade 4. Significant, powerful and positive correlation was determined between serum IMA and albumin-adjusted IMA levels and degrees of DFU (r=0.878 and r=0.846, P<.001 for both). Serum IMA levels in the DFU group were significantly higher than in the DM and control groups (P<.001). The optimal cut-off values for IMA in predicting DFU was 23.5ng/mL (sensitivity 96%, specificity 87% and AUC=0.97, P<.001). Additionally, at a cut-off value of 20.6ng/mL, serum albumin-adjusted IMA differentiated cases of DFU from healthy individuals with 90% sensitivity and 83% specificity (AUC=0.95, P<.001) Serum IMA levels exhibited significant, positive correlation with CRP, ESR, WBC, fasting plasma glucose and HbA1c (r=0.575, r=0.592, r=0.597, r=0.68 and r=0.74, respectively, P<.001). Serum albumin levels were significantly negatively correlated with IMA, CRP, ESR and WBC values (r=-0.49, r=-0.56, r=-0.62 and r=-0.53, respectively, P<.001). Our study findings indicate that together with CRP, ESH, WBC and albumin, increased IMA levels in patients with DM can be useful in the early prevention of DFU development and in predicting the severity of DFU infection.

Analysis of endogenous oxidative damage markers and association with pulmonary involvement severity in patients with SARS-CoV-2 pneumonia

IntroductionThe SARS-CoV-2 virus affects many organs, especially the lungs, with widespread inflammation. We aimed to compare the endogenous oxidative damage markers of coenzyme Q10, nicotinamide dinucleotide oxidase 4, malondialdehyde, and ischemia-modified albumin levels in patients with pneumonia caused by SARS-CoV-2 and in an healthy control group. We also aimed to compare these parameters between patients with severe and non-severe pulmonary involvement. MethodsThe study included 58 adult patients with SARS-CoV-2 pneumonia and 30 healthy volunteers. CoQ10 and MDA levels were determined by high-pressure liquid chromatography. NOX4 and IMA levels were determined by ELISA assay and colorimetric method. ResultsHigher levels of CoQ10, MDA, NOX4, and IMA and lower levels of COQ10H were observed in patients with SARS-CoV-2 pneumonia than in the control group. MDA, IMA, NOX4, and CoQ10 levels were significantly higher in patients with severe pulmonary involvement than in patients with non-severe pulmonary involvement, but no significant difference was observed in CoQ10H levels. CoQ10 levels were significantly and positively correlated with both ferritin and CRP levels. ConclusionSARS-CoV-2 pneumonia is significantly associated with increased endogenous oxidative damage. Oxidative damage seems to be associated with pulmonary involvement severity.

Thiol-disulfide homeostasis and ischemia-modified albumin as a marker of oxidative stress in patients with sarcopenia.

Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength. Chronic inflammatory conditions and increased oxidative stress are in the pathogenesis of sarcopenia. Our aim was to evaluate the relationship between sarcopenia and thiol-disulfide homeostasis and ischemia-modified albumin levels as an oxidative stress marker. Patients aged ≥65 years were recruited in this study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criterion. Total thiol, native thiol, disulfide and ischemia-modified albumin levels were measures according to clinical and laboratory features. Patients were divided into two groups according to their sarcopenia presence; thiol-disulfide homeostasis and ischemia-modified albumin levels were evaluated between these groups. Overall, 94 patients were analyzed. The mean age was 75.0 ± 6.71 years. A total of 39% of the patients were diagnosed as probable sarcopenia, 3.2% had sarcopenia, 6.4% had severe sarcopenia and 51.1% were diagnosed as normal. The levels of native thiol, total thiol, disulfide level and disulfide-native thiol, native thiol-total thiol and disulfide-total thiol ratios were similar in patients with sarcopenia when compared with the control group. In addition, there were no differences between albumin and ischemia-modified albumin levels. In univariate regression analysis, handgrip strength was found to be an independent predictor of native thiol and total thiol, and disulfide levels. This is the first study in the literature that evaluates the thiol-disulfide homeostasis and ischemia-modified albumin levels in sarcopenic older patients. Long-term studies are warranted to confirm the relationship between oxidative stress markers and sarcopenia. Geriatr Gerontol Int 2021; 21: 584-589.

Ischemia Modified Albumin as a Novel Biochemical Indicator in Peripheral Artery Patients

Objective: Peripheral artery disease (PAD) is the name given to blocked blood flow in major arteries other than cerebral and coronary circulation. The diagnosis and treatment of PAD is very important because of the high frequency of PAD. In this study, it was aimed to investigate the possible change in next generation oxidative stress-antioxidant status indicators as a biochemical parameter that may be useful in the diagnosis and follow-up of PAD. Method: Forty healthy controls and 40 male and female patients with peripheral artery disease who applied to the Alanya Alaaddin Keykubat University Research and Training Hospital were enrolled in the study on a voluntary basis. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), ischemia modified albumin (IMA) and Thiol balance were studied with the colorimetric method. Results: The TOS (p <0.001), OSI (p <0.001), IMA (p = 0.027), total thiol (0.004) levels were higher in the peripheral artery patients compared to the control group, while the TAS (p <0.001) and native thiol / total thiol ratio (index 3) (p = 0.018) values ​​were significantly lower. Conclusion: The increase in TOS and IMA levels may be used as an indicator of peripheral artery disease. There is an increase in inflammation in the ischemia and atherosclerosis processes. An ischemia-specific protein called ischemia-modified albumin may be used as a rapid and practical laboratory marker in common peripheral artery disease.

The Evaluation of Ischemia Modified Albumin and Adropin Levels in Patients with Pulmonary Embolism

Background: Pulmonary embolism (PE) is a serious clinical condition and difficult to be diagnosed. The aim of the present study was to evaluate serum adropin and ischemia-modified albumin (IMA) levels in the patients with PE. &#x0D; Materials and Methods: The study consisted of 109 participants, including 50 patients with PE and 59 healthy individuals. The patients diagnosed with PE through computed tomography pulmonary angiography (CTPA) were included into the study. Serum adropin and IMA concentrations were measured by an enzyme-linked immunosorbent assay kit. &#x0D; Results: The patients with PE had higher serum adropin (607.5±205.1 ng/mL) and lower IMA (2128.6±801.8 ng/mL), compared with those in the controls (505.5±231.3 ng/mL and 2466.9±1044.9 ng/mL, respectively); however, the difference was not significant. In the study, we found a weak and negative correlation between adropin and IMA levels in the patients with PE (p=0.020, r=-0.348).&#x0D; Conclusions: In our study among the patients with PE, there was no significant difference between adropin and IMA levels, although serum atropin concentration was high, and IMA concentration was low. So, we consider that both IMA and adropin are the inappropriate markers for the diagnosis of PE.

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.

The prognostic value of ischemia-modified albumin in patients with sepsis.

Sepsis is a significant contributor of mortality all over the world. Emergency departments have a critical role for diagnosing a suspected sepsis in a patient, since early and proper administration of antibiotics may decrease mortality significantly. But, the unavailability of an objective and reliable diagnostic test is the major challenge of this critical issue. The aim of this study is to evaluate the prognostic value of a novel biomarker, the ischemia-modified albumin (IMA) in patients with sepsis and septic shock in emergency department. This prospective, observational study included 81 patients with sepsis or septic shock and 75 controls. Sociodemographic characteristics of the patients, site of infection, IMA levels, other biomarkers (procalcitonin, pH, lactate), mortality at 24-h and 28-day were evaluated. The serum IMA levels in patient and control groups were 117.8 ± 85 IU/g and 115.8 ± 134.0 IU/g, respectively (P = 0.072). There was a weak but statistically significant positive correlation between IMA and lactate levels (P = 0.009). The mortality rates of patient group at 24-h and 28 days were 21% and 79%, respectively, but serum IMA levels were not found to be a prognostic marker to predict mortality. The main reason for the similarity between groups regarding IMA levels was thought to be associated with the distribution of the acute and chronic health problems other than sepsis in the control group. Emergency department physicians should not only depend on serum IMA levels for predicting the prognosis of patients with sepsis or septic shock.

Evaluation of Ischaemia Modified Albumin as a Marker of Oxidative Stress in Beta Thalassemia Major Children

&#x0D; &#x0D; &#x0D; &#x0D; Introduction: Iron overload in thalassemia catalyses the production of a variety of reactive oxygen species leading to cumulative cell damage. Ischemia modified albumin (IMA) is an end product of oxidative stress. It is imperative to pick up oxidative stress early in order to prevent the organ damage in thalassemia. Therefore this study was undertaken to estimate IMA levels and to see the correlation between ferritin and IMA to establish whether ferritin can be a proxy marker for oxidative stress.&#x0D; Methods: A total of 76 children were included in the study out of which 46 were diagnosed cases of β- Thalassemia major and 30 formed the healthy controls. Pre transfusion haemoglobin, AST, ALT, ferritin and IMA levels were estimated and compared with healthy control children. Correlation was drawn between haemoglobin, AST, ALT, ferritin with IMA.&#x0D; Results: There is significant elevation in the level of IMA and ferritin in children with Thalassemia major as compared to the healthy controls (p = &lt; 0.001). There was a significant positive correlation between ferritin and IMA and a significant negative correlation between haemoglobin % and IMA. Regression relationship between ferritin and IMA established that IMA (ng/ mL) = 246.118 + 0.829 (Ferritin ng/dL).&#x0D; Conclusions: IMA levels were significantly elevated in β- thalassemia major children and correlated positively with ferritin levels. By establishing a regression relationship between ferritin and IMA levels, we can fairly estimate the levels of IMA. Hence, we can utilise ferritin as a proxy marker of oxidative stress instead of IMA.&#x0D; &#x0D; &#x0D; &#x0D;

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.

Effects of Different Heart Positions During Off-pump Coronary Artery Bypass Surgery on Serum Ischemia Modified Albumin Level and Cardiac Output

Objectives: We aimed to evaluate the potential effects of heart positioning during off-pump CABG (OPCAB) without cardiac stabilizer device on serum levels of IMA and cardiac output. Materials and Methods: This was a prospective study, in which consecutive patients who underwent isolated OPCAB were included. Data including electrocardiography and intraarterial hemodynamic monitoring parameters were recorded. Arterial pressure waveform (APW) was analyzed. Cardiac output was measured for circumflex coronary artery (Cx), diagonal coronary artery (D1), left anterior descending coronary artery (LAD), and right coronary artery (RCA) positions. Preoperative and postoperative 1, 2, 4, and 12-hour blood samples were taken for serum ischemia modified albumin measurements. Results: Forty patients who underwent OPCAB were included in the study. The mean age was 60.3 ± 10.2 years. Hospital mortality, stroke, postoperative myocardial infarction, acute kidney injury, sternal infection and re-operation for bleeding/tamponade were not observed postoperatively. Six patients (15%) who developed postoperative AF had a significantly higher mean serum IMA level compared with patients who did not.There was no statistically significant difference in preoperative and postoperative mean serum IMA levels (p = 0.925). Mean CO values measured at four different positions of the heart were not significantly different from each other except a difference between LAD and Cx(p=0.002). Conclusion: Our results showed that when the heart was in Cx anastomosis position, the cardiac output was significantly lower than LAD position; however, there was no significant serum IMA raise despite cardiac output decrease. IMA levels did not change significantly from baseline values. Patients who developed postoperative AF had higher IMA levels than patients who did not develop AF.

Clinical diagnostic value of combined detection of IMA, D-D and MCP-1 in acute myocardial infarction.

The aim of the study was to analyze the clinical value of the combined detection of ischemia-modified albumin (IMA), D-dimer (D-D) and monocyte chemoattractant protein-1 (MCP-1) in the diagnosis of acute myocardial infarction (AMI). Altogether 87 patients with AMI from January 2017 to January 2018 were enrolled in the AMI group, and 82 patients without coronary artery disease were included in the control group. The serum levels of IMA, D-D, MCP-1, cardiac troponin (CTnT) and high-sensitivity C-reactive protein (hs-CRP) in the two groups were detected by ELISA. The blood lipids of the two groups and the levels of IMA, D-D, MCP-1 after treatment were detected. The association between IMA, D-D, MCP-1, CTnT, hs-CRP and blood lipid in patients with AMI was analyzed. The values of IMA, D-D, and MCP-1 alone and combined in the diagnosis of AMI were analyzed by ROC curve. The levels of IMA, D-D, MCP-1, CTnT and hs-CRP in the AMI group were significantly higher than those in the control group (P<0.05). The levels of IMA, D-D and MCP-1 in the patients with poor prognosis were significantly higher than those of the good prognosis group (P<0.05). The changes of IMA, D-D and MCP-1 levels were positively correlated with the levels of CTT and hs-CRP (P<0.05). The AUC, specificity and sensitivity of patients with AMI diagnosed with MCP-1 alone were 0.8084, 81.61 and 69.51%, respectively. Those of patients diagnosed by D-D were 0.7302, 59.77 and 81.71%, those of patients diagnosed by IMA alone were 0.7289, 58.62 and 80.49%, and those of patients detected by the combination of MCP-1, D-D and IMA were 0.9047, 58.62 and 93.90%. In conclusion, the levels of IMA, D-D and MCP-1 in AMI patients are higher than those in the control group. The levels of IMA, D-D and MCP-1 were positively correlated with CTnT and hs-CRP levels in AMI patients. Combined detection of IMA, D-D, and MCP-1 can improve the accuracy.

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.

An investigation of thiol/disulfide homeostasis and ischemia-modified albumin levels to assess the oxidative stress in dogs with canine distemper

This study aimed to investigate the diagnostic value of thiol/disulfide homeostasis (TDH) and ischemia-modified albumin (IMA) levels in evaluating oxidative stress in dogs with canine distemper. The study materials consisted of 24 cross-breed dogs: 18 dogs with canine distemper (CD group) and 6 healthy dogs as the control. Blood samples for analysis of antioxidant-oxidant parameters were taken from both groups. In addition to TDH parameters (native thiol [NT], total thiol [TT], and disulfide [Ds] levels and Ds/NT, Ds/TT, and NT/TT ratios), IMA and albumin (ALB) levels were also determined in the blood serum of the groups. The IMA levels of the CD group were significantly higher than the control group (P&lt;0.05). Antioxidant parameters (NT, TT) and oxidant parameters (Ds, Ds/NT, and Ds/TT) both exhibited a significant positive correlation among themselves (P&lt;0.01). The areas under the ROC curve of IMA, Ds/NT, and Ds/TT were 0.78, 0.62, and 0.62 respectively. The high levels of IMA, Ds, Ds/NT, and Ds/TT and low levels of NT, TT, NT/TT and ALB in dogs with canine distemper can be used to assess the oxidative stress caused by the disease. Overall, the diagnostic performances of IMA, Ds/NT, and Ds/TT for detection of increased oxidative stress were similar, but IMA was superior.