Mean Ischemia-modified Albumin Levels Research Articles

Evaluation of Maternal Ischemia-Modified Albumin Levels during Pregnancy and Their Effect on Fetal Birth Weight.

Background and Objectives: The purpose of this study is to evaluate the impact of maternal ischemia-modified albumin (IMA) levels on pregnancy-related complications, fetal growth, and development over time. Materials and Methods: The prospective longitudinal and single-center study included 43 pregnant women ages 18 to 43. Routine pregnancy follow-up began at the first antenatal examination for all pregnant women before 14 weeks gestation, with IMA levels measured during the first, second, and third trimesters. The albumin cobalt binding test was used to determine the amount of ischemia-modified albumin (IMA). The patients' medical, sociodemographic, and nutritional data were analyzed. The primary outcome was to investigate how changes in maternal ischemia affected albumin levels during pregnancy and the relationship between these changes and newborn weight. Results: This study included 43 cases with a mean age of 28.5 ± 5.2 years and a mean gestation period of 39.2 ± 1.3 weeks. The mean IMA levels for cases in the first trimester, second trimester, and third trimester were 0.53 ± 0.06, 0.64 ± 0.11, and 0.64 ± 0.06, respectively. The second and third trimesters showed significantly higher levels of ischemia-modified albumin (IMA) than the first trimester (p < 0.01). There was no statistically significant difference in IMA levels between the second and third trimesters (p = 1.000; p > 0.05). There was no statistically significant correlation between fetal birth and percentage changes in IMA measurements between the first and second trimesters, the first and third trimesters, or the second and third trimesters (p > 0.05). Conclusions: Our study determined that maternal ischemia-modified albumin levels during pregnancy did not correlate with fetal birth weight. Our findings revealed that age, sociodemographic changes, BMI, weight gain, and pregnancy complications had no effect on the change in IMA levels during pregnancy. We believe that this result will serve as a benchmark for future studies on IMA levels during pregnancy.

Can Ischemia-Modified Albumin Be a Helpful Marker in the Diagnosis and Follow-Up of Childhood Intussusception?

Intussusception is the invagination of a proximal segment of the intestine into a more distal segment. The present study aimed to determine the sensitivity of the ischemia-modified albumin (IMA) and the correlation between IMA and the severity of intestinal ischemia in intussusception cases. Thirty-six consecutive children aged between 0 and 16 years presenting with the clinical and radiological features of intestinal obstruction caused by intussusception were enrolled in the study. The age- and sex-matched control group was composed of patients undergoing outpatient surgery. The patients were categorized as cases of type I (ileoileal), type II (ileocecal), and type III (colocolic) based on the ultrasonography findings. The mean IMA level of the intussusception group was 179.13 ± 220.33 ng/mL, whereas the mean level was found as 89 ± 70.9 ng/mL in the control group. When the patients were categorized as ileoileal, ileocecal, and colocolic, the mean IMA levels were detected as 235.65 ± 268.14 ng/mL, 174.46 ± 212.8 ng/mL, and 46.95 ± 19.56 ng/mL, respectively. There was a moderate correlation between the invaginated segment lengths measured by the surgeon during the operation and IMA levels. Our study findings reveal that IMA can be used as an auxiliary diagnostic marker in patients presenting with symptoms and signs suggestive of intussusception. Thus, patients can be screened for mechanical bowel obstruction due to intussusception and may be referred to pediatric surgery centers earlier for further examination.

Evaluation of serum ischemia modified albumin (IMA) level and serum uric acid level as a preliminary biomarker of epilepsy

Oxidative stress, hypoxia, and ischemia are considered prime factors in the pathogenesis of epilepsy. Hyperuricemia (HU) is a common incidental finding in epileptic patients, but the importance of HU as a risk factor in epilepsy is debated. Many hypothetical mechanisms that link HU to increased oxidative stress in epilepsy have been put forward. This research aimed to evaluate the role of serum Ischemia Modified Albumin (IMA) level and serum uric acid (UA) level as a preliminary biomarker in the diagnosis of epilepsy.: The present cross-sectional research was conducted on 25 individuals having epilepsy and 25 healthy individuals. Serum uric acid level had estimated by the uricase method. Serum IMA was evaluated by albumin cobalt binding assay to assess oxidative stress, hypoxia, and ischemia. Mean Serum UA and IMA level were found significantly high (p&amp;#60;0.001) in epileptic group. In the epileptic group, 76 % (19/25) individuals had HU. Mean serum IMA was higher in epileptic individuals with HU compared to epileptic individuals with normal serum UA levels. Correlation between serum UA level and serum IMA level was found positive among the study population. Serum UA showed a significant odd ratio to predict epilepsy on binary logistic analysis.: The present study revealed that serum UA levels and IMA levels escalated in epileptic patients. Thus, serum UA levels and IMA levels can be deemed as preliminary biomarkers for the diagnosis of epilepsy.

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 H<inf>2</inf>O<inf>2</inf>/L and 13.1 µmol H<inf>2</inf>O<inf>2</inf>/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.

Utility of Ischemia-Modified Albumin as a Biomarker for Acute Appendicitis: A Systematic Review and Meta-Analysis.

Acute appendicitis is a frequently encountered surgical emergency. Despite several scoring systems, the possibility of delayed diagnosis persists. In addition, a delayed diagnosis leads to an increased risk of complicated appendicitis. Hence, there is a need to identify biological markers to help clinicians rapidly and accurately diagnose and prognosticate acute appendicitis with a high sensitivity and specificity. Although several markers have been evaluated, the pressing concern is still the low specificity of these markers. One such marker is serum ischemia-modified albumin (IMA), which can be a novel biomarker for accurately diagnosing and prognosticating acute appendicitis. The authors conducted a systematic search of the PubMed, EMBASE, Web of Science, and Scopus databases through February 2023 as per the PRISMA guidelines. The difference in the levels of IMA between patients with acute appendicitis vs. healthy controls, and the difference in the levels of IMA between patients with complicated vs. non-complicated acute appendicitis were taken as the outcome measures. Statistical analysis was performed using a random effects model and mean difference (MD) was calculated. The methodological quality of the studies was assessed by utilizing the Newcastle-Ottawa scale. A total of six prospective comparative studies were included in the meta-analysis. The analysis revealed that the mean level of serum IMA was significantly raised in the acute appendicitis group (MD 0.21, 95% CI 0.05 to 0.37, p = 0.01). Similarly, the mean serum IMA levels were also raised in the complicated appendicitis group compared to the non-complicated appendicitis group (MD 0.05, 95% CI 0.01 to 0.10, p = 0.02). Three of the studies included were, however, of poor methodological quality. Serum IMA is a viable potential marker for diagnosing and prognosticating acute appendicitis. However, due to the limited methodological quality of available studies, further prospectively designed and adequately powered studies are needed.

The relationship between Thiol/disulfide homeostasis and endometrial hyperplasia in patients with abnormal uterine bleeding/

Introduction: The role of oxidative stress and antioxidant capacity in the development of endometrial hyperplasia (EH) is controversial. Aim: The study aimed to evaluate Thiol/disulfide Homeostasis and ischemia modified albumin (IMA) levels in patients with EH without atypia. Materials and Methods: In this prospective case-control study, patients with EH without atypia (HP group) (n=28), patients with nonhyperplasia (proliferative/secretory/irregular proliferative/irregular secretory endometrium) (non-HP group) (n=28), and 28 healthy women (control group) were included. The patient's clinical characteristics, serum Thiol/disulfide parameters, and IMA levels were compared between groups. Results: A total of 84 patients were included in the study. Patients’ mean age, BMI, and mean native thiol (-SH-), total thiol (-SH-+-SS-), disulfide (-SS-), and IMA levels were similar among the three groups. The -SS- /-SH- ratio was higher in the HP group than the non-HP group. -SS- /-SH-+-SS- ratio was higher in the HP group vs. the other two groups. The -SS- /-SH-+-SS ratio was higher in the HP group vs. the non-HP group. -SH-/ -SH-+-SS- ratio was lower in the HP group than in the non-HP group. ET was greater in the HP group than in the non-HP and control groups. ET was also significantly greater in the non-HP group vs. in the control group. -SS-/-SH- ratio was found to be predictive with 64% sensitivity and 68% specificity for EH (area under curve = 0.672, p = 0.01). Conclusion and Suggestions: The dynamic thiol/disulfide balance shifted to the disulfide side in women with endometrial hyperplasia.

Ischemia-Modified Albumin Levels in Patients with Bell's palsy

Background: Although several causes have been regarded as possible including viral, autoimmune, inflammatory, and vascular ischemia, the accurate etiology and pathophysiology of Bell's palsy (BP) remain unclear. The aim of the present article was to determine whether serum levels of ischemia-modified albumin (IMA) are associated with BP and if there is a posttreatment change in IMA levels. Materials and Methods: This was a prospective study enrolling 23 patients (10 males and 13 females; mean age: 44.71 ± 16.72 years; and range, 20–57 years) and 23 healthy individuals (12 males and 11 females; mean age: 37.91 ± 9.16 years; and range, 9–73 years) as the control group. Blood samples were obtained from the antecubital vein from all of the volunteers. Albumin cobalt binding test was used to obtain the IMA levels. Results: The mean IMA level was 0.38 ± 0.06 absorbance units in the study group at the time of diagnosis, 0.35 ± 0.07 absorbance units at the posttreatment period, and 0.35 ± 0.06 absorbance units in the control group. IMA levels of patients in posttreatment period were lower than the onset of illness. The result was statistically significant (P = 0.01). Conclusion: The data demonstrate that IMA decreased in BP with treatment. This is a preliminary study and we could not obtain results that clearly support the ischemic hypothesis of pathogenesis of BP; we think it gives an idea for further studies.

Ischemia modified albumin levels in intrauterine growth restriction: levels are increased in fetal cord blood but not in maternal blood.

In this study, our aim was to determine the differences between intrauterine growth restriction (IUGR) and normal birth weight fetuses in terms of ischemia modified albumin (IMA) levels. For this purpose, we measured ischemia modified albumin levels in the cord blood of fetuses and venous blood of mothers. This study is a prospective study conducted at University of Health Sciences Tepecik Training and Research Hospital between January 2018 and December 2019. According to the inclusion/exclusion criteria, 227 patients were included in the study. Participants were divided into two groups according to the presence (patient group) or absence (control group) of intrauterine growth restriction (IUGR). In addition to routine parameters recorded during pregnancy, the IMA levels and Doppler USG findings of all participants were recorded. The mean cord blood serum IMA levels of the patient group were significantly elevated compared to controls (p = 0.038). Whereas mean maternal blood serum IMA levels were similar among groups (p = 0.453). The cord blood and mother blood serum IMA levels were not significantly different with regard to the presence or absence of perinatal asphyxia. In the literature, studies evaluating IMA levels in the cord and maternal blood of IUGR fetuses are limited. In IUGR patients, IMA level is expected to increase and in our study, IMA levels were significantly increased but the presence of oxidative stress has not been found to affect IMA levels.

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.&#x0D; 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.&#x0D; 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 &gt;0.05 for all).&#x0D; 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.

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.

Serum ischemia-modified albumin level returns to its premenopausal level with 1-year hormone therapy in healthy menopausal women.

IntroductionTo assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IMA) levels in healthy menopausal women.Material and methodsThirty surgical menopausal women who were admitted to our menopausal polyclinic during a 1-year period and diagnosed with menopause and planned to have HT for menopausal symptoms were enrolled in this prospective study. The serum İMA levels were recorded before and after (3 months, 6 months, 12 months later) hormone treatment (2 mg estradiol hemihydrate).ResultsThe mean age of women was 47.60 ± 2.34 years. The mean serum IMA levels were 0.610 ± 0.096 absorbance units (ABSU) at the beginning and 0.484 ± 0.080 ABSU after 3 months of hormone therapy. Following 6 months of hormone therapy, serum IMA level was 0.546 ± 0.075, and reached 0.580 ± 0.089 ABSU following 12 months of therapy.ConclusionsThese findings suggest that HT may not block the menopause induced ischemia process. Although HT had a positive effect on serum IMA levels following 3 months’ use, serum IMA levels returned to baseline levels after 12 months’ use. Based on this study’s findings, long-term use of HT may not have a positive effect on cardiovascular disease protection.

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.

Evaluation of ischemia modified albumin levels in major depression patients

Aim: Depression is an important public health problem, which has been associated with an antioxidant defense system. Ischemia-modified albumin (IMA) is a new biomarker that measures ischemia. The aim of this study was to evaluate IMA levels as a new parameter related to oxidative stress in patients with major depressive disorder (MDD). Methods: This cross-sectional case-control study included 59 patients aged between 18-65 years who were admitted to our psychiatry outpatient clinic between June 2018-December 2018, diagnosed with MDD and had not used psychotropic drugs for 3 months. In addition, 59 age and sex matched healthy controls were included in the study. Serum IMA and albumin levels were measured in blood samples taken from each patient and from control groups. Hamilton Depression Rating Scale (HDRS) was applied to the subjects to evaluate the depression level. Results: Among the MDD group, 27 patients (45.8%) were male and 32 (54.2%) were female. The number of males and females in the control group were 29 (49%) and 30 (51%). Mean ages of the patients in MDD and control groups were 39.40 (12.20) and 38.67 (9.29) years, respectively. No statistically significant difference was found between the groups in terms of age and gender (P=0.942 and P=0.714, respectively). The mean IMA level of MDD and control group patients were 0.84 (0.39) and 0.82 (0.30), respectively; the difference was statistically significant (P<0.001). There was also a statistically significant difference between the albumin levels of the two groups (P=0.01). Correlation analysis showed a positive correlation between serum IMA levels and HDRS scores (r=0.235, P=0.008). Conclusion: In our study, IMA levels of MDD patients were significantly higher than that of the control group. This result may be an indicator of increased oxidative stress in patients with depression. There is little data in the literature evaluating IMA levels in psychiatric disorders.

Relation of ischemia-modified albumin to disease manifestations and activity in Egyptian patients with Beh\xe7et\u2019s disease

Aim of workTo determine level of ischemia-modified albumin (IMA) in patients with Behçet’s disease (BD) and to assess its role in disease manifestations and activity.Patients and methodsThe study included 48 patients with BD and 38 matched controls. Disease activity was estimated by the BD current activity form. Serum IMA was measured.ResultsMean age of the patients was 33.8±7.9 years. There were 42 males and six females, and the disease duration was 52.9±48.8 months. The serum IMA level was significantly increased in the patients with BD (50.9±12.9 U/ml) compared with the control (7.76±1.6 U/ml) (P<0.001). There was a statistically significant association between IMA level and disease activity, with high mean IMA level among active cases (P=0.01). There was no statistically significant association between IMA level and any of other clinical characteristics in patients with BD. Sensitivity and specificity test for IMA level in detection of cases illustrated accuracy of 98.5% with sensitivity 95.8% and specificity 78.9% at cutoff value of 9.4 U/ml.ConclusionThere is growing evidence indicating the role of oxidative stress in BD. IMA is accepted as an essential marker of oxidative stress in patients with BD. It has a potential diagnostic value for the detection of the disease. Furthermore, it correlates with the disease activity.

Ischemia-Modified Albumin Levels in Patients With Essential Thrombocytosis

Objective: The aim of this study was to investigate the levels of ischemia-modified albumin (IMA) in people with essential thrombocytosis (ET).Methods: A total of 30 patients with ET patient group and 30 volunteers with no known disease control group (C group) were included in this study after the approval of ethics committee and written informed consent was obtained. Patients with a history of major thrombosis were excluded. IMA levels and independent variables were investigated and effects on thrombosis susceptibility were also studied. In addition to that; comorbid disease state, drug use and used drugs group were questioned in patient group and effects of them on IMA levels were studied.Results: In our study, when ET patient group and C group were compared, the mean serum IMA levels in ET patient group and C group was detected as 0,6726 (0,527-0,776) Absorbans Unite (ABSU) and 0,4342 (0,346-0,612) ABSU respectively and in ET patient group was significantly higher than C group (p&amp;lt;0,001). The glucose, total cholesterol and triglyceride values were significantly higher in ET patient group (p= 0,026, p= 0,058, p= 0,004, respectively). There is a correlation between IMA concentration and age (p= 0,042).Conclusions: In our study IMA levels were found significantly high in ET patient group, this supports increased risk of thrombosis in ET. The difference of metabolic parameters between the ET patient group and C group can be explained by insulin resistance and atherosclerosis background caused by chronic inflammation.

Ischemia-modified albumin levels in children with asthma: a pilot study.

Hypoxia may occur in the severe exacerbations of asthma. Ischemia-modified albumin (IMA) may increase in ischemia, in addition to oxidative stress and inflammation. The aim was to evaluate IMA levels in children during the asthma exacerbation and the asymptomatic period. Children with asthma who were followed up in our clinic were included and healthy children were selected as the control group. The severity of exacerbation was evaluated with Global Initiative for Asthma and Modified Pulmonary Index Score. Serum IMA levels were measured at the time of exacerbation and 4 weeks after treatment during asymptomatic period. Skin prick test and C reactive protein (CRP) levels were measured. A total of 26 patients and 26 controls were included. Mean IMA level was 0.45±0.12 absorbance units -ABSU- during asthma exacerbation and 0.32±0.08 ABSU in the control group (p=0.001). Mean IMA levels (0.41±0.14 ABSU) during the stable period were higher than the control group (p=0.005). There was no difference in terms of IMA levels when patients were grouped according to anti-inflammatory treatment, upper respiratory tract infection before exacerbation, CRP levels or sensitivity of skin prick tests. However, IMA levels were higher in patients with severe asthma exacerbation (p=0.009) in comparison with mild/moderate exacerbation. Positive correlation was observed between IMA levels and severity of exacerbation (r: 0.498, p=0.010). Asthmatic children had higher IMA levels than the control group, both in stable and exacerbated asthma. There was a positive relationship between IMA levels and severity of asthma exacerbation.

The significance of thiol/disulfide homeostasis and ischemia-modified albumin levels to assess the oxidative stress in patients with different stages of diabetes mellitus

This study investigated the value of Thiol/Disulfide homeostasis and ischemia-modified albumin (IMA) levels in discriminating diabetic cases with different stages of retinopathy and without retinopathy. In total, 122 patients with type 2 diabetes mellitus (DM) were enrolled in this prospective cross-sectional study. These patients were separated into three subgroups: Group 1 included 42 patients with DM and no diabetic retinopathy (DR), Group 2 included 40 patients with DM having non-proliferative DR and the Group 3 had 40 patients with DM having proliferative DR. The native thiol, total thiol, and disulfide levels and disulfide–native thiol, disulfide–total thiol, and native thiol–total thiol ratios as well as the IMA levels were analyzed and compared among the groups. There were no statistically significant differences regarding the ages and genders of the patients between the groups. The native thiol level, the total thiol level and the native thiol–total thiol ratio showed a statistically significantly reduction, while the disulfide level, the disulfide–native thiol ratio, and the disulfide–total thiol ratio showed a statistically significantly elevation in the Group 3 compared with the Group 1 and Group 2. Additionally, the mean IMA levels were statistically significantly higher in Group 3 when compared to Group 1 and Group 2 (p = .003 and p = .014, respectively). In conclusion, both Thiol/Disulfide homeostasis parameters and IMA levels increase with the progression of DR. Thiol/Disuldife homeostasis balance and IMA levels may be used a biomarker to monitor the tissue ischemia in DM and to discriminate the different stages of DR, in the future.

Association of Endocan, Ischemia-Modified Albumin, and hsCRP Levels With Endothelial Dysfunction in Type 2 Diabetes Mellitus.

We investigated the relationship of ischemia-modified albumin (IMA) and high-sensitivity C-reactive protein (hsCRP) levels with direct (endocan) and indirect (carotid intima-media thickness [cIMT] and 24 hours urine protein excretion) endothelial dysfunction indicators in type 2 diabetes mellitus (T2DM). Patients with T2DM (n = 88) and 88 healthy individuals were included in the study. The median endocan (475.15 vs 216.37 pg/mL; P < .001, respectively) and hsCRP (10.74 vs 3.11 mg/L; P < .001, respectively) and the mean IMA (0.64 ± 0.12 vs 0.51 ± 0.12 absorbance units; P < .001, respectively) levels were higher in participants with endothelial dysfunction compared to those without endothelial dysfunction in T2DM. The 24-hour urine protein excretion and cIMT levels had a positive correlation with hsCRP ( r = .357; P = .001 and r = .592; P < .001, respectively), IMA ( r = .519; P < .001 and r = .495; P < .001, respectively) and endocan ( r = .347; P = .001 and r = .583; P < .001, respectively) levels in the T2DM group. Stepwise multivariable logistic regression analysis, which included laboratory findings found to be associated with endothelial dysfunction, showed that endocan (odds ratio [OR] = 1.456; P = .004), hsCRP (OR = 1.298; P = .008), and IMA (OR = 2.270, P = .003) were independent risk factors. It was found that none of these markers were superior in terms of diagnostic discrimination for endothelial dysfunction. Endocan, IMA, and hsCRP levels were found to be associated with endothelial dysfunction in patients with T2DM.

The Collocation of Ischemia-Modified Albumin and Blood Gas Parameters in the PICU Setting.

Ischemia modified albumin (IMA) is a marker that has been determined to be elevated in hypoxic conditions. This study aimed to investigate the relationships between serum IMA and blood gas parameters (BGPs) and evaluate whether IMA can be used as a parameter clinically in terms of reflecting tissue hypoxia in ventilator management. BGPs and serum IMA level were measured in blood samples drawn simultaneously from patients. Mean serum IMA levels, mean pCO2, mean pO2, and lactate levels were 82.56 ± 25.47 ng/mL, 47.99 ± 22.81 mm Hg, 53.62 ± 30.43 mm Hg, and 2.13 ± 3.22 mmol/L, respectively. No correlation was found between serum IMA level and BGPs. Our findings showed that serum IMA level can be concluded not to be a suitable parameter in ventilator management. However, IMA can be a reliable guide if used together with venous BGPs in terms of the estimating of tissue oxygenation, especially within the last few hours.

The role of ischemia-modified albumin levels in the diagnosis of acute appendicitis

Aim: Although there are several auxiliary laboratory tests, diagnosis of acute appendicitis (AA) mainly depends on clinical findings. The aim of this study was to evaluate the role of ischemia-modified albumin (IMA) in the diagnosis of AA. Methods: IMA levels of histopathologically confirmed AA cases and healthy volunteers were evaluated. Results: Mean IMA levels were 9.6 ± 12.5 absorbance units (ABSU) in the AA group and 3.04 ± 0.47 ABSU in the control group. Moreover, IMA levels positively correlated with the diagnosis of AA (r = 0.309, P = 0.013). The preoperative mean IMA level was 9.6 ± 12.5 ABSU, while the postoperative mean IMA level was 6.9 ± 11.7 ABSU (P = 0.001). There was a significant decrease in IMA levels after appendectomy. Conclusion: This study shows elevated IMA levels in patients with AA and a significant decrease of IMA levels after appendectomy. Oxidative stress plays a role in the pathogenesis of AA, and IMA levels can be used as an accessory parameter in diagnosis.