Serum Ischemia-modified Albumin Levels Research Articles

Maternal serum ischemia-modified albumin as an oxidative stress biomarker in preterm pre-labor rupture of membranes.

To evaluate the maternal serum ischemia-modified albumin (IMA) concentration as an oxidative stress biomarker in pregnancies complicated by preterm pre-labor rupture of membranes (PPROM) without maternal clinical infection and compare these results with healthy pregnancies. The present cohort study included 40 pregnancies complicated by PPROM and 49 similar gestational age healthy pregnancies in the third trimester of gestation. Maternal venous blood specimens were obtained at the day of first diagnosis. Maternal serum IMA level was assayed with an Albumin Cobalt Binding test. The subjects were followed up until delivery and perinatal outcomes were recorded. The maternal serum IMA concentrations were significantly higher in the study group (0.56 ± 0.05 absorbance units) as compared to controls (0.54 ± 0.03 absorbance units) (p = 0.020). The maternal serum IMA concentrations were not significantly correlated with the initial maternal white blood cell count (r: 0.118, p = 0.269) and C-reactive protein levels (r: 0.066, p = 0.541). The maternal serum IMA concentrations were negatively correlated with gestational age at delivery (r: -0.248, p = 0.019), birthweight (r: -0.247, p = 0.020) and Apgar scores (r: -0.200, p = 0.049; r: -0.245, p = 0.020). The threshold value of maternal serum IMA concentration above 0.55 absorbance units indicated the pregnancy complicated by PPROM by 57.5% sensitivity and 57.1% specificity (Area under curve 0.613, confidence interval 0.50-0.73). The current study supported for the first time that there is an association between increased maternal serum IMA levels and the development of PPROM in the third trimester of gestation without maternal clinical infection. Elevated maternal serum IMA levels may alert the obstetrician about poor ongoing perinatal outcomes in the early phase of PPROM before increased maternal C-reactive protein and white blood cell count.

Assessment of serum levels of ischemia modified albumin and interleukin-17 in children with atopic dermatitis.

Atopic dermatitis (AD) is the most prevalent chronic inflammatory skin disease in childhood. Interleukin 17 (IL17) is one of the pro-inflammatory cytokines that has an important role in the pathogenesis of many skin diseases including AD. Ischemia modified albumin (IMA) is an indicator of oxidative stress, inflammation and ischemia. The aim of the study was to assess the IL-17 and IMA serum levels in the children patients with AD in comparison to a control group. Additionally, the study seeks to examine the correlation between these biomarkers and their association with disease severity, disease stages, and other clinical characteristics. The case-control study enrolled two groups: (patient group: 50 children with AD) and (control group: 50 healthy age and sex-matched children). Full history was taken from all cases along with full dermatologic examination. The assessment of AD severity was conducted by using Eczema Area and Severity Index (EASI). Evaluation of IL-17 and IMA was performed by using ELISA technique. There was a statistically significant elevation in the mean levels of IL-17 and IMA in patients with AD compared to the control group. A strong positive correlation was observed between IL-17 and IMA levels. Additionally, both IL-17 and IMA levels exhibited a statistically significant negative correlation with the duration of the disease and the age of the patients. The elevated serum levels of IL17 and IMA and their positive correlation confirm that AD is a systemic inflammatory disease influenced and associated with increased oxidative stress.

Oxidative and Antioxidative Biomarker Profiles in Neonatal Hypoxic-Ischemic Encephalopathy: Insights for Pathophysiology and Treatment Strategies.

BACKGROUND Neonatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of perinatal and postnatal morbidity and mortality worldwide. Catalase (CAT) activity detection is used to determine levels of inflammation and oxidative stress. Glutathione (GSH) is the most critical non-enzymatic endogenous antioxidant. Lipid peroxidation levels marked after hypoxia can be detected based on the level of malondialdehyde (MDA). Ischemia-modified albumin (IMA) is considered a biomarker for cardiac ischemia and is known to increase in the liver, brain, and kidney in states of insufficient oxygenation. We aimed to explain the results and relations between the oxidant and antioxidants to detail oxidant-antioxidant balance and cellular mechanisms. MATERIAL AND METHODS Serum levels of IMA and MDA, as an oxidative stress marker, and CAT and GSH, as antioxidant enzymes, were measured in first blood samples of 59 neonates diagnosed with HIE, with pH <7, base excess >12, and APGAR scores. RESULTS Neonates who were ≥37 weeks of gestation and had hypoxia were included. Compared with healthy newborns (n=32), CAT was statistically significantly lower in the hypoxia group (P=0.0001), while MDA serum levels were significantly higher in neonates with hypoxia (P=0.01). There was no difference between hypoxic and healthy neonates in GSH and IMA measurements (P=0.054, P=0.19 respectively). CONCLUSIONS HIE pathophysiology involves oxidative stress and mitochondrial energy production failure. Explaining the pathways between oxidant-antioxidant balance and cell death, which explains the pathophysiology of HIE, is essential to develop treatment strategies that will minimize the effects of oxygen deprivation on other body organs, especially the brain.

Assessment of Serum Ischemia Modified Albumin Level and Erectile Functions in Individuals with Premature Greying of Hair

Assessment of Serum Ischemia Modified Albumin Level and Erectile Functions in Individuals with Premature Greying of Hair

Oxidative stress markers in breast cancer

Purpose: Oxidative stress is thought to play a role in the etiology of breast cancer. The aim of this study was to compare serum Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Oxidative Stress Index (OSI) and Ischemia Modified Albumin (IMA) levels in breast cancer patients and healthy women and to determine whether there is a relationship between oxidative stress markers and breast cancer.&#x0D; Materials and methods: Newly diagnosed 106 breast cancer patients at the Bozyaka Training and Research Hospital General Surgery Clinic and 30 healthy women were included in the study. Serum levels of IMA, TAS, TOS were analyzed by spectrophotometric methods. &#x0D; Results: IMA, TOS and OSI values were found significantly higher in the breast cancer group. Although the TAS values in patients with breast cancer were lower than the control group, the difference was not statistically significant. &#x0D; Conclusions: In our study, it was seen that oxidative stress levels increased in breast cancer patients due to decreased TAS, significantly increased IMA, TOS and OSI results. Therefore, we think that increased oxidative stress may be related to breast cancer and that IMA, TOS and OSI can be used as markers of oxidative stress to differentiate breast cancer patients from healthy women.&#x0D; Keywords: breast cancer, cancer, biomarkers, ischemia-modified albumin, oxidative stress

Evaluation of maternal serum thiol and ischemia-modified albumin levels in cases of placenta previa: A case-control study in a tertiary center.

We aim to compare the maternal serum thiol and ischemia-modified albumin (IMA) levels between pregnant women with placenta previa and those with uncomplicated pregnancies and to determine whether changes in these levels were useful in predicting cases of abnormally invasive placenta (AIP). Fifty-five pregnant women diagnosed with placenta previa according to the diagnostic criteria (case group) were compared to 100 women with uncomplicated pregnancies of similar demographic characteristics (control group). The patients with placenta previa were further divided into two subgroups: AIP (n = 20) and placenta previa without invasion (n = 35). The maternal serum native thiol, total thiol, disulfide, and IMA levels of the groups were evaluated. The native thiol, total thiol, and IMA values were significantly lower in the case group than in the control group (p < 0.001). The disulfide values were similar between the study and control groups (p = 0.488). When the AIP and placenta previa without invasion groups were compared, the levels of native thiol, total thiol, disulfide, and IMA were similar (p > 0.05). Maternal serum thiol and IMA levels were lower in placenta previa cases compared to the control group. However, these parameters were not useful in predicting AIP cases.

Study of Maternal Serum Ischemia-modified Albumin and Ischemia-modified Albumin Ratio in Uncomplicated and Complicated Pregnancy

Abstract Introduction: The maternal and fetal outcomes are poorer in pregnancies associated with obstetric complications. A newly recognized marker of hypoxia, serum ischemia-modified albumin (IMA), which serves as an early predictive marker of myocardial infarction in the emergency department, is now being studied in obstetric complications of pregnancy. Aims and Objectives: (1) To study the levels of maternal serum IMA in the early 2nd trimester (12–20 weeks) to predict the occurrence of uncomplicated and complicated pregnancy post 20 weeks of gestation. (2) To evaluate the IMR ratio (IMAR) (serum IMA-to-human serum albumin ratio) and its significance in the obstetric complications of pregnancy. Methodology: This prospective cohort study was conducted on 150 antenatal women with gestational age from 12 to 20 weeks. A complete detailed history of all participants was taken and they were followed up to the time of delivery for the specific complications (i.e., pregnancy-induced hypertension [PIH], preeclampsia, eclampsia, and gestational diabetes in mother and stillbirth, preterm birth, and fetal growth restriction [FGR] in the fetus) that developed during pregnancy. IMA levels and IMA ratio were obtained and correlated with the development of the defined complications of pregnancy. The data were recorded, tabulated, and subjected to statistical analysis. Results: A significant relationship between IMA value and the incidence of PIH, preeclampsia, and eclampsia and between IMAR value and the incidence of preeclampsia and eclampsia was seen among the study population (P &lt; 0.05). We observed that IMA and IMAR values were higher in women who did not have any fetal complications than in women who had fetal complications, namely, stillbirth, preterm birth, and FGR. However, this difference was not significant (P &gt; 0.05). Conclusion: Serum IMA and IMAR levels were higher in women with PIH, preeclampsia, and eclampsia. The most common pregnancy outcome was small for gestation age. No significant link was found between serum IMA levels or IMAR and the severity of eclampsia, gestational diabetes, stillbirth, preterm, and FGR.

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.

Diagnostic Value of Ischemia-Modified Albumin as a Biomarker in Patients with Peripheral Vertigo at Emergency Department of State Hospital in Ankara: A Cross-Sectional Study.

In previous studies, it was shown that ischemia-modified albumin (IMA) is an early marker of ischemia and different pathologies. However, IMA level change is unknown in patients with peripheral vertigo. It is also known that serum albumin levels can change in some patients with peripheral vertigo and that changes in serum albumin levels affect IMA levels. In this study, we aimed to assess IMA, albumin-adjusted IMA, and albumin levels in patients with peripheral vertigo by comparing a control group. This prospective, case-control study included 46 patients aged 18-70 years who presented to emergency department with vertigo. Forty-nine healthy volunteers without known disease were included as controls. Serum albumin and IMA levels were measured, and albumin-adjusted IMA levels were calculated. Data were analyzed by statistical methods. Mean age was 54.0 ± 15.7 in the patient group, whereas 43.8 ± 9.9 years in the control group. Albumin level was found to be significantly lower in patients with peripheral vertigo when compared to controls (P < 0.001). IMA level was found to be higher in the patient group compared to the controls, but it was not statistically significant (P = 0.06). However, albumin-adjusted IMA, which shows the real IMA level, was found to be higher than the control group (P = 0.02). It was observed that IMA level was slightly higher in patients with peripheral vertigo, although not significantly, compared to the control group. However, the albumin-adjusted IMA level, which indicates the real IMA level, was observed to be higher in this group than in the control group. It was determined that the sensitivity of this test was 34%, and the specificity was 87%. Patients with peripheral vertigo had lower albumin levels compared to controls.

The value of serum lipoprotein-associated phospholipase A2, ischemia-modified albumin, and cystatin C in predicting coronary heart disease risk: a single center retrospective cohort study.

This study aims to explore the value of serum lipoprotein-associated phospholipase A2 (Lp-PLA2), ischemia-modified albumin (IMA), and cystatin C (Cys-C) in predicting the risk of coronary heart disease (CHD). Clinical data from 104 CHD patients admitted to our hospital from January 2020 to December 2022 were analyzed. Of them, 31 patients had stable angina (Group-S), 36 patients were diagnosed with unstable angina (Group-U), and 37 patients had acute myocardial infarction (Group-A). Additionally, clinical data from 35 healthy individuals undergoing physical examination during the same time period were selected as the control group. Levels of blood lipid indicators and serum Lp-PLA2, IMA, and Cys-C levels were compared between the groups. The rates of diabetes, hypertension, and smoking in Group-S, Group-U, and Group-A were significantly higher than those in the control group (p<0.05). Levels of Lp-PLA2, IMA, and Cys-C in Group-S, Group-U, and Group-A were significantly higher than those in the control group (p<0.05). Levels of Lp-PLA2, IMA, and Cys-C in Group-U and Group-A were significantly higher than those in Group-S, and Group-A had the highest value of these indexes (p<0.05). Multivariate logistic regression analysis showed that Lp-PLA2, Cys-C, and IMA were important risk factors for the onset of CHD (p<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of Lp-PLA2, IMA, and Cys-C predicting the occurrence of CHD was 0.775, 0.835, and 0.735, respectively. The combined prediction of the three factors has an AUC of 0.920, which is higher than the individual prediction. Lp-PLA2, IMA, and Cys-C are closely related to the onset and progression of CHD. These indicators, therefore, can be used in clinical practice to predict and evaluate CHD.

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.

Evaluation of calprotectin and ischemia-modified albumin serum levels as biomarkers to measure disease activity in Behçet’s disease

BackgroundAlthough several cytokines and markers have been recognized to assess disease activity in Behçet’s disease (BD), they are not routinely utilized in daily practice. This study aimed at assessing the usefulness of calprotectin and ischemia-modified albumin (IMA) serum concentrations to measure disease activity in BD.ResultsThe active BD cases had significantly greater IMA serum levels than inactive BD cases (p = 0.013) and controls (p < 0.001). In addition, the inactive BD group had significantly higher IMA serum levels than controls (p < 0.001). The serum calprotectin levels in active and inactive BD groups were significantly greater compared to those measured in controls (p < 0.001). On the other hand, the difference in serum calprotectin concentration was insignificant between the active and inactive BD patients. Binary logistic regression analysis revealed that hs-CRP and IMA serum levels are the strongest predictors for the activity of the active BD (p = 0.011 and 0.005, respectively). ROC curve analysis for the ability of IMA serum level to discriminate between active and inactive BD groups revealed an AUC = 0.738.ConclusionSerum calprotectin and IMA concentrations were significantly elevated in BD. IMA was significantly greater among active BD cases in comparison to inactive BD cases indicating its potential importance as a new marker of activity in BD.Trial registrationTrial registration on ClinicalTrials.gov: NCT05868538.

Value of ischemia-modified albumin in ankylosing spondylitis

Background/Aim: Ankylosing spondylitis (AS) is a chronic inflammatory illness with a poorly known pathogenesis. Current biomarkers that are used to estimate inflammation are normal in some patients despite having active disease. Recent studies have revealed that oxidative stress may have a role in AS and that there is a close relationship between oxidative stress and inflammation. Ischemia-modified albumin (IMA) is a promising new biomarker for oxidative stress. Thus, the aim of this study was to assess IMA levels and their relationship with disease activity and other inflammatory markers in patients with AS. Methods: This prospective case-control study included 48 patients with AS and 25 healthy controls (HCs). The measured serum levels of IMA, interleukin (IL)-17, and IL-23 were compared between patients with AS and the HC group. We also analyzed the correlation between IMA and disease activity, acute phase reactants, and HLA-B27 positivity. The Ankylosing Spondylitis Disease Activity Score with C-Reactive Protein (ASDAS-CRP) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to determine disease activity. Results: There was no difference in serum IMA levels between the AS and HC groups (25.08 [20.49-46.83] vs. 29.89 [29.89-42.0], P=0.146). Only IL-23 was significantly higher in patients with AS (10.81 [7.25-14.06] vs. 7.95 [6.85-10.46], P=0.039). Furthermore, there was no correlation between IMA and IL-23, IL-17, CRP, ESR, BASDAI, or ASDAS-CRP (r=-0.079, P=0.593; r=-0.043, P=0.771; r=-0.018, P=0.906; r=0.047, P=0.751; r=0.281, P=0.053; r=0.162, P=0.271). There was no significant difference between IMA, IL-17, and IL-23 levels in patients with low disease activity (BASDAI &lt;4, ASDAS-CRP &lt;2.1) and high disease activity (BASDAI ≥4, ASDAS-CRP ≥2.1) (BASDAI: P=0.146, P=0.303, P=0.071, and ASDAS-CRP: P=0.451, P=0.410, P=0.324, respectively). There was no difference in IMA levels between HLA-B27-positive patients and HLA-B27-negative patients (P=0.070). Conclusion: Although oxidative stress has been suggested to play a role in AS pathogenesis, we did not find an increase in serum levels of IMA, an oxidative stress biomarker, in patients with AS. Our results suggest that IMA may not be a reliable indicator of inflammation. Further research is needed to determine whether IMA may have a role as a biomarker in AS.

A Comparative Study of Ischemia-Modified Albumin: A Promising Biomarker for Early Detection of Acute Coronary Syndrome (ACS).

Introduction The second most common cause of emergency department (ED) visits is chest pain and discomfort. Timely identification or threat stratification is crucial for identifying high-risk individuals who benefit from sophisticated diagnostic investigations (including cardiac biomarkers) and early relevant therapies. We aimed to assess the levels of ischemia-modified albumin (IMA) and also to study its sensitivity and specificity in comparison with cardiac troponin T/troponin I and electrocardiogram (ECG) (alone and in combination) in the diagnosis of acute myocardial infarction. Methods Adults (either gender) presented at the ED of a tertiary care centre with classical chest pain suggestive of angina pectoris or angina-like chest pain and ECG changes suggestive of ACS, ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial MI (NSTEMI), and unstable angina, within three hours of onset were enrolled. Demographic and clinical information was recorded. ECG, haematological investigationslike complete blood count, blood sugar level, lipid profile, IMA, troponin I, and creatinine kinase-MB (CK-MB), and radiologicalinvestigations like 2D-echocardiography (2D-ECHO) and coronary angiography were performed. Results A total of 100 subjectswere enrolled in the study out of which 50 were cases and 50 were controls. Cases were older as compared to controls (mean age 60.5 versus46.0 years). Of the 50 cases, 33 (66%) were males. There were equal numbers of males (33 each) and females (17 each) subjects in both the groups. Typical chest pain, risk factors, and history of coronary arterydisease (CAD) were higher in cases. ECG diagnosis revealed the presence of STEMI (52%) and coronary angiography revealed the presence of double vessel CAD(60%) in cases. Among controls, gastroesophageal reflux disorder was the most common cause of chest pain followed by costochondritis and pneumonia. Glucose (fasting and postprandial), all lipid profile parameters (except high-density lipoprotein) and IMA values were significantly higher in cases as compared to controls. A combination of ECG+IMA has the highest sensitivity (90%) with 79% PPV in the diagnosis of ACS within three hours of the onset of chest pain, and ECG+IMA+2D-ECHO had similar results. However, ECG is equally sensitive. IMA alone has 64% sensitivity with 82% diagnostic accuracy which was higher than other biomarkers (CK-MB, cardiac troponinI). Conclusions As found in our study, amongthe biomarkers used, the diagnostic accuracy of IMA was the highest and better than that of cardiac troponin I and CK-MB. Although ECG is the preferred diagnostic tool for diagnosing ACS (STEMI, NSTEMI, and unstable angina) in patients presenting within three hours of the onset of chest pain, a confirmation can be done with the help of other diagnostic tests and investigations like serum IMA levels and further treatment can be initiated.

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.

Assessment of the Serum Ischemia Modified Albumin Level and Its Relation to Total Oxidant Status and Disease Activity in Vitiligo Patients

Abstract Background Vitiligo is an acquired depigmentary skin disorder characterized by loss of functioning epidermal melanocytes. Oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. Total oxidant status (TOS) had been reflect the global status of oxidative stress in serum. While, albumin acts as a buffering agent for toxic molecules within the circulation. It undergoes structural changes when exposed to ischemia or oxidative stress and ischemia modified albumin IMA are produced under these conditions with high levels. Hence it considered as a marker of oxidative stress in different clinical conditions. Aim of the Work The aim of this work was to evaluate the serum level of ischemia modified albumin in vitiligo patients and its relation to total oxidant status and disease activity. Patients and Methods This is a cross sectional study. Forty-eight patients with vitiligo were included in this study. Twenty-four were considered active cases while the other 24 were non-active vitiligo patients. The study also included 48 age-and sex-matched healthy adults as a control group. Five ml of venous blood were withdrawn from each patient and control subjects. The vitiligo activity and tensity were assessed by VIDA and VETI scores respectively. Serum IMA and TOS had been assist by ELISA kits. Results Our study found a significant increase in serum total oxidant status (TOS) and serum ischemia-modified albumin (IMA) levels in vitiligo patients compared to controls. We also found a positive correlation between TOS levels and IMA levels and vitiligo disease activity represented by VIDA score. Conclusion The total oxidant status (TOS) and IMA levels were increased in vitiligo patients' sera and positively correlated to disease activity. To the best of our knowledge, we were the first to detect the significantly positive correlation between serum IMA and vitiligo disease activity.

The Role of Small Dense LDL Cholesterol and Ischemia Modified Albumin in Patients with Hyperlipidemia

Background: The analysis of lipid profiles is a crucial step for cardiovascular risk evaluation, prevention, and therapeutic management. Small dense LDL (sdLDL) is one of the distinct subfractions of LDL and is established to have pro-atherogenic properties. Ischemia-modified albumin (IMA) is an early biomarker arising as a result of oxidative stress and ischemia. Objective: This study aimed to determine serum levels of sdLDL and IMA in patients with hyperlipidemia. Methods: Seventy-four patients with hyperlipidemia and 35 healthy controls were included. sdLDL was determined by the heparin-magnesium precipitation method. IMA was measured quantified manually with the colorimetric method. The patient group was divided into three groups: HyperTG (n=11), HyperLDL (n=38), and combined hyperlipidemia (n=25). Results: Median serum sdLDL and IMA levels were higher in patients with hyperlipidemia than healthy participants (both, p&lt;0.001). Elevated sdLDL levels were observed in the HyperLDL group compared to the HyperTG group and the combined hyperlipidemia group (p&lt;0.001). Cut-off values for the detection of patients with hyperlipidemia were &gt;70 mg/dL for sdLDL and &gt;0.7 AU for IMA, and both parameters showed considerably high levels of sensitivity and specificity. Multiple logistic regression analysis revealed that high sdLDL (p=0.042) and high IMA (p&lt;0.001) were independently associated with hyperlipidemia after adjusting for age and sex. Conclusion: Serum sdLDL and IMA levels could be used as biomarkers for dyslipidemia-associated diseases. Further studies with larger sample size are needed to validate the impact of sdLDL on the pathogenesis of atherogenesis, and its value in the diagnosis and prognosis hyperlipidemia. Keywords: Small dense LDL, Lipoprotein, Ischemia modified albumin, IMA, Atherosclerosis

Analysis of Ischemia-Modified Albumin (IMA) and Coagulation Parameters in Patients with SARS-CoV-2 Pneumonia

Background: Coronavirus disease 2019 (COVID-19) is a systemic disease which causes an increased inclination to thrombosis by leading to coagulation system activation and endothelial dysfunction. Our objective in this study is to determine whether ischemia-modified albumin (IMA) can be used as a new marker in patients with COVID-19 for evaluating the increased coagulation risk, pneumonic infiltration, and thus, prognosis. Methods: Our study included 59 patients with COVID-19 compatible pneumonic infiltration on lung computed tomography (CT) who applied to and were hospitalized in the Internal Diseases Outpatient Clinic, then followed up and treated, as well as 29 healthy individuals with a negative COVID-19 rRT-PCR test without any additional disease. Hemogram, coagulation, routine biochemistry, and serum IMA activity parameters were studied. Results: In our study, the higher serum IMA level in COVID-19 patients with pneumonic infiltration compared to that of the healthy control group was found to be statistically significant. No significant correlation was found between the serum IMA levels and the coagulation and inflammation parameters in the 59 COVID-19 patients included. Conclusions: Serum IMA levels in COVID-19 patients with pneumonic infiltration on CT were found to be higher than in the control group. Examination of biochemical parameters, especially thrombotic parameters that affect prognosis such as IMA, can be a guide in estimating pneumonic infiltration.

Dynamic Thiol-Disulfide Homeostasis in Children with Newly Diagnosed Iron Deficiency Anemia

Objective: Iron is an element, which is found in the structure of antioxidant enzymes and has an important role in the inactivation of reactive oxygen species. Disruption of oxidant-antioxidant balance may be playing a role in the pathogenesis of iron deficiency anemia (IDA). Dynamic thiol-disulfide homeostasis (DTDH) and serum ischemia-modified albumin (IMA) levels are important indicators of pro-oxidant/antioxidant status. In this study, we aimed to evaluate DTDH parameters and serum IMA levels in children with newly diagnosed IDA, who did not receive iron therapy. Material and Methods: Fifty patients diagnosed with IDA and 33 healthy age- and sex-matched control patients were included in the study. DTDH parameters and IMA levels of the patients and control groups were measured. The same parameters were also compared in patients with Hb&amp;lt;7 g/dl (profound IDA) (n:14/50, 28%) and Hb≥7 g/dl (mild-moderate IDA) (n: 36/50, 72%) in the IDA group. The relationship between DTDH parameters in these groups were investigated. Results: Native thiol, total thiol, native thiol/total thiol levels, constituting antioxidant capacity indicators, were found to be significantly lower in IDA patients; while oxidant disulfide, disulfide/native thiol, disulfide/total thiol, and IMA levels were found to be statistically higher compared to those in the control group (p&amp;lt;0.050). When DTDH parameters and IMA levels were examined; there was a positive correlation between antioxidant parameters and a negative correlation between oxidative parameters with hemoglobin and ferritin levels (p&amp;lt;0.050). Also, oxidative parameters were found to be much higher in profound IDA group than in the group with Hb&amp;gt;7 g/dl (p&amp;lt;0.050). Conclusion: In this study, increase in serum disulfide and IMA levels with the decrease in serum native thiol and total thiol levels indicated oxidative stress in IDA patients before treatment, compared to the control group. Evaluation of these indicators in children is important in predicting the toxicity due to IDA.

The Relationship with Disease Severity of Ischemia-Modified Albumin Levels in Diabetic Nephropathy

Background: While type 2 diabetes (T2DM) is increasing rapidly, developing diabetic complications are the leading cause of morbidity and mortality. Biochemical markers are important for early diagnosis and treatment of nephropathy, which is a common complication. The aim of this study is to evaluate serum ischemia-modified albumin (IMA) levels in the development of diabetic nephropathy in T2DM patients and to determine the effectiveness of this parameter in predicting the presence and severity of nephropathy. Materials and Methods: 68 adult patients diagnosed with T2DM and 30 healthy controls were included in this study. The T2DM group consisted of 34 patients without microalbuminuria (&lt;30 mg/g) and 34 patients with microalbuminuria (30–300 mg/g) according to albumin/creatinine ratio (UACR). Biochemical data and serum IMA levels of the patient and control groups were measured and compared. Results: In terms of IMA levels, the difference between T2DM patients with microalbuminuria (0.55 ± 0.08 ABSU) and without microalbuminuria (0.42 ± 0.05 ABSU) and control (0.37 ± 0.08 ABSU) groups was significant (p&lt;0.0001). The T2DM group with microalbuminuria had the highest glucose, HbA1c, UACR, and IMA levels. There was a positive correlation between IMA levels and UACR (r = 0.541, p &lt; 0.001). IMA had a weak correlation with HbA1c (r = 0.345, p = 0.002). ROC analysis was performed and the IMA test had a high diagnostic value in the diagnostic differentiation of T2DM patients with microalbuminuria. According to multiple logistic regression analysis, IMA levels were an independent risk factor for DN (p = 0.003). Conclusions: Our data showed that IMA values increased significantly in diabetic patients, especially in those with microalbuminuria, and this increase was correlated with UACR levels. This study has shown that increased IMA levels are an important marker for the presence and severity of microalbuminuria in diabetic patients and therefore may be important in the early detection of renal dysfunction in T2DM. We even think that it can be used as an important marker in the follow-up of diabetic patients, even before the development of microalbuminuria.