Serum Ischemia-modified Albumin Levels Research Articles

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.
 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. 
 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. 
 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.
 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.

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.

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.

Serum oxidative stress factors predict myocardial ischemia reperfusion injury after percutaneous coronary intervention in patients with acute myocardial infarction and type 2 diabetes mellitus.

Serum oxidative stress factors may be considered to be essential parameters for indicating cell oxidative damage. We designed this study to investigate the clinical diagnostic value of serum oxidative stress factors (superoxide dismutase (SOD), malondialdehyde (MDA), and myeloperoxidase (MPO)) combined with ischemia-modified albumin (IMA) and heat shock protein 70 (HSP70) for myocardial ischemia-reperfusion injury (MIRI) after percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM). From November 2020 to August 2021, 94 patients with AMI + T2DM and 86 patients with AMI were enrolled in the study; they were sub-grouped into the MIRI and non-MIRI groups following the occurrence of MIRI within 48 h after PCI. SOD, MDA, MPO, IMA, and HSP70 levels were determined. The clinical values of the combined serum oxidative stress factors, IMA, and HSP70 levels to predict MIRI events were analyzed. There was a higher probability of MIRI events in the AMI + T2DM group than the AMI group (p < 0.05). The ROC curve for the combined prediction of SOD, MDA, MPO, IMA, and HSP70 for the occurrence of MIRI events was higher in both the AMI and the AMI + T2DM groups than for predictive factors alone (all p < 0.05). Combined prediction of SOD, MDA, MPO, IMA, and HSP70 has the highest diagnostic value for predicting MIRI events after PCI in AMI patients, especially in patients with AMI combined with T2DM.

Dynamic thiol-disulphide homeostasis and ischemia modified albumin levels in neonatal calf diarrhea

The aim of this study was to determine dynamic thiol-disulphide homeostasis (TDH) parameters and ischemia modified albumin (IMA) levels in calves with neonatal diarrhea and compare with healthy controls. A total of 50 calves were included in the study. There were 25 calves in both diarrhea and healthy groups. Serum native thiol, total thiol, disulfide and IMA levels were measured using new methods. Native thiol (P=0.025) and total thiol (P=0.041) values decreased significantly in calves with neonatal diarrhea compared to the healthy control group. Disulphide (P= 0.133), disulphide/native thiol ratio (P=0.001) and IMA (P=0.0018) parameters were lower in healthy group, and the difference between the two groups was significant for the parameters other than disulphide. This study shows that TDH is impaired in neonatal calf diarrhea and IMA levels are increased due to oxidative stress.

The effect of positive pressure ventilation on serum ischemia-modified albumin levels in obese patients with obstructive sleep apnea syndrome.

Respiratory abnormalities in obstructive sleep apnea syndrome (OSAS) are corrected with positive pressure ventilation treatments. We investigated the effect of positive airway pressure (PAP) treatment on the serum level of ischemia-modified albumin (IMA), an oxidative stress product, in OSAS patients with higher body mass index (BMI) and indication for PAP treatment. Seven consecutive female and 23 male patients with a BMI of ≥30 kg/m2 who were diagnosed as having OSAS according to ICSD3 criteria and were planned for PAP, were included. The Epworth Sleepiness Scale and STOP-Bang Questionnaire were performed. Morning arterial blood gas, hemogram, biochemistry, insulin, and IMA were measured after polysomnography and after three months of PAP. There were no significant changes in lactate, CRP, and serum electrolyte levels measured before and after PAP, except for potassium. When 30 patients were compared in terms of serum IMA levels at baseline and after treatment, the mean baseline value was 0.56 absorbance units (ABSU), and the 3rd-month follow-up IMA value was 0.53 ABSU (p= 0.537). The mean serum fasting insulin level was 15.85 µIU/mL and 11.6 (p= 0.002) and the mean HOMA index was 4.4 and 3.0 (p= 0.001), respectively. Serum IMA levels seem not to be an appropriate marker for the evaluation of PAP treatment in OSAS patients with higher BMI. PAP is associated with a decrease in the fasting insulin level, HOMA index, and hematocrit, but not with serum electrolytes except potassium.

A Novel Biomarker in Primary Glaucoma: Aqueous Humor and Serum Levels of Ischemia Modified Albumin (IMA).

To analyze ischemia-modified albumin (IMA) levels in aqueous humor and serum, and their correlation to RNFL thinning in primary glaucoma patients. Cross-sectional study. Patients were divided into the control and glaucoma groups. The control group was patients with senile cataracts. The glaucoma group consisted of patients diagnosed for the first time as primary open-angle glaucoma (POAG) or primary angle closure glaucoma (PACG). Exclusion criteria were secondary glaucoma and patients with systemic disease. A complete cataract examination was done for all patients, and glaucoma examinations for the glaucoma group. In both groups, the IMA aqueous humor was obtained during cataract and glaucoma procedure. Serum levels of IMA, malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α) were examined during preoperative examinations. Control group comprised 33 participants, and glaucoma group 41 patients (21 PACG and 20 POAG). Mean IMA aqueous humor (AQH) levels found in cataract group 6.039±3.16 ng/mL, glaucoma group 14.89±6.08 ng/mL, PACG group 12.69±6.25 ng/mL and POAG group 17.33±4.988 mg/mL. Mean IMA serum levels in cataract group 14.75±6.53 ng/mL, glaucoma group 13.89±6.53 ng/mL, PACG group 12.79±6.46 ng/mL± and POAG group 14.93±10.74 ng/mL. Glaucoma group had significant higher level of IMA in aqueous humor compared to control group, but opposite findings in serum IMA levels between groups. POAG patients had a higher aqueous IMA level compared to PACG group and correlated significantly with IOP. IMA AQH also negatively correlated to the RNFL thickness in both POAG and PACG group. Cut off 9.5 ng/mL was considered as a normal limit value to differentiate between control and glaucoma group. Primary glaucoma patients showed a significantly increased level of IMA AQH as a local ischemic biomarker compared to the control group. Systemic oxidative activity is not a representation of local ocular oxidative stress in both cataract and glaucoma group.

Value of thiol and ischemia modified albumin (IMA) in predicting mortality in serious COVID-19 pneumonia

Background/aimViral infections of the respiratory tract are generally related to many factors such as excessive production of cytokines, inflammation, cellular death, redox imbalance or oxidative stress. The aim of this study was to determine the serum levels of thiol and IMA in patients with severe COVID-19 pneumonia to evaluate oxidative stress. Study designThis was a prospective, sectional cohort study conducted at a pandemics hospital between 01.01.2022 and 01.02.2022. MethodsA total of 153 patients who had been confirmed with severe COVID-19 pneumonia in the emergency unit were prospectively analyzed. The control group was formed by 50 healthy volunteers with similar age and no chronic disease history. Thiol and IMA levels were statistically compared both in the patient and the control groups, and within the patient groups (survived and non-survival). ResultsWhile 96 out of 153 patients had survived, 57 patients had non-survival. There was a statistically significant distinction between the survived and non-survival patients with regard to Thiol and IMA levels (p < 0.001). The thiol levels in the patient group were significantly lower compared to the control group, and the IMA levels were significantly higher (p < 0.001). The sensitivity, specificity and NPV were 70.2%, 86.5% and 83% when thiol cut-off value was ≤345.2 μmol/L (AUC: 0.886, p < 0.001). The sensitivity, specificity and NPV were 70.2%, 85.4% and 82.8% when the IMA cut-off was >302.9 ABSU (AUC: 0.875, p < 0.001). ConclusionsOur results demonstrate that thiol and IMA levels may be used as bioindicators for risk classification and mortality in patients with serious COVID-19 pneumonia.

Evaluating Ischemia-Modified Albumin as an Early Biomarker for Hypertensive Disorders During Pregnancy: A Case-Control Study.

Background Ischemia-modified albumin (IMA) is looked upon as a newer marker of myocardial ischemia. There is a paucity of literature however with regardto studies correlating levels of IMA in patients with hypertensive disorders of pregnancy. The present study therefore aimed at estimating the levels of IMA in patients with gestational hypertension and assessing its utility in predicting hypertensive disorders of pregnancy. Methods The present study was a hospital-based case-control study conducted in the Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Nagpur. IMA was estimated in 30 controls (Group I) and 20 cases of gestational hypertension (Group II) using a spectrophotometric assay detecting free unbound Cobalt left behind. The clinical data and lab results were presented as mean ± SD. Student's t-test was applied and Pearson's correlation coefficient was calculated. A value of p < 0.05 was taken as statistically significant. The ROC (Receiver Operator Characteristic) curve was used to establish the cut-off of serum IMA levels in pregnancy-induced hypertension (PIH). Results There was no significant difference in age and period of gestation (POG) at the time of sample collection between the groups. There was a significant difference in the systolic and diastolic blood pressures (BPs) of both groups. The mean level of serum IMA was significantly higher in cases of gestational hypertension (0.88 ± 0.14 absorbance units {ABSU}) as compared to controls (0.69 ± 0.08 ABSU) (p<0.001). On correlation analysis, the systolic and diastolic BPs were found to be highly positively correlated with serum IMA levels (p<0.001). ROC curve analysis suggested that at a cut-off of 0.73 ABSU, IMA has 85% sensitivity and 80% specificity for predicting gestational hypertension. Conclusion Statistically significant results of serum IMA levels obtained in gestational hypertension which falls on the lesser severe spectrum of the diseaseimply that serum IMA can be used for early diagnosis of gestational hypertension and impending Pre-eclampsia (PE) and Eclampsia.