Evaluation of Ischemia-Modified Albumin and C-Reactive Protein in Type 2 Diabetics with and without Ketosis

Abstract

OverviewTo investigate whether serum ischemia-modified albumin or C-reactive protein is reliable for predicting type 2 diabetic patients with ketosis.ApproachOne hundred and four diabetic patients, 48 with diabetic ketosis, and 33 controls were enrolled in the study. Serum ischemia-modified albumin and C-reactive protein were measured and evaluated for their ability to distinguish diabetic ketosis.ResultsCompared to the controls, the ischemia-modified albumin and C-reactive protein levels were higher in patients with diabetic ketosis and type 2 diabetes at the baseline. The levels of ischemia-modified albumin were higher in patients with type 2 diabetes than in the controls. C-reactive protein and ischemia-modified albumin levels were reduced after insulin treatment. The level of ischemia-modified albumin was an independent risk marker for diabetic ketosis (OR = 1.085, P = 0.008, 95% CI: 1.022–1.152). Receiver operating characteristic curves revealed that the areas under the curve were 0.917 for the modified albumin and 0.357 for C-reactive protein.ConclusionThis study indicates that ischemia-modified albumin was significantly associated with diabetic ketosis and was more sensitive than C-reactive protein in reflecting diabetic ketosis.

Ischemia‐modified albumin and advanced oxidation protein products as potential biomarkers of protein oxidation in Alzheimer's disease

“…There are concerns about the tissue-specificity of IMA, it has been suggested that IMA is a biomarker for oxidative stress in ischemia or non-ischemia related disease. 28 In agreement with the present study, the IMA could be a risk biomarker for AD.…”

“…Ma et al found high levels of IMA in type 2 diabetic patients with ketosis, and determined a high correlation between IMA and CRP. 28 In the present study, we did not observed any correlations between the IMA and CRP, which might highlight the impact of oxidative stress on AD pathogenesis. Can et al observed high IMA values in AD patients, and they measured the IMA by colorimetric methods.…”

“…Although most oxidized proteins that are functionally inactive are rapidly removed, some can gradually accumulate with time and thereby contribute to damage associated with aging, as well as various diseases . Existing data suggest that IMA is not specific for cardiac ischemia, and is also elevated in patients with liver cirrhosis, pulmonary embolism, diabetes mellitus and cerebrovascular disease . IMA is approximately 1–2% of the total circulating albumin, and increases to 6–8% in patients experiencing ischemia .…”

“…27 Existing data suggest that IMA is not specific for cardiac ischemia, and is also elevated in patients with liver cirrhosis, pulmonary embolism, diabetes mellitus and cerebrovascular disease. [28][29][30] IMA is approximately 1-2% of the total circulating albumin, and increases to 6-8% in patients experiencing ischemia. 30 The major finding of the present study was that the serum IMA levels were significantly higher in patients with AD when compared with the control group.…”

Associations of FPG, A1C and disease duration with protein markers of oxidative damage and antioxidative defense in type 2 diabetes and diabetic retinopathy

“…18,19 IMA has been well accepted in the literature as a marker of OS, and its elevation has been associated with endothelial dysfunction, inflammation, and hyperglycemia in different types of diabetes with and without complications. [17][18][19][30][31][32][33][34] Hyperglycemia in DM is linked to OS, and retinal exposure to hyperglycemia activates multiple enzymes/ pathways accelerating OS and development of DR. [9][10][11]35 Hyperglycemia promotes increased IMA formation probably owing to mechanisms of hypoxia and OS. [17][18][19] Interestingly, it was reported that increased glycosylation of hemoglobin increases its affinity for oxygen, therefore, preventing its release at the tissue inducing hypoxia and OS.…”