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

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Ischemia-Modified Albumin (IMA) Is Associated with Poor Survival in Patients with Newly Diagnosed Idiopathic Pulmonary Fibrosis (IPF): A Pilot Study

“…Several studies have suggested that the measurement of structurally modified albumin could assist with monitoring oxidative stress in several clinical conditions, such as renal failure, ischemic heart disease, acute appendicitis, cerebral infarction, and pre-eclampsia [ 19 , 20 , 21 , 22 , 23 ]. It is well known that IPF patients exhibit heightened systemic and tissue oxidative stress levels, influenced by various contributing factors that exacerbate this oxidative burden within the disease context [ 4 , 5 ].…”

“…Subsequent research expanded this finding, revealing that serum IMA concentrations increased in various pathological conditions linked to oxidative stress. As a result, it has been regarded not only as a biomarker of ischemia but also as an indicator of oxidative stress within diverse pathological contexts [ 19 , 20 , 21 , 22 , 23 ]. This study aims to explore the possible association between the serum concentrations of IMA and adverse clinical outcomes in patients diagnosed with IPF and, therefore, provide initial mechanistic insights into the factors mediating the link between oxidative stress and disease progression in this group.…”

Helicobacter pylori Eradication Therapy in Patients with Decreased Renal Function: A Systematic Review

“…Although patients with dialysis were included, the subgroup analyses by renal function were performed. The success of the eradication was assessed via a 13 C-urea breath test 6 weeks after the eradication. CCr was monitored for 3 months before the start of the study and during the study to ensure that it remained constant.…”

“…Regarding non-randomized controlled trials, the quality of the research was evaluated based on the Newcastle-Ottawa Scale [12,13]. The Newcastle-Ottawa Scale consists of 4 items for selection, 2 items for comparability, and 3 items for outcome or exposure.…”

Predictive Value of Neutrophil-to-Monocyte Ratio, Lymphocyte-to-Monocyte Ratio, C-Reactive Protein, Procalcitonin, and Tumor Necrosis Factor Alpha for Neurological Complications in Mechanically Ventilated Neonates Born after 35 Weeks of Gestation

“…These markers offer insights into the neonate’s inflammatory status and immune response, which are intricately linked to the development of neurological complications [ 13 , 14 ]. Similarly, these markers proved to be valuable resources in studying other different conditions such as tumor pathology or inflammatory conditions [ 15 , 16 ].…”