A novel indicator of widespread endothelial damage and ischemia in diabetic patients: ischemia-modified albumin.
Ischemia-modified albumin (IMA) is a novel marker of tissue ischemia. Nowadays, IMA is accepted as a marker of oxidative stress. In this study, we aimed at establishing an association between IMA and hyperglycemia, blood pressure, lipid parameters, microvascular complications, hsCRP, and microalbuminuria in type 2 diabetes patients without overt macrovascular disease and acute ischemia. Fifty type 2 diabetes mellitus patients without a history of macrovascular disease or end-stage renal disease were enrolled into the study. Age-matched 30 healthy individuals were also included in the study as a control group. Plasma IMA (0.329 ± 0.046 and 0.265 ± 0.045 AbsU; P < 0.0001) and hsCRP levels (0.51 ± 0.36 and 0.32 ± 0.17 mg/dl; P < 0.0001) were significantly higher in the diabetic group compared to healthy controls. IMA level was significantly correlated with hsCRP (r = 0.76; P < 0.0001), HbA1c (r = 0.72; P < 0.0001), microalbuminuria (r = 0.40; P = 0.004), systolic blood pressure (r = 0.28; P = 0.049), diastolic blood pressure (r = 0.44; P = 0.005), and HOMA-IR (r = 0.42; P = 0.005) levels in the entire diabetic subjects. In the diabetic patients group, presence of microalbuminuria was associated with a higher plasma IMA level (0.355 ± 0.035 and 0.265 ± 0.0045 AbsU; P < 0.0001, patients with microalbuminuria and control subjects, respectively). In the type 2 diabetes patients with nephropathy, IMA level (0.355 ± 0.035 and 0.311 ± 0.046 AbsU; P = 0.002) was determined higher compared to the diabetes patients without nephropathy. Diabetic patients without an overt cardiovascular disease still have a higher serum IMA level compared to healthy controls. The correlation of high plasma IMA levels with high hsCRP and microalbuminuria levels in diabetic subjects indicates the presence of a chronic ischemic process. Therefore, elevated IMA levels may indicate an underlying subclinical vascular disease in type 2 diabetes mellitus patients.
Canakkale Onsekiz Mart Universitesi, Tip Fakultesi, Endokrinoloji ve Metabolizma Hastaliklari BD, 17100 Çanakkale, Turkey. kukinc@comu.edu.tr
Kubilay
K
Ukinc
Selcuk
S
Eminagaoglu
Halil Onder
HO
Ersoz
Cihangir
C
Erem
Caner
C
Karahan
Arif Bayram
AB
Hacihasanoglu
Mustafa
M
Kocak
D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis / Q000378:metabolism / Q000502:physiology*; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003940:Diagnostic Techniques, Endocrine; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015427:Reperfusion Injury / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012709:Serum Albumin / Q000032:analysis / Q000378:metabolism / Q000502:physiology*
D000418:Albumins; D015415:Biomarkers; D012709:Serum Albumin