title: The value of serum ischemia-modified albumin for assessing liver function in patients with chronic liver disease.
abstract: BACKGROUND
  Ischemia-modified albumin (IMA), measured by the cobalt-binding capacity of albumin, is a promising biomarker for cardiac ischemia. The IMA-to-serum albumin ratio (IMAR) has been reported to relate to the severity of decompensated liver cirrhosis. This study aimed to assess IMA and IMAR as a liver function test and to investigate whether albumin infusion changes IMAR in patients with liver cirrhosis.
  
  
  METHODS
  Blood samples were collected from healthy volunteers (n=51) and patients with chronic hepatitis (n=25), liver cirrhosis (n=24) and uremia (n=13). Parameters examined included serum levels of IMA, albumin, total bilirubin, creatinine, international normalized ratio (INR), model for end-stage liver disease (MELD) score, child-turcotte-pugh (CTP) score, indocyanine green (ICG) retention rate and total antioxidant capacity (TAC). Paired serum samples from patients pre- and post-albumin infusion (n=9) were collected and the changes were compared.
  
  
  RESULTS
  IMA and IMAR increased in patients with chronic hepatitis or cirrhosis, as compared to healthy volunteers. In patients with liver disease, IMA and IMAR were significantly associated with ICG retention, bilirubin, TAC and INR. In addition, IMAR was associated with CTP and MELD score in patients with cirrhosis. Albumin therapy improved patients' serum levels of creatinine and bilirubin and MELD score, but not IMA and IMAR.
  
  
  CONCLUSIONS
  IMAR, reflecting liver function and oxidative stress, is a more objective liver function test as it was not affected after a 3-day albumin infusion. More investigations, however, are needed to validate the use of IMAR in cases of chronic liver disease.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chiung-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Tsai
authors.forename: Po-Ju
authors.initials: PJ
authors.lastname: Lin
authors.forename: Shu-Chu
authors.initials: SC
authors.lastname: Shiesh
mesh_terms: D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005260:Female; D006505:Hepatitis / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007208:Indocyanine Green / Q000032:analysis; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012709:Serum Albumin / Q000008:administration & dosage / Q000032:analysis*; D012720:Severity of Illness Index; D013624:Taiwan; D014511:Uremia / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D003404:Creatinine; D007208:Indocyanine Green; D001663:Bilirubin