Evaluation of the relationship between adjusted ischemia-modified albumin and the presence and severity of peripheral artery disease

Author:

Özsin Kadir K1ORCID,Engin Mesut1ORCID,Sanrı Umut S1,Toktaş Faruk1,Kahraman Nail2ORCID,Huysal Kağan3,Üstündağ Yasemin3,Yavuz Şenol1

Affiliation:

1. Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

2. Department of Cardiovascular Surgery, Bursa City Hospital, Bursa, Turkey

3. Department of Clinical Biochemistry, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

Abstract

Objectives Albumin undergoes structural changes under ischemia and oxidative stress, turning into ischemia-modified albumin (IMA). It has been proposed as an early biomarker for various diseases associated with ischemia. We aimed to investigate the relationship between serum IMA and peripheral artery disease (PAD) and whether it is a risk marker for the severity of PAD. Methods This prospective case-control study included 100 patients with lower extremity PAD and 50 volunteers without. Patients with resting pain, ulcer, and gangrene were excluded from the study. Patients with PAD included in the study were divided into two groups as mild claudication and moderate-severe claudication. Adjusted-IMA levels were calculated according to the median albumin values of the groups. The basic clinical features and laboratory findings of the participants were recorded and compared. Possible risk factors for presence and severity of PAD and IMA levels were examined by logistic regression and receiver-operating characteristic (ROC) curve analyses. Results IMA and adjusted-IMA levels were significantly higher in the PAD group ( p < 0.001, p < 0.001, respectively). IMA and adjusted-IMA levels were significantly higher in PAD group 2, which had moderate-to-severe claudication and more pronounced ischemic symptoms ( p < 0.001, p < 0.001, respectively). Advanced age, presence of hypertension, smoking, low albumin levels, and high adjusted-IMA levels were independent predictors of PAD. There was a negative high correlation between adjusted-IMA levels and ABI ( r: −0.666, p < 0.001, Spearman’s correlation). ROC curve analysis demonstrated that adjusted-IMA cut-off values of 0.802 or above could predict presence and severity of peripheral artery disease with 70% sensitivity and 78% specificity (AUC: 0.825, 95% CI: 0.758–0.893, log rank p: 0.000). Conclusion We determinated that increased adjusted-IMA levels were a predictors of the presence and severity of PAD. In addition, adjusted-IMA values can be a valuable marker in the follow-up of clinical severity of PAD.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine,Surgery

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