Evaluation of the Association between Ischemia Modified Albumin (IMA), Glycemic and Lipid Status in Diabetic Nephropathy (original) (raw)
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Sensitivity and specificity of ischaemia modified albumin in detecting diabetic nephropathy in T2DM
The Egyptian Journal of Internal Medicine, 2018
Background Ischemia-modified albumin (IMA) is a novel marker of tissue ischemia and oxidative stress. Aim We assessed the level of IMA concentration in type 2 diabetes mellitus (T2DM) patients with diabetic nephropathy and its correlation with glycemia level, duration of diabetes, dyslipidemia, serum creatinine, and urinary albumin/creatinine ratio. Patients and methods This study included 91 patients who were divided into three groups: group A (33) included T2DM patients without nephropathy; group B (29) included T2DM patients with nephropathy; and group C (29) included healthy as control. Blood samples were analyzed manually for plasma IMA by spectrophotometric cobalt (II)-albuminbinding assay. Results Serum levels of IMA were significantly higher in group B in comparison to group A with a P value less than 0.001 and group C with a P value less than 0.0001. IMA positively correlated with blood pressure, duration of diabetes, fasting blood glucose, postprandial blood glucose, glycated hemoglobin, cholesterol, lowdensity lipoprotein, triglycerides, serum creatinine, and albumin/creatinine ratio, all with a P value less than 0.0001 and also with BMI (P<0.003). IMA was a significant discriminator for diabetic nephropathy (P<0.001) with 100% specificity and 100% sensitivity. Conclusion IMA could serve as an indicator of glycemic control and a sensitive marker of diabetic nephropathy.
Aim: This study aimed at evaluation of ischemia-modified albumin (IMA), malondialdehyde (MDA), and advanced oxidative protein products (AOPP) as markers of vascular injury in diabetic nephropathy (DN) with derivation of cutoff values for the same. Materials and methods: Study population comprised 60 diabetes patients and 30 controls, with diabetes patients further categorized into three groups based on urine albumin/creatinine ratio (UACR) of ,30 mg/g (diabetes without microalbuminuria), 30–300 mg/g (early DN), and .300 mg/g of creatinine (overt DN). Serum IMA, MDA, and AOPP were estimated by enzyme-linked immunosorbent assay; HbA1c, serum creatinine, urine albumin, and urine creatinine were estimated using automated analyzers. Statistical analysis was done using analysis of variance, Pearson’s correlation coefficient, and receiver-operating characteristic curve. Results: A statistically significant difference was found in the levels of IMA among patients with early DN (154 ng/mL), diabetes without nephropathy (109.4 ng/mL), and healthy controls (45.7 ng/mL), with highest levels in early DN cases. Similar increase was seen in AOPP as well. A significant correlation was observed between IMA and UACR in diabetes without nephropathy (r = 0.448). Conclusion: The present study postulates serum IMA as a novel biomarker for the assessment of disease progression in diabetes even before microalbuminuria, and a cutoff point $99 ng/mL can be used for detection of early DN.
The Relationship between Ischemia Modified Albumin and Lipids in Type 2 Egyptian Diabetic Patients
2014
3 Abstract: The most important reason for risk increase in diabetic patients is endothelial dysfunction and subclinical low grade systemic inflammation. Ischemia modified albumin (IMA) is produced as a result of serum albumin flowing through ischemic tissues and is a marker of oxidative stress and ischemia, as serum level of modified albumin rise in many diseases accompanied by ischemia. In this study we evaluated the relationship between serum IMA and lipid profile in type 2 Egyptian diabetic patients. Forty subjects participated in this study; 20 of them were type 2 diabetic patients with normal lipid profile; 20 patients were type 2 diabetic patients with dyslipidemia; and 10 subjects as a control group. The study revealed a significant positive correlation of serum IMA to glycosylated hemoglobin of type 2 diabetic patients without dyslipidemia and a non significant correlation of serum IMA to all lipids of the patients of the same group. The study also revealed a significant pos...
Extended lipid profile and urine albumin-creatinine ratio in type 2 diabetes mellitus
GSC Biological and Pharmaceutical Sciences
Background: Diabetes is a chronic metabolic disorder and has become the one of the most challenging global health problem of 21 st centuary. Diabetic nephropathy is a major complication of diabetes and an established risk factor for cardiovascular events. Lipid abnormalities occur in patients with diabetic nephropathy, which further increase their risk for cardiovascular events. We aimed to research association between extended lipid profile and urine albumin-creatinine ratio (UACR), hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorder and cerebrovascular accident in patients with type 2 diabetes mellitus. Methods: A hospital based cross- sectional study was conducted on 48 patients with type 2 diabetes mellitus. All patients fasting blood glucose (FBG), HbA1c, total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), apolipoprotein-A (apo-A), apolipoprote...
Ischemia modified albumin in early diabetic nephropathy
Medpulse Publication, 2018
Background: Ischemia and hypoxia are observed in diabetic patients in addition to chronic hyperglycemia and intensified oxidative stress. It is reflected by increased markers levels of oxidative protein damage, especially in patients with vascular complications, as well as ischemia−modified albumin (IMA). Objective: To assess the plasma levels of IMA in T2DM patients with early diabetic nephropathy and their relationship with routine markers of kidney disease severity (urinary microalbumin, plasma creatinine concentration) Materials And Methods: Plasma IMA levels were manually determined in 100 patients and 50 healthy people by spectrophotometric Co(II)−albumin binding assay. Micoalbuminuria was detected using turbidimetric method and creatinine using Jaffe’s method in Cobas Autoanalyzer Results: The IMA levels in the diabetic patients were significantly higher than in the healthy controls and increased progressively with the degree of DN. The normoalbuminuria group 1 had the lowest IMA level, which significantly increased with development of microalbuminuria and as nephropathy progressed in group 2 and group 3. There were significant relationships between IMA and microalbuminuria (r = 0.87) Conclusion: This study indicates that the observed increased IMA in T2DM is connected with diabetic nephropathy. Measuring IMA plasma levels provided additional information about nephropathy development and it may be helpful in assessing the severity of oxidative stress, which causes kidney dysfunction at an early stage.
Lipid profile in Type 2 diabetes mellitus and in diabetic nephropathy
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Diabetes mellitus (DM) is characterized by abnormalities of carbohydrate, protein and fat metabolism due to absolute or relative deficiency of insulin secretion, accompanied by varying degrees of resistance to insulin. Diabetes mellitus is currently the most common etiology for chronic kidney disease (CKD). Abnormalities of lipoprotein metabolism is associated with Diabetic nephropathy(DN), which can be influenced by derangement of renal function and the degree of metabolic control in diabetes mellitus. Our objective is to compare the levels of lipid profile, urine microalbumin and glycated haemoglobin (HbA1c) between type 2 Diabetes mellitus (T2DM) without any complications, T2DM with nephropathy and normal controls who were age and sex matched. Materials and Method: Study group consisted of 75 individuals of whom 25 were T2DM without any complications, 25 were T2DM with nephropathy and 25 were healthy controls. Total cholesterol (TC), Triglycerides(TG), LDL Cholesterol(LDL-c), HDL Chlolesterol (HDL-c), HbA1c and urine microalbumin were measured in these subjects. Results: The values of TC, TG, LDL-c, HbA1c and urine microalbumin levels were significantly higher in T2DM without any complications and T2DM with nephropathy when compared to controls. HDL-c level was significantly lower in T2DM without any complications and T2DM with nephropathy when compared to controls. Conclusions: T2DM and DN are associated with dyslipidemia which is more pronounced in diabetic nephropathy. Therefore, early detection of dyslipidemia in Type 2 diabetics and accordingly therapeutic intervention could control the resulting cardiovascular or renal complications.
Lipid abnormalities in insulin-dependent diabetic patients with albuminuria
Diabetes Care, 1984
The relationship between serum lipid, lipoprotein, and apolipoprotein levels and abnormalities of renal function has been investigated in 112 insulin-dependent (type I) diabetic patients. They were subdivided into three matched groups according to the amount of albuminuria: group A (albuminuria < 20 μg/min), group B (albuminuria between 20 and 150 μg/min; Albustix negative), and group C (albuminuria > 150 μg/min; Albustix positive). Twenty-one nondiabetic subjects with albuminuria above 150 μg/min but without nephrotic syndrome and/or renal failure and 77 healthy subjects were also studied. Mean total and LDL cholesterol, triglycerides, and apo B were higher, while HDL cholesterol and HDL/LDLcholesterol ratio were lower in group C than in groups A and B; the apo A/apo B ratio was lower in group C than in group A. Differences in apo B and in apo A/apo B ratio were found between groups A and B. No correlation between lipid parameters and amount of albuminuria was observed. Signi...
Ischemia-Modified albumin level in type 2 diabetes mellitus—Preliminary report
Disease Markers, 2008
Aim:The main goal of the present study was the evaluation of ischemia-modified albumin (IMA) in patients with type 2 diabetes mellitus and estimation of its connection with vascular complications, glycemic control, hypertension, dyslipidemia and obesity.Methods:In 76 diabetic patients and 25 control subjects, a plasma level of IMA by manually performed, spectrophotometric Co(II)-albumin binding assay was determined. Other parameters such as glucose, fructosamine, HbA1c, total cholesterol and its fractions (HDL, LDL), triglicerydes were estimated by routine methods.Results:Diabetic patients had significantly higher level of IMA in comparison with control subjects. There were not significant differences between groups with various states of vascular complications although the lowest concentration of IMA was observed in patients with microangiopathy. Patients with poor glycemic control had higher IMA level in comparison with these with good glycemic control. Significant correlation was...
Role of Glycated Albumine as a Predictor of Nephropathy in Type 2 Diabetic Iraqi Patients
Background: Diabetic nephropathy is a common complication of diabetes mellitus type2. Glycated albumin level increase in states of abnormally high glucose concentration in diabetes mellitus. The increase in concentration glycated albumin plays role in diabetic nephropathy through stimulation of collagen and fibronectin expression in mesangial cell. Objective: This study aimed to evaluate the roles of the serum glycated albumin as predictor of diabetic nephropathy with type2 diabetic patients with normal albuminuria , micro albuminuria and comparing them with normal healthy subjects. Method : This study was conducted in Medical City, Baghdad Teaching Hospital during the period from December 2015 to June 2016.The study included (90) subjects with age range between (30 – 56) years, divided in to three groups , 30 healthy control, 30 type 2 diabetic mellitus patients with normal albuminuria (micro albumin < 30 µg/ml) and 30 type2 diabetic mellitus patients with micro albuminuria (micro albumin >30 µg/ml).Body mass index (BMI) was determined, Fasting blood sugar (FBS) ,serum creatinine ,blood urea ,and glycated hemoglobin (HbA1c%) were measured for each individual in addition to the concentration of albumin in urine and estimation glomerular filtration rate (eGFR) was calculated. Results : The results of the present study showed that the levels of fasting blood sugare , HbA1c %,blood urea ,and serum creatinin, were significantly higher in micro albuminuria than normal albuminuria and healthy control and Glycated Albumin(GA%) levels showed a statically significant difference (p <0.05) among the studied groups ,it was significantly higher in group micro albuminuria than group normal albuminuria when compared with healthy control group (19.0±5.7), (17.1±5.1), and (15.6±4.6) respectively. Conclusion: Diabetic patient with micro albuminuria show increase the level of serum GA % which may be considered as predictor of diabetic nephropathy. Keyword: diabetic nephropathy, micro albuminuria, serum albumin, Glycated Albumin (GA%)
Journal of Diabetes Mellitus, 2020
Background: Diabetic nephropathy is one of the major complications of diabetes. Nephropathy patients must be evaluated for dyslipidemia as it is an established risk factor for cardiovascular events. We compared the degree of dyslipidemia among type 2 diabetes mellitus (T2DM) subjects with or without nephropathy and analyzed the factors associated with nephropathy among them. Methods: In this retrospective study, T2DM patients with overt nephropathy were enrolled in the study group (n = 50); without nephropathy were enrolled in the control group (n = 50). Both groups were matched for age duration of diabetes. After taking informed consent anthropometrical clinical examinations were done. Biochemical investigations (Total cholesterol , TG, HDL, LDL, VLDL, sdLDL-C, S. urea, S. creatinine were done in SCB MCH, Biochemistry department. Urine microalbumin per gm of creati-nine was done. TG/HDL-C ratio, a surrogate marker for small, dense, LDL particles (sdLDL), and estimated glomerular filtration rate (eGFR) were calculated using equations. Results were analyzed statistically using SPSS version 20. Results: Mean Total cholesterol, TG, LDL, sdLDL are significantly high in nephropathy patients with p values 0.026, 0.012, 0.014, 0.04 respectively. Estimated GFR has a significant positive correlation with TCHOL (r = −0.850, p = 0.01), TG (r = −0.14, p = 0.008), LDL (r = −0.62 p = 0.037). Estimated GFR has a significant negative correlation with S. urea (r = −0.587, p ≤ 0.01), S. creatinine (r = −0.59, p ≤ 0.01), UACR (r = −0.47, p ≤ 0.01). Dyslipidema sdLDL is significantly more in nephropathy group in comparison to diabetic group with p values 0.033, 0.045 respectively. Conclusion: Our study shows that dyslipidemia was highly prevalent among subjects with nephropathy. So cardiovascular risks can be averted by regular screening for dyslipidemia in diabetic nephropathy patients.