Partner's Perceived Social Support Influences Their Spouse's Inflammation: An Actor-Partner Analysis

Social support has been linked to lower cardiovascular morbidity and mortality. However, most studies have examined perceived support as an intrapersonal construct. A dyadic approach to social support highlights how interdependence between individuals within relationships, including partner perceptions and interactions, can influence one's health. This study's overall purpose was to test actor-partner models linking perceived social support to inflammation. Ninety-four cisgender married couples completed perceived support measures and had their blood drawn for CRP and IL-6 to produce an overall inflammatory index. The primary results indicate that only a partner's level of perceived support was related to lower inflammation in their spouse. Our sample size, although moderate for inflammatory studies, was probably not large enough to detect actor influences. These data highlight the importance of taking a dyadic perspective on modeling perceived support and its potential mechanism.

Ischemia-Modified Albumin: Origins and Clinical Implications

Albumin is one of the most abundant proteins in the body of mammals: about 40% of its pool is located in the intravascular space and the remainder is found in the interstitial space. The content of this multifunctional protein in blood is about 60-65% of total plasma proteins. A decrease in its synthesis or changes of functional activity can destabilize oncotic blood pressure, cause a violation of transporting hormones, fatty acids, metals, and drugs. Albumin properties change under ischemic attacks associated with oxidative stress, production of reactive oxygen species, and acidosis. Under these conditions, ischemia-modified albumin (IMA) is generated that has a reduced metal-binding capacity, especially for transition metals, such as copper, nickel, and cobalt. The method of determining the cobalt-binding capability of HSA was initially proposed to evaluate IMA level and then licensed as an ACB test for routine clinical analysis for myocardial ischemia. Subsequent studies have shown the viability of the ACB test in diagnosing other diseases associated with the development of oxidative stress. This review examines recent data on IMA generation mechanisms, describes principles, advantages, and limitations of methods for evaluation of IMA levels, and provides detailed analysis of its use in diagnostic and monitoring therapeutic efficacy in different diseases.

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

BACKGROUND

Ischemia-modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress and an independent predictor of major adverse cardiovascular events.

OBJECTIVES

To measure the levels of IMA in 45 children and adolescents with β-thalassemia major (β-TM) compared with 30 healthy controls and assess its relation to lipid peroxidation, vascular complications and subclinical atherosclerosis.

METHODS

β-TM patients without symptoms of heart disease were studied focusing on transfusion history, chelation therapy, serum ferritin, malondialdehyde (MDA) and IMA levels. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed.

RESULTS

IMA and MDA levels were significantly higher in β-TM patients compared with controls (p < 0.001). IMA was higher among patients with heart disease, pulmonary hypertension risk and serum ferritin ≥2500 µg/l than those without. TM patients compliant to chelation had significantly lower IMA levels. IMA levels were positively correlated to MDA and CIMT while negatively correlated to ejection fraction and fractional shortening.

CONCLUSION

Our results highlight the role of oxidative stress in the pathophysiology of vascular complications in thalassemia. IMA could be useful for screening of β-TM patients at risk of cardiopulmonary complications and atherosclerosis because its alteration occurs in early subclinical disease.

Diagnostic value of pleural effusion ischaemia-modified albumin in patients with cardiac failure

Background

Ischaemia-modified albumin (IMA) is a relatively new marker of ischaemia. IMA has not been studied previously in pleural effusions due to congestive heart failure (CHF). The aim of our study was to assess the diagnostic value of IMA in the pleural fluid (PF) and serum for the identification of pleural effusion due to CHF.

Methods

The concentrations of pleural fluid and serum IMA were measured in a total of 40 patients: 10 with CHF and 30 with non-cardiac failure (10 with acute pulmonary embolism, 10 with parapneumonic effusion and 10 with malignancy). The area under the curve (AUC) quantified the overall diagnostic accuracy of the tests.

Results

The study demonstrated that IMA concentration was higher in both pleural fluid and serum of CHF patients compared with non-cardiac patients. PF and serum IMA demonstrated AUCs of 0.927 (95% CI: 0.844–1.00, P < 0.001), and 0.792 (95% CI: 0.653–0.930, P = 0.006), respectively, for diagnosing effusions due to CHF. The sensitivity and specificity of PF-IMA for CHF at the cut-off concentration of ≥1.0 absorbance units was 90% and 80%, respectively. Its negative predictive value (NPV) was quite high (96%). Positive correlation was found between PF-IMA concentrations and serum-IMA ( r = 0.540, P < 0.001).

Conclusions

Measuring IMA concentrations in serum and pleural fluid may be helpful in distinguishing pleural effusion due to a cardiac or non-cardiac aetiology.