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Mangoni AA, Zinellu A. Ischemia-modified albumin in rheumatic diseases: A systematic review and meta-analysis. Immun Inflamm Dis 2024; 12:e1324. [PMID: 38888377 PMCID: PMC11184647 DOI: 10.1002/iid3.1324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/29/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION The identification of novel, easily measurable disease biomarkers might enhance the diagnosis and management of patients with rheumatic diseases (RDs). We conducted a systematic review and meta-analysis of ischemia-modified albumin (IMA), a marker of oxidative stress, acidosis, and ischemia, in RD patients and healthy controls. METHODS We searched PubMed, Web of Science, and Scopus from inception to January 15, 2024. The risk of bias and the certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. RESULTS In 20 studies investigating a total of 1188 RD patients (mean age 45 years, 64% females) and 981 healthy controls (mean age 44 years, 66% females), RD patients had significantly higher IMA concentrations when compared to controls (standard mean difference, SMD = 0.50, 95% CI: 0.18-0.83, p = .003; I2 = 92.4%, p < .001; low certainty of evidence). In subgroup analysis, the pooled SMD was significantly different in studies investigating ankylosing spondylitis (p < .001), Behçet's disease (p < .001), and rheumatoid arthritis (p = .033), but not familial Mediterranean fever (p = .48). Further associations were observed between the pooled SMD and the broad classification of autoimmune and/or autoinflammatory diseases, the study country, and the method used to measure IMA. CONCLUSION Our study suggests that IMA is a promising biomarker of oxidative stress, acidosis, and ischemia, as it can effectively discriminate between patients with different types of RDs and healthy controls. Our results warrant confirmation in longitudinal studies of patients with different types of RDs and different ethnicities (PROSPERO registration number: CRD42024509126).
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Affiliation(s)
- Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public HealthFlinders UniversityAdelaideAustralia
- Department of Clinical PharmacologyFlinders Medical Centre, Southern Adelaide Local Health NetworkAdelaideAustralia
| | - Angelo Zinellu
- Department of Biomedical SciencesUniversity of SassariSassariItaly
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Vukelić D, Baralić K, Marić Đ, Đukic-Ćosić D, Bulat Z, Panieri E, Saso L, Djordjevic AB. Hepato-renal toxicity of low dose metal(oid)s mixture in real-life risk simulation in rats: Effects on Nrf2/HO-1 signalling and redox status. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168352. [PMID: 37952665 DOI: 10.1016/j.scitotenv.2023.168352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023]
Abstract
The understanding that humans are exposed to a low level of toxic metals and metalloids in their lifetime has resulted in a shift in scientific and regulatory perspectives from the traditional evaluation of single metal toxicity to complex mixtures, relevant to real-life exposure. Therefore, the aim of this study was to examine the impact of real-life, 90-days exposure to mixture of toxic metal(oid)s, Cd, Pb, Ni, Cr, As and Hg, on the nuclear factor erythroid 2-related factor 2 and hemoxygenase-1 (Nrf2/HO-1) signalling and redox status by assessing total sulfhydryl groups (SH), glutathione (GSH), superoxide dismutase activity (SOD), malondialdehyde (MDA), and ischemia modified albumin (IMA) in the liver and kidney of Wistar rats. Animals (20 males and 20 females) were randomized in 2 control and 6 treated groups that received by oral gavage mixture of metal(oid)s solutions in doses that reflect blood metal(oid) levels determined in previous human biomonitoring study as benchmark dose (F/M _BMD), median (F/M _MED), and 95th percentile (F/M _95). Our results have shown that metal(oid)s mixture impaired the activation of the Nrf2/HO-1 pathway in the kidney and liver of male rats and kidney of female rats, followed by depletion of GSH levels in males. Additionally, in males elevated levels of IMA in the liver were observed, while in both genders increased MDA levels were observed in the kidney. Interestingly, the effects were more pronounced in male than in female rats. This study is among the first that examined hepato-renal toxic mechanisms of real-life metal mixture exposure, while our results might be of immense importance for assessing the risk of exposure to mixtures of toxic substances.
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Affiliation(s)
- Dragana Vukelić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia
| | - Katarina Baralić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia
| | - Đurđica Marić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia.
| | - Danijela Đukic-Ćosić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia
| | - Zorica Bulat
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia
| | - Emiliano Panieri
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, 00185 Rome, Italy; Department of General Direction (DG), Section of Hazardous Substances, Environmental Education and Training for the Technical Coordination of Management Activities (DGTEC), Italian Institute for the Environmental Protection and Research, Rome, Italy
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Aleksandra Buha Djordjevic
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221 Belgrade, Serbia
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Anđelković M, Djordjevic AB, Vukelić D, Đukić-Ćosić D, Aćimović M, Bojanić N, Bartolović D, Bulat P, Antonijević B, Bulat Z. Cadmium and lead implication in testis cancer; is there a connection? CHEMOSPHERE 2023; 330:138698. [PMID: 37062390 DOI: 10.1016/j.chemosphere.2023.138698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/14/2023]
Abstract
Testis cancer (TC) is the most common malignancy of young men. Current evidence from studies, alongside genetics and hormonal status, suggests a significant role of toxic metals, cadmium (Cd) and lead (Pb), in the origin and development of TC. Besides oxidative stress and endocrine disruption, interaction with bioelements is one of the critical mechanisms of Cd and Pb toxicity and malign transformation. This study aimed to investigate metal levels in blood, healthy, and tumor testis tissue and to reveal hormone, oxidative status, and bioelements levels in patients with TC. The study enrolled 52 patients with TC and 61 healthy volunteers. Toxic metals and bioelements levels were analyzed by atomic absorption spectrophotometry (AAS) while electrochemiluminescence immunoassay (ECLIA) and spectrophotometry methods were used for hormone and oxidative parameters evaluation. Significantly higher blood Cd levels were depicted in TC cohort. Furthermore, blood Cd elevation was associated with a 1.98 higher probability of TC developing. However, a metal concentration between healthy and tumor testis tissue did not differ significantly. Lower levels of estradiol and testosterone, established in a cohort of TC patients, followed the significant role of hormones in TC development. At the same time, ischemia-modified albumin (IMA) has been recognized as a parameter with very good accuracy as a potential diagnostic marker for TC. The study revealed different distribution patterns of copper (Cu) and zinc (Zn) in the three compartments of the patients, as well significant correlation between essential metals Cu/Zn and toxic metals Cd/Pb indicating metal-metal interactions as pivotal mechanisms of metals toxicity.
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Affiliation(s)
- Milena Anđelković
- University Hospital Medical Center Kosovska Mitrovica, Kosovska Mitrovica, Serbia; Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Aleksandra Buha Djordjevic
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Dragana Vukelić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia.
| | - Danijela Đukić-Ćosić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Miodrag Aćimović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Urology and Nephrology, Clinical Center of Serbia, Belgrade, Serbia
| | - Nebojša Bojanić
- Institute of Urology and Nephrology, Clinical Center of Serbia, Belgrade, Serbia
| | - Daniela Bartolović
- Institute of Urology and Nephrology, Clinical Center of Serbia, Belgrade, Serbia
| | - Petar Bulat
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Institute of Occupational Health "Dr Dragomir Karajović", Belgrade, Serbia
| | - Biljana Antonijević
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Zorica Bulat
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
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Ischemia-Modified Albumin: Origins and Clinical Implications. DISEASE MARKERS 2021; 2021:9945424. [PMID: 34336009 PMCID: PMC8315882 DOI: 10.1155/2021/9945424] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022]
Abstract
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.
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Savas HB, Etli M. Ischemia Modified Albumin as a Novel Biochemical Indicator in Peripheral Artery Patients. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2021. [DOI: 10.29333/jcei/10960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Babat N, Kaya Y, Demir H. Correlation IMA with TIMI frame count in slow coronary flow: can it be a guide for treatment? Aging Male 2020; 23:635-640. [PMID: 30739525 DOI: 10.1080/13685538.2018.1561842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AIM Coronary slow flow (CSF) is defined as late opacification in epicardial coronary arteries with no significant stenosis. The aim of this study is to evaluate the relationship between ischemia-modified albumin (IMA) by using Spectrophotometer in CSF. METHODS Level of IMA was measured by spectrophotometer. CSF patients were chosen for the determination of IMA level. All obtained data were compared with control groups. RESULTS Serum IMA levels increased in the CSF group. It was observed that there was a significant increase in IMA levels in patients with CSF when compared to controls (p < 0.05). CONCLUSION IMA may play a role in the pathogenesis of CSF. IMA levels in the serum can be considered as a marker to predict coronary slow flow. IMA level can be used as a guide for coronary slow flow. Also, as increases number square frame, value IMA Increases similarly. It was found that the severity of impotence was correlated with CSF. Therefore, the IMA level may be predictive of the course of treatment. This study is the first one to show the relationships of IMA in CSF. In addition, further studies should be performed on IMA in CSF patients.
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Affiliation(s)
- Naci Babat
- Department of Cardiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Yuksel Kaya
- Department of Cardiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Halit Demir
- Department of Cardiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
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Cakirca G, Guzelcicek A, Yilmaz K, Nas C. Increased ischemia-modified albumin levels in children with steroid-sensitive nephrotic syndrome. Pak J Med Sci 2020; 36:1490-1494. [PMID: 33235562 PMCID: PMC7674859 DOI: 10.12669/pjms.36.7.2924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: Growing evidence shows that oxidative stress plays an important role in the development and progression of nephrotic syndrome (NS). In this study, we aimed to examine serum IMA levels as an indicator of oxidative stress in children with steroid-sensitive NS (SSNS) in remission and relapse. Methods: This cross-sectional study was carried out at the Pediatric Nephrology Unit of Sanliurfa Training and Research Hospital, Sanliurfa, Turkey, from April 2019 to December 2019. In this study Serum IMA and albumin levels were determined in 70 children with SSNS and 45 healthy controls. Among the children with SSNS, 50 were in remission and 20 were in relapse. Then, adjusted IMA levels were calculated from the IMA/albumin ratio. Results: IMA and adjusted IMA levels significantly increased and albumin significantly decreased in children with SSNS in relapse and remission compared with those of the healthy controls. Moreover, these alterations were more prominent in the relapse group than in the remission group. IMA was inversely correlated with albumin in children with SSNS (r= −0.881, p= <0.001). Conclusions: Our findings demonstrated that elevated IMA and adjusted IMA levels observed in patients with SSNS were associated with increased oxidative stress and could indirectly reflect the degree of oxidative damage in glomerular structures.
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Affiliation(s)
- Gokhan Cakirca
- Gokhan Cakirca, Department of Biochemistry, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Ahmet Guzelcicek
- Ahmet Guzelcicek, Department of Pediatrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Kenan Yilmaz
- Kenan Yilmaz, Department of Pediatric Nephrology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Cemal Nas
- Cemal Nas, Department of Biochemistry, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
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Sezgin B, Kinci MF, Pirinççi F, Camuzcuoğlu A, Erel Ö, Neşelioğlu S, Camuzcuoğlu H. Thiol-disulfide status of patients with cervical cancer. J Obstet Gynaecol Res 2020; 46:2423-2429. [PMID: 32909381 DOI: 10.1111/jog.14480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/26/2020] [Accepted: 08/30/2020] [Indexed: 12/14/2022]
Abstract
AIM The evaluation of dynamic thiol-disulfide homeostasis among patients with the cancer of the uterine cervix. METHODS The study was conducted in 62 cervical cancer patients and 61 healthy women who had been followed up in an obstetrics and gynecology clinic between September 2018 and April 2020. Serum disulfide, native thiol, total thiol, ischemia modified-albumin, total antioxidant and oxidant capacities, and oxidative stress index values were measured in all participants. RESULTS The mean plasma disulfide levels of the cervical cancer group was statistically significantly higher than that of the control group (25.79 ± 6.90 μmol/L, 22.31 ± 6.11 μmol/L, respectively) (P = 0.004). Plasma native thiol and total thiol levels were lower in cervical cancer patients (299.27 ± 99.05 μmol/L and 350.86 ± 102.72 μmol/L, respectively) compared to controls, but no statistically significant difference was observed (318.00 ± 93.75 μmol/L and 376.44 ± 98.51 μmol/L, respectively) (P = 0.284, P = 0.161). With respect to the ischemia modified-albumin level, no statistically significant difference was observed between two groups. There were statistically significant positive association between disulfide level and both the stage of cervical cancer (r = 0.278, P = 0.029) and total oxidant capacity level (r = 0.256, P = 0.046). CONCLUSION Dynamic thiol-disulfide homeostasis may participate in the pathophysiological mechanisms of cervical cancer and may be a potential biomarker for early identification of cervical cancer in future.
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Affiliation(s)
- Burak Sezgin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mehmet F Kinci
- Department of Obstetrics and Gynecology, Mugla Sitki Kocman University Training and Research Hospital, Muğla, Turkey
| | - Fatih Pirinççi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Aysun Camuzcuoğlu
- Department of Obstetrics and Gynecology, Private Adatıp Sakarya Hospital, Sakarya, Turkey
| | - Özcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Salim Neşelioğlu
- Department of Clinical Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
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Evaluation of serum ischaemia-modified albumin levels in patients with Bell's palsy. The Journal of Laryngology & Otology 2019; 133:810-813. [PMID: 31434591 DOI: 10.1017/s0022215119001683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This prospective study aimed to evaluate the relationship between serum ischaemia-modified albumin levels and Bell's palsy severity. METHODS The study included 30 patients diagnosed with Bell's palsy and 30 healthy individuals. The patients were separated into three disease severity groups (grades 2, 3 and 4) according to House-Brackmann classification. Blood samples were collected from all participants and the results compared between groups. RESULTS Significant differences in serum ischaemia-modified albumin were found between the study and control groups (p < 0.001); values were significantly higher in the study group than in the control group. CONCLUSION The significantly higher levels of serum ischaemia-modified albumin in the study group suggest that Bell's palsy pathogenesis is associated with oxidative stress.
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ATAŞ H, GÖNÜL M, ÖZTÜRK Y, KAVUTÇU M. Ischemic modified albumin as a new biomarker in predicting oxidative stress in alopecia areata. Turk J Med Sci 2019; 49:129-138. [PMID: 30762322 PMCID: PMC7350867 DOI: 10.3906/sag-1708-35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background/aim Results show that oxidative stress is a pathophysiologic factor for alopecia areata (AA); however, the markers used can be confounding. Thus, we aimed to investigate the role of oxidative stress in the pathogenesis of AA through an evaluation of ischemia-modified albumin (IMA); other markers of the oxidant/antioxidant system, such as SOD, CAT, GSH-ST, and MDA; and contributing clinical risk factors. Materials and methods The usefulness of IMA as a new marker for oxidative stress was compared with that of other markers and evaluated in patients with AA. Results The mean serum level of IMA was of higher statistical significance in AA patients than in the control group (IMA: 0.57 ± 0.01 vs. 0.52 ± 0.02 ΔABSU, P < 0.0001). IMA (P = 0.03, OR = 25.8, 95% CI = 1.4–482.7) was found to be an independent predictor of oxidative stress in patients with AA. Increased severity of AA was found as an independent risk factor for IMA. Conclusion Long-lasting disease, male sex, >1 site of involvement of disease, and increased severity of disease were correlated with increased oxidation. Presence of AA, male sex, and severe disease were determined to be independent risk factors for antioxidant and oxidant systems. IMA has great potential as a biomarker of oxidative stress in AA when compared to other studied biomarkers.
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Affiliation(s)
- Hatice ATAŞ
- Department of Dermatology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Müzeyyen GÖNÜL
- Department of Dermatology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, AnkaraTurkey
| | - Yasin ÖZTÜRK
- Department of Biochemistry, Faculty of Science, Gazi University, AnkaraTurkey
| | - Mustafa KAVUTÇU
- Department of Biochemistry, Faculty of Science, Gazi University, AnkaraTurkey
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Du XF, Zhang LL, Zhang DZ, Yang L, Fan YY, Dong SP. Clinical significance of serum total oxidant/antioxidant status in patients with operable and advanced gastric cancer. Onco Targets Ther 2018; 11:6767-6775. [PMID: 30349309 PMCID: PMC6187998 DOI: 10.2147/ott.s153946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose Oxidative stress was significantly associated with the development of malignancies. The purpose of this study was to evaluate the significance of serum total oxidant/antioxidant status in operable advanced gastric cancer patients. Materials and methods A total of 284 patients who underwent curative resection for primary stage III gastric cancer were enrolled. Total oxidant status, total antioxidant status, and oxidative stress index (OSI) were evaluated within 24 hours before surgery, and compared with 120 healthy donors. The correlation between the OSI and survival outcome was analyzed by the Kaplan–Meier method with log-rank test and Cox’s regression methods, respectively. Results Mean OSI of gastric cancer patients was higher than healthy controls (1.41±0.96 vs 0.78±0.42, P<0.001). All patients were stratified into two groups using the optimal cutoff value (1.42) of OSI using a sensitivity of 94.1% and a specificity of 64.0% as optimal conditions from receiver operating curve analysis. Patients with an OSI ≥1.42 had poorer mean overall survival (45.6 vs 29.8 months, P=0.022) and mean recurrence-free survival (43.3 vs 28.1 months, P=0.011) than patients with an OSI <1.42 in univariate analysis, and OSI was also confirmed as an independent predictor for survival for gastric cancer in multivariate analysis (hazard ratio, 0.541; 95% CI: 0.127–1.102; P=0.01). Conclusion Preoperative OSI can be considered as an independent prognostic factor for operable and advanced gastric cancer.
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Affiliation(s)
- Xue-Fang Du
- Department of Gastroenterology, First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China,
| | - Li-Li Zhang
- Department of Gastroenterology, First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China,
| | - De-Zhong Zhang
- Gastrointestinal Surgery, The First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China
| | - Lu Yang
- Department of Gastroenterology, First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China,
| | - Ying-Ying Fan
- Department of Gastroenterology, First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China,
| | - Shu-Ping Dong
- Department of Gastroenterology, First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China,
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Gecit İ, Eryılmaz R, Kavak S, Meral İ, Demir H, Pirinççi N, Güneş M, Taken K. The Prolidase Activity, Oxidative Stress, and Nitric Oxide Levels of Bladder Tissues with or Without Tumor in Patients with Bladder Cancer. J Membr Biol 2017; 250:455-459. [PMID: 28815271 DOI: 10.1007/s00232-017-9971-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/18/2017] [Indexed: 10/19/2022]
Abstract
This study was designed to evaluate the malondialdehyde (MDA), glutathione (GSH) and nitric oxide (NO) levels, and also prolidase, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) enzyme activities in malignant and benign cancers of bladder tissue. A total of 59 patients admitted to our clinic due to microscopic or macroscopic haematuria, were prospectively included in the study. Because of some reasons (no request to participate in the study, the inability to reach, other malignancies, alcohol consumption, metabolic disease), eight patients were excluded from study. Of the 51 patients, 25 were bladder tumor patients, and 26 were patients without cancers. The bladder tissue samples were obtained from all patients under anesthesia (spinal, epidural or general) for the measurement of MDA, GSH and NO levels, and prolidase, GSH-Px and SOD enzyme activities. Among the patients with bladder cancers, 7 patients were females and 18 patients were males, with an average age of 68.4 ± 2.49. Among patients without tumors, 6 patients were females and 20 patients were males, with an average age of 58 ± 2.05. In patients with bladder tumors, the oxidants (MDA, NO, prolidase) were higher, and the antioxidants (SOD, GSH, GSH-Px) were lower than those in patients without tumors. It was concluded that the oxygen free radicals play a role in the etiology of bladder cancers similar to many other tumors and inflammatory conditions. Therefore, we assume that antioxidants may provide benefits in the prevention and treatment of bladder cancer.
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Affiliation(s)
- İlhan Gecit
- Department of Urology, Faculty of Medicine, İnonu University, Malatya, Turkey.
| | - Recep Eryılmaz
- Department of Urology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Servet Kavak
- Department of Biophysics, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İsmail Meral
- Department of Physiology, School of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Halit Demir
- Division of Biochemistry, Department of Chemistry, Faculty of Science, Yuzuncu Yil University, Van, Turkey
| | - Necip Pirinççi
- Department of Urology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Mustafa Güneş
- Department of Urology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Kerem Taken
- Department of Urology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Wang D, Feng JF, Yuan GY, Yang YH, Liu YS, Yang YW. Association between chromosomal aberration of exfoliated bladder cells in the urine and oxidative stress in patients with bladder transitional cell carcinoma. Oncol Lett 2017; 14:137-144. [PMID: 28693145 PMCID: PMC5494805 DOI: 10.3892/ol.2017.6128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 03/09/2017] [Indexed: 01/10/2023] Open
Abstract
The aim of the current study was to investigate the chromosomal aberrations of exfoliated bladder cells in the urine and blood oxidative stress in patients with bladder transitional cell carcinoma (BTCC). A total of 40 healthy controls and 246 patients with BTCC were recruited. Abnormal levels of CSP3, CSP7, CSP17 and GLPp16 were detected by fluorescence in situ hybridization (FISH) in exfoliated bladder cells in the urine of patients with BTCC. Serum total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were measured. Significant differences were observed in the abnormal CSP3, CSP7, CSP17, GLPp16 signals and FISH positive rate between patients with BTCC and healthy controls (P<0.001). Serum TOS, TAS and OSI were also significantly different between the two groups (P<0.001). The clinical stage of BTCC was not associated with abnormal CSP3, CSP7, CSP17, GLPp16 or FISH positive rate and oxidative stress (P>0.05). A Gamma rank correlation analysis revealed an association between the pathological grade of BTCC with abnormal CSP3, CSP7 and CSP17 as well as FISH positive rate (P<0.001). In addition, the clinical stage of BTCC was associated with serum TOS, TAS and OSI (P<0.001). Evaluation of the association between chromosomal aberrations and oxidative stress revealed that abnormal CSP3, CSP7 and CSP17 were positively associated with serum TOS and OSI (P<0.001), abnormal CSP7 and CSP17 were negatively associated with serum TAS (P<0.001), but abnormal GLPp16 was not associated with serum TOS, TAS or OSI (P>0.05). Therefore, the chromosomal aberrations of exfoliated bladder cells in the urine are associated with blood oxidative stress in patients with BTCC, and these factors may contribute to the occurrence and development of BTCC.
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Affiliation(s)
- Dong Wang
- Department of Oncology, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
| | - Jia-Fu Feng
- Department of Clinical Laboratory, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
| | - Guang-Ya Yuan
- Department of Urology, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
| | - Yong-Hong Yang
- Department of Pathology, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
| | - Yun-Shuang Liu
- Department of Clinical Laboratory, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
| | - Yu-Wei Yang
- Department of Clinical Laboratory, Mianyang Central Hospital, Affiliated to Southwest Medical University, Mianyang, Sichuan 621000, P.R. China
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14
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Ataş H, Kocabıyık M, Gönül M, Öztürk Y, Kavutçu M. Usefulness of ischemia-modified albumin in predicting oxidative stress in patients with vitiligo. Biomark Med 2017; 11:439-449. [DOI: 10.2217/bmm-2016-0259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate the emphasis of oxidative stress in the pathogenesis of vitiligo through an evaluation of ischemia-modified albumin (IMA). Results/methodology: IMA was of higher statistical significance in patients than in the control group (IMA: 0.57 ± 0.2 vs 0.52 ± 0.2 ΔABSU; p < 0.0001). IMA (p < 0.0001; OR: 8.9; 95% CI = 3.1–26.1) was found as an independent predictor of oxidative stress. Increases in affected body surface area and age were found to be independent risk factors for IMA. The sensitivity, specificity and positive and negative predictive values and capacity of IMA were higher than other studied biomarkers. Discussion/conclusion: IMA can be detected in the condition of oxidative stress in vitiligo; it has great potential as a biomarker of said condition, when compared with other studied biomarkers.
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Affiliation(s)
- Hatice Ataş
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Dermatology, Ankara, Turkey
| | - Murat Kocabıyık
- Gazi University, Faculty of Medicine, Biochemistry, Ankara, Turkey
| | - Müzeyyen Gönül
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Dermatology, Ankara, Turkey
| | - Yasin Öztürk
- Gazi University, Faculty of Medicine, Biochemistry, Ankara, Turkey
| | - Mustafa Kavutçu
- Gazi University, Faculty of Medicine, Biochemistry, Ankara, Turkey
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15
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Ece I, Ozturk B, Yilmaz H, Yormaz S, Şahin M. The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress: a prospective clinical trial. Ann Surg Treat Res 2017; 92:179-183. [PMID: 28382289 PMCID: PMC5378557 DOI: 10.4174/astr.2017.92.4.179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/07/2016] [Accepted: 10/24/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA). Methods In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation. Results Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different. Conclusion SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.
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Affiliation(s)
- Ilhan Ece
- Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Bahadir Ozturk
- Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Huseyin Yilmaz
- Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Serdar Yormaz
- Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Mustafa Şahin
- Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
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Sancak EB, Turkön H, Çukur S, Erimsah S, Akbas A, Gulpinar MT, Toman H, Sahin H, Uzun M. Major Ozonated Autohemotherapy Preconditioning Ameliorates Kidney Ischemia-Reperfusion Injury. Inflammation 2016; 39:209-217. [PMID: 26282390 DOI: 10.1007/s10753-015-0240-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Medical ozone has therapeutic properties as an antimicrobial, anti-inflammatory, modulator of antioxidant defense system. Major ozonated autohemotherapy (MOA) is a new therapeutic approach that is widely used in the treatment of many diseases. The objective of the present study was to determine whether preischemic application of MOA would attenuate renal ischemia-reperfusion injury (IRI) in rabbits. Twenty-four male New Zealand white rabbits were divided into four groups, each including six animals: (1) Sham-operated group, (2) Ozone group (the MOA group without IRI), (3) IR group (60 min ischemia followed by 24 h reperfusion), and (4) IR + MOA group (MOA group). The effects of MOA were examined by use of hematologic and biochemical parameters consisting of neutrophil to lymphocyte ratio (NLR), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), ischemia-modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI). In addition, the histopathological changes including the tubular brush border loss (TBBL), tubular cast (TC), tubular necrosis (TN), intertubular hemorrhage and congestion (IHC), dilatation of bowman space (DBS), and interstitial inflammatory cells infiltration (IECI) were evaluated. In the IR group, compared to the Sham group, biochemical parameters indicating oxidative stress, NLR, IL-6, TNF-α, IMA, TOS, and OSI have increased. MOA reduced inflammation and oxidative stress parameters. Although TAS values have decreased in the IR group and increased in the MOA-pretreated group, no significant changes in TAS values were detected between the IR and MOA groups. The total score was obtained by summing all the scores from morphological kidney damage markers. The total score has increased with IR damage when compared with the Sham group (13.83 ± 4.30 vs 1.51 ± 1.71; p = 0.002). But, the total score has decreased significantly after application of MOA (5.01 ± 1.49; p = 0.002; compared with the IR group). MOA preconditioning is effective in reducing tissue damage induced in kidney ischemia-reperfusion injury. The protective effect of MOA is mediated via reducing inflammatory response and regulating of reactive oxygen species (ROS). Renal histology also showed convincing evidence regarding MOA's protective nature against kidney injury induced renal ischemia-reperfusion. Consequently, MOA might be helpful in protecting the kidneys from IR-induced damage in humans, probably through the anti-inflammatory effect and reducing the total oxidant status.
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Affiliation(s)
- Eyup Burak Sancak
- Department of Urology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey. .,Canakkale Onsekiz Mart Universitesi, Terzioglu Yerleskesi, Barbaros Mh, 17100, Canakkale, Turkey.
| | - Hakan Turkön
- Department of Biochemistry, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Selma Çukur
- Department of Pathology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Sevilay Erimsah
- Department of Histology and Embryology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Alpaslan Akbas
- Department of Urology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Murat Tolga Gulpinar
- Department of Urology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Huseyin Toman
- Department of Anesthesiology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Hasan Sahin
- Department of Anesthesiology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Metehan Uzun
- Department of Physiology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
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17
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Sancak EB, Akbas A, Silan C, Cakir DU, Turkon H, Ozkanli SS. Protective effect of syringic acid on kidney ischemia-reperfusion injury. Ren Fail 2016; 38:629-35. [DOI: 10.3109/0886022x.2016.1149868] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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18
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Ashok Kumar P, Anand U. Multiple Biomarkers to Assess the Pathophysiological State in Critically Ill Patients with Sepsis. Indian J Clin Biochem 2015; 31:310-4. [PMID: 27382202 DOI: 10.1007/s12291-015-0525-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/10/2015] [Indexed: 01/09/2023]
Abstract
Sepsis is associated with various metabolic derangements as a consequence of inflammatory response, ischemia and oxidative stress. Four parameters of relevance are procalcitonin (PCT), ischemia modified albumin (IMA) pH and lactate. The study was carried out to highlight the concomitant occurrence of sepsis, ischemia and lactic acidosis, all of which could have deleterious effects on organ function. 26 critically ill patients with a provisional diagnosis of sepsis were the test subjects. The control group had 25 apparently healthy volunteers. PCT, lactate and IMA were assayed. PCT was estimated on an automated analyser using electro-chemiluminescence. Lactate and pH were estimated on a blood gas analyzer. Serum IMA was estimated spectrophotometrically by Albumin Cobalt Binding Test. Statistical tools like students 't' test and Venn diagram were employed to depict the outcome of the study. All critically ill patients had significantly higher IMA levels (0.96746 ± 0.73407) as compared to the control group (0.00728 ± 0.00895) with a p value of <0.0001. The Venn diagram was used to depict the finding that all 26 test subjects had elevated levels of IMA, of which PCT was elevated in 22 and lactate in 20. Both PCT and lactate were abnormal in 17 patients. The most significant observation was that all critically ill patients, irrespective of the presence of sepsis or lactic acidosis had elevated levels of IMA which is clearly indicative of the ubiquitous presence of oxidative stress. The Venn diagram is an elegant representation of the concurrent multiple pathophysiological processes which occur in critically ill patients.
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Affiliation(s)
- Prashanth Ashok Kumar
- PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, 641004 India ; No 20 A/10, Gopalakrishnan Street, Indira Devi Apartments, T.Nagar, Chennai, 600017 India
| | - Usha Anand
- Department of Biochemistry, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, 641004 India ; Department of Biochemistry, Anand Diagnostic Laboratory, Bangalore, 560001 India
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Pereira CD, Minamino N, Takao T. Free Thiol of Transthyretin in Human Plasma Most Accessible to Modification/Oxidation. Anal Chem 2015; 87:10785-91. [DOI: 10.1021/acs.analchem.5b03431] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
| | - Naoto Minamino
- National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Toshifumi Takao
- Institute
for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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20
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Phaniendra A, Jestadi DB, Periyasamy L. Free radicals: properties, sources, targets, and their implication in various diseases. Indian J Clin Biochem 2015; 30:11-26. [PMID: 25646037 PMCID: PMC4310837 DOI: 10.1007/s12291-014-0446-0] [Citation(s) in RCA: 1232] [Impact Index Per Article: 136.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 05/14/2014] [Indexed: 02/07/2023]
Abstract
Free radicals and other oxidants have gained importance in the field of biology due to their central role in various physiological conditions as well as their implication in a diverse range of diseases. The free radicals, both the reactive oxygen species (ROS) and reactive nitrogen species (RNS), are derived from both endogenous sources (mitochondria, peroxisomes, endoplasmic reticulum, phagocytic cells etc.) and exogenous sources (pollution, alcohol, tobacco smoke, heavy metals, transition metals, industrial solvents, pesticides, certain drugs like halothane, paracetamol, and radiation). Free radicals can adversely affect various important classes of biological molecules such as nucleic acids, lipids, and proteins, thereby altering the normal redox status leading to increased oxidative stress. The free radicals induced oxidative stress has been reported to be involved in several diseased conditions such as diabetes mellitus, neurodegenerative disorders (Parkinson's disease-PD, Alzheimer's disease-AD and Multiple sclerosis-MS), cardiovascular diseases (atherosclerosis and hypertension), respiratory diseases (asthma), cataract development, rheumatoid arthritis and in various cancers (colorectal, prostate, breast, lung, bladder cancers). This review deals with chemistry, formation and sources, and molecular targets of free radicals and it provides a brief overview on the pathogenesis of various diseased conditions caused by ROS/RNS.
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Affiliation(s)
- Alugoju Phaniendra
- Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, 605 014 India
| | - Dinesh Babu Jestadi
- Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, 605 014 India
| | - Latha Periyasamy
- Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, 605 014 India
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Ellidag HY, Aydin O, Eren E, Yilmaz N, Ergin M. Decreased HDL-Dependent Paraoxonase and Arylesterase Enzyme Activity May Indicate a Worse Prognosis in Multiple Myeloma. Asian Pac J Cancer Prev 2014; 15:9847-51. [DOI: 10.7314/apjcp.2014.15.22.9847] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Ellidag HY, Eren E, Yılmaz N, Cekin Y. Oxidative stress and ischemia-modified albumin in chronic ischemic heart failure. Redox Rep 2014; 19:118-23. [PMID: 24620936 DOI: 10.1179/1351000213y.0000000083] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES Knowledge about the role of oxidative stress in human diseases, including cardiovascular system disorders, emphasizes the need for reliable markers of oxidative stress. Here, we evaluated the levels of the novel marker ischemia-modified albumin (IMA), albumin-adjusted IMA (adj-IMA), and the IMA/serum albumin ratio (IMAR) in patients with chronic ischemic heart failure (CIHF). METHODS A total of 55 patients with CIHF and 40 age- and sex-matched healthy individuals were included in the study. Serum levels of IMA, total antioxidant status, and total oxidant status were analyzed, and the adj-IMA level, IMAR, and oxidative stress index were calculated. RESULTS Serum IMA, IMAR, total oxidant status levels, and oxidative stress index were significantly higher in patients with CIHF than in the controls (all P < 0.0001), whereas albumin and total antioxidant status levels were significantly lower in the CIHF patients (P < 0.0001 and P = 0.0004, respectively). However, there was no significant difference in serum adj-IMA levels between the groups (P = 0.8). DISCUSSION We observed impaired oxidant/antioxidant status in favor of oxidative stress in CIHF patients. Oxidative stress may be a key factor in the development of hypoalbuminemia in CIHF. Further studies are needed to establish the relationships among IMA, albumin, and redox balance in CIHF.
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