Sensitivity and specificity of ischaemia-modified albumin in detecting diabetic nephropathy

Abstract

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)-albumin-binding 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, low-density 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.

Keywords

• diabetic nephropathy
• ischemia-modified albumin
• type 2 diabetes mellitus