Serum ischemia-modified albumin and oxidized LDL in cord blood and serum of neonates born to pre-eclamptic mothers.

BACKGROUND: We investigated oxidized low-density lipoprotein (OxLDL) and ischemia-modified albumin (IMA) in cord blood and neonatal blood of 7-day-old neonates born to pre-eclamptic and normotensive healthy mothers. METHODS: The study was performed on 30 neonates born to pre-eclamptic and 20 neonates born to normotensive mothers. IMA and OxLDL were determined on spectrophotometry and ELISA, respectively. RESULTS: IMA in cord blood was higher in the pre-eclamptic group as compared with the normotensive group, but the difference between the groups was not significant. IMA in neonate venous blood was significantly higher in the pre-eclamptic group than in the normotensive group (P < 0.001). OxLDL in both cord blood and in neonate venous blood was significantly higher in the pre-eclamptic group compared with the normotensive group (P < 0.001). IMA and OxLDL were significantly decreased after delivery in both groups. CONCLUSIONS: Significantly increased cord blood OxLDL and significantly increased OxLDL and IMA 7 days after birth in neonates born to pre-eclamptic mothers might be an indicator of increased oxidative stress in pre-eclampsia.

Total antioxidant and total oxidant states, and serum paraoxonase-1 in neonatal sepsis.

BACKGROUND: Paraoxonase-1 (PON-1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high-density lipoprotein (HDL). The aim of this study was to evaluate PON-1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON-1 in neonatal sepsis treatment. METHODS: A total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON-1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated. RESULTS: In the neonatal sepsis patients, pre-treatment TAS, TOS and OSI were significantly higher than the post-treatment levels (P < 0.0001, P < 0.0001 and P < 0.0001, respectively), and PON-1 was significantly lower (P < 0.0001). Similarly, pre-treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) and PON-1 was significantly lower (P < 0.0001). Post-treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post-treatment TOS, OSI and PON-1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively). CONCLUSION: Low serum PON-1 was found in neonatal sepsis. Serum PON-1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.

Increased ischaemia-modified albumin is associated with inflammation in acute rheumatic fever.

INTRODUCTION: Ischaemia-modified albumin, a novel biochemical marker for tissue ischaemia, was found to be associated with oxidative stress. The purpose of this study was to assess the role of ischaemia-modified albumin in the diagnosis of acute rheumatic fever and also to evaluate the ischaemia-modified albumin levels in children with heart valve disease. METHODS: The study groups, aged 5-18 years, consisted of 128 individuals - 40 with acute rheumatic fever, 35 with congenital heart valve disease, 33 with chronic rheumatic heart disease, and 20 healthy control subjects. RESULTS: The ischaemia-modified albumin, erythrocyte sedimentation rate, and C-reactive protein levels of the acute rheumatic fever group were significantly higher than those in the chronic rheumatic heart disease, congenital heart valve disease, and control groups, separately (p < 0.001). The ischaemia-modified albumin levels in both carditis and isolated arthritis subgroups of children with acute rheumatic fever were significantly higher than in the control group (p < 0.001, p < 0.01, respectively). However, there was no statistically significant difference between the chorea subgroup and control subjects. In addition, significant correlations were observed between ischaemia-modified albumin and acute phase reactants of patients with acute rheumatic fever (p < 0.001 for both erythrocyte sedimentation rate and C-reactive protein). The ischaemia-modified albumin levels of chronic rheumatic heart disease, congenital heart valve disease, and control subjects were similar. CONCLUSIONS: The increased level of ischaemia-modified albumin in children with acute rheumatic fever seems to be associated with inflammation. However, further studies are needed to provide stronger evidence.

Investigation of oxidative stress markers in essential hypertension.

BACKGROUND: The main goal of this study was to evaluate ischemia modified albumin (IMA), total antioxidant status (TAS), and total oxidant status (TOS) levels in treated essential hypertensive patients and to compare them with levels of normotensive subjects. METHODS: In 45 hypertensive and 30 control subjects, serum levels of IMA were determined manually using a spectrophotometric Co(II)-albumin binding assay. TAS and TOS levels were evaluated spectrophotometrically. Lipid profile was estimated by routine methods. RESULTS: Hypertensive patients had significantly higher levels of TOS and IMA (p = 0.020 and p = 0.034, respectively) and lower levels of TAS (p = 0.016) in comparison with control subjects. Serum levels of TAS were negatively correlated with TOS and IMA levels in the patient group. Serum levels of TOS were also positively correlated with IMA levels. There was no significant correlation between blood pressure and TAS, TOS, and IMA levels. CONCLUSIONS: Our results showed higher levels of IMA in hypertensive patients. We suggest that higher levels of IMA may result from increased oxidative stress and decreased antioxidant status in hypertensive patients.

Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke.

OBJECTIVE: To investigate diagnostic value of ischemia-modified albumin (IMA) levels in patients applying to emergency with symptoms of acute coronary syndrome (ACS) and acute ischemic stroke (AIS). METHODS: Two patient groups (ACS and AIS) and a control group were constituted. The study was discontinued upon reaching 30 patients in each group. Following patient approval at the initial visit, a total of 10 ml venous blood sample was obtained from all patients with a high clinical suspicion of ACS and AIS. The Troponin I and the IMA levels were determined in the blood samples. RESULTS: Statistically significant higher IMA values were determined in the patient groups compared to the control group (p<0.001 for both groups). No statistically significant correlation was found between the IMA and the Troponin I values in the ACS and the AIS groups (p>0.05 for both groups). The sensitivity of IMA was 83% and 87% for ACS and AIS, respectively. The specificity of IMA was 90% and 87% for ACS and AIS, respectively. CONCLUSION: The sensitivity and specificity values, determined according to the optimal cut-off values in the groups demonstrated that IMA could be a useful diagnostic marker in ACS and AIS patients.

Serum intestinal fatty acid binding protein and phosphate levels in the diagnosis of acute intestinal ischemia: an experimental study in rabbits.

BACKGROUND: Acute intestinal ischemia is a serious clinical disorder with mesenteric infarction, which has high mortality. It is important to establish a biochemical marker for the early diagnosis of acute intestinal ischemia. OBJECTIVES: The aim of this experimental study was to assess the changes in the serum levels of intestinal fatty acid binding protein (IFABP) and phosphate by time using the acute intestinal ischemia model in rabbits. METHODS: In this study, 21 New Zealand rabbits were randomly divided into three groups. Blood samples were obtained at 0, 1, 3, and 6 h in the control group. Blood samples were obtained at 0, 1, 3, and 6 h in the sham group after simple laparotomy. Blood samples were obtained at the same hours in the ischemia group after simple laparotomy and ligation of the superior mesenteric artery. RESULTS: There was no significant difference between the control, the sham, and the ischemia groups in terms of serum IFABP levels at any time (p > 0.05). Serum phosphate levels significantly increased in the ischemia group (p < 0.001). Studies on IFABP have begun emerging in the literature, and there is no standard approach for the technique to measure the IFABP level. No studies on IFABP were found in the literature on rabbits. CONCLUSION: Based on our results, the role that IFABP levels play in the diagnosis of acute intestinal ischemia is unclear at this time. Serum phosphate levels continued to rise as the duration of ischemia was prolonged. These findings support the suggestion that serum phosphate levels are valuable for the diagnosis of acute intestinal ischemia.

Effect of chronic regular exercise on serum ischemia-modified albumin levels and oxidative stress in type 2 diabetes mellitus.

Objectives. Our aim was to determine the effect of chronic regular exercise on ischemia-modified albumin (IMA) levels and oxidative stress in type 2 diabetes mellitus (DM). Design and methods. Sixty patients with type 2 DM were randomly divided into two groups as exercise (17 M, 13 F) and non-exercise (12 M, 18 F) groups, each consisting of 30 patients. The exercise group underwent a 3-month aerobic regular exercise consisting of moderate-intensity power walking. The non-exercise subjects remained sedentary throughout the study period. Serum total antioxidant status (TAS), total oxidant status (TOS), and IMA levels of the groups were determined at baseline and 3 months later. Results. There was no significant change in TOS and IMA levels of exercise group but TAS levels were significantly increased (p < 0.05). Also, postexercise systolic (p < 0.001) and diastolic (p < 0.05) blood pressures of the exercise group were significantly lower than the baseline values. In addition, there was no significant change in TAS and TOS levels of the non-exercise group; however, IMA levels were significantly increased (p < 0.01). Conclusion. We have shown, for the first time, that exercise prevents increase in IMA levels in type 2 DM which might have resulted from increased levels of TAS and reduces the risk of ischemia in these patients. These findings show that chronic exercise is beneficial in the prevention of oxidative stress in patients with type 2 DM as documented by decreased IMA levels.

Plasma fatty acid composition in continuous ambulatory peritoneal dialysis patients: an increased omega-6/omega-3 ratio and deficiency of essential fatty acids.

Patients with end-stage renal disease, including those treated with peritoneal dialysis, have a high risk for death, particularly from cardiovascular causes. Plasma fatty acid (FA) composition is used as an indicator of disease risk, because its alteration has been related to metabolic disease and cardiovascular disease. For this purpose, we have measured plasma FA composition in continuous ambulatory peritoneal dialysis (CAPD) patients and compared them with those of healthy subjects. This study was performed on 51 (21 M, 30 F) CAPD patients at least 6 months under dialysis, aged 20-75 years (mean 47.81 ± 11.8 years) and 45 (25 M, 20 F) healthy control subjects aged 20-60 years (mean 38.62 ± 12.9 years). Plasma 10-cis-pentadecanoic acid, 10-cis-heptadecanoic acid, heneicosanoic acid, tricosanoic acid, nervonic acid, saturated fatty acid, and monounsaturated FA levels and delta 9 desaturase activity were significantly higher whereas linoleic acid, linolenic acid, 11,14-eicosedienoic acid, arachidonic acid, docosahexaenoic acid, and omega-3 FA levels were significantly lower in the CAPD group than those in the healthy group. Our results show that there are FA abnormalities and especially a depletion in essential FA levels and a high level of omega-6/omega-3 ratio in CAPD patients, the underlying mechanism of which is not known and needs to be investigated. Therefore, we believe that essential FA supplementation should be encouraged for CAPD patients.

Ischemia-modified albumin levels in patients with end-stage renal disease patients on hemodialysis: does albumin analysis method affect albumin-adjusted ischemia-modified albumin levels?

Ischemia-Modified albumin (IMA) has been used as an early marker in the evaluation of the patients with acute coronary syndrome. We aimed to evaluate IMA in end-stage renal disease (ESRD) patients on hemodialysis and the effect of albumin methods on albumin-adjusted IMA levels. A total of 30 ESRD patients were included in this study. Serum IMA and albumin levels were measured before and after a hemodialysis session. Albumin concentrations were determined with bromocresol green and bromocresol purple methods. Postdialysis IMA and albumin-adjusted IMA levels with two different albumin methods were significantly increased compared with the predialysis levels (P<0.05). However, we did not find any difference in albumin-adjusted IMA levels in either at the beginning or at the end of the dialysis session. IMA levels increase after hemodialysis, whereas albumin method has no effect on albumin-adjusted IMA levels.

Beneficial effects of levosimendan on cerebral vasospasm induced by subarachnoid haemorrhage: an experimental study.

BACKGROUND: The aim of this study was to investigate the ability of levosimendan to prevent cerebral vasospasm in a rabbit model of subarachnoid haemorrhage (SAH). ANIMALS AND METHODS: Eighteen New Zealand white rabbits were allocated into three groups randomly. SAH was induced by injecting autologous blood into the cisterna magna. (Group 1 = control:sham surgery group, Group 2 = SAH alone group, Group 3 = SAH plus levosimendan group). Histopathological examination was performed on day 3 as described. Intravenous levosimendan dose (initially 12 microg kg(-1) infusion, continuously for at least 10 minutes and then continued with a dose of 0.2 microg kg(-1) min(-1)) treatment was started after the induction of SAH. Three days later, the animals were sacrificed. RESULTS: In pathological investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between all groups (p < 0.005). Malondialdehyde level was also found significantly low in the levosimendan group compared with the SAH group. CONCLUSION: Intravenous levosimendan treatment was found effective by increasing the pathological luminal area and reducing muscular wall thickness measurements. This is the first study to show that intravenous administration of levosimendan is effective in preventing cerebral vasospasm induced by SAH in rabbits.

Effect of preoperative atorvastatin therapy on paraoxonase activity and oxidative stress after coronary artery bypass grafting.

The aim of this study was to examine the influence of preoperative atorvastatin therapy on oxidative stress in coronary artery bypass grafting (CABG) patients. Forty patients who underwent elective CABG were enrolled into the study. Of these patients, 20 received atorvastatin (Group I) for 15 days prior to surgery and 20 patients did not use any antihyperlipidemic agents preoperatively (Group II). Serum paraoxonase 1 (PON1) and arylesterase activities, and total antioxidant status (TAS) and total oxidant status (TOS) were measured before surgery and at 1, 6 and 24 hours after the operation. Paraoxonase 1 and arylesterase activities (p<0.001) and TAS levels (p<0.001 for 1(st) hour and p<0.05 for 6(th) hour) in Group II were significantly reduced at the 1( st) and 6(th) hours after the operation, whereas the activities of the enzymes (p<0.01) and TAS levels (p<0.05) were significantly reduced only at the 1(st) hour after the operation in Group I. The total oxidant status of both groups was significantly increased at the 1( st) hour after operation (p<0.05 for Group I and p<0.01 for Group II). In conclusion, 15 days of preoperative atorvastatin therapy does not significantly change either the serum PON1 activity or the oxidative stress after CABG.

Homocysteine levels and total antioxidant capacity in children with acute rheumatic fever.

OBJECTIVE: The aim of the study was to investigate total antioxidant capacity (TAC) and homocysteine levels in children with acute rheumatic fever (ARF). DESIGN AND METHODS: Nineteen patients with ARF and twenty healthy children, age- and sex-matched were included in the study. Follow-up studies were made at the 7(th), 14(th), 21(st) and 28(th) day of diagnosis. RESULTS: Children with ARF had significantly higher serum homocysteine levels and lower TAC than the same parameters of the controls at all measurements. Following the anti-inflammatory therapy, we found a progressive increase in TAC and a decrease in homocysteine levels of the patients. CONCLUSION: We concluded that increased serum homocysteine levels and decreased serum TAC of the patients with ARF can be considered as a sign of increased inflammation and oxidative stress in these patients which needs to be considered during therapy. Further studies are needed to understand the underlying mechanisms of these findings.

Effect of diet oils on lipid levels of the brain of rats.

The effects of sunflower oil, olive oil, margarine, soybean oil and butter on cholesterol and triglyceride levels were investigated in the brain of rats. Rats were fed with a diet containing 15% of the oils for a period of 8 weeks. The rats were then decapitated, brain samples were removed, homogenized and cholesterol and TG levels were measured. Brain cholesterol and Triglycerides levels of all animals receiving different oils were significantly higher according to the contol except TG level of animals receiving margarine. Brain cholesterol levels of the vegetable oils were statistically higher than those receiving saturated oil. Thus, cholesterol level of the rats fed with olive oil group was significantly higher than that of the other groups but those receiving sunflower oil group and Triglycerides level of the animals receiving olive oil was significantly higher than that of the other groups except animal supplemented with soybean oil. Thus, it is concluded that brain lipid levels of rats are differently effected by various oils and mechanism of which needs to be investigated.

Lipoprotein-associated phospholipase-A2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke.

BACKGROUND: The study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. METHODS: The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA2 was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates. RESULTS: In all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA2 enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 ± 13.8, 31.4 ± 13.6, and 41.4 ± 8.1 nmol min-1·mL-1, respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95%CI: 0.722-0.929), sensitivity was 71% for an optimal Lp-PLA2 cut-off value of 31.4 nmol min-1·mL-1, and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95%CI: 0.652-0.884), sensitivity was 75% for an optimal Lp-PLA2 cut-off value of 38.1 nmol min-1·mL-1, and specificity was 74%. CONCLUSIONS: Lp-PLA2 enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA2 enzyme activity can be used for diagnostic purposes.

Investigation of oxidative stress and some antioxidants in patients with acute and chronic viral hepatitis B and the effect of interferon-alpha treatment.

OBJECTIVE: The aim of the study was to determine oxidative stress in patients with acute and chronic viral hepatitis B. DESIGN AND METHODS: 23 (11 F, 12 M) healthy controls, 23 (8 F, 15 M) patients with acute viral hepatitis B (AVHB) and 25 (9 F, 16 M) patients with chronic viral hepatitis B (CVHB) were studied. Serum malondialdehyde (MDA), conjugated dienes (CD), ALT, AST, total and direct bilirubins, beta-carotene and whole blood reduced glutathione (GSH) levels of all subjects were measured. In patients with CVHB, these parameters were measured both before and 6 months after treatment with interferon-alpha (IFN-alpha). RESULTS: MDA, CD, ALT, AST and total and direct bilirubin levels of the patients with AVHB and CVHB before treatment were significantly higher (P<0.001) whereas GSH and beta-carotene levels were lower (P<0.001) than those of the controls. MDA, CD, GSH, beta-carotene, ALT, AST and total and direct bilirubin levels of the patients with CVHB returned approximately to normal levels 6 months after treatment with IFN-alpha. CONCLUSION: Our results clearly show that patients with AVHB and CVHB are under the influence of increased oxidative stress (MDA and CD were increased) associated with lower levels of some antioxidants (beta-carotene and GSH). These impairments return to normal levels after IFN-alpha treatment of CVHB patients. These findings suggest that antioxidant supplementation might be considered in patients with acute or chronic hepatitis B.

The determination of histopathological and biochemical effects of the rabbit knee joint injected dexketoprofen trometamol.

This study was conducted to investigate possible histopathological effects and biochemical reflections of intra-articular dexketoprofen trometamol. A total of 24 New Zealand rabbits were included in the study. Blood sampling was carried out from all animals on the first day, then they were randomly allocated either to the control group (Group C, n = 9) or the dexketoprofen trometamol group (Group D, n = 15). Group C underwent each two intra-articular injections of saline, 0.25 mL into right and 0.50 mL into left knee. Group D was injected 0.25 mL (6.25 mg) dexketoprofen trometamol into the right knee and 0.50 mL (12.5 mg) into the left. The groups were divided randomly into three. Tissue and blood samples were collected from Groups C1 and D1 on the first day, C2 and D2 on the second day and C3 and D3 on the 10th day of the study. Interleukin-1 (IL-1ß), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) levels were studied. The histopathological examination of C and D groups did not present any deterioration. IL-6 basal levels were significantly higher in Group D2 compared with C2 and C3 compared with D3. Basal TNF-α levels were higher compared with day 1 in Group C1, and IL-6 and CRP levels were higher in Group D3. Also, none of the increases in these values are supported by histopathological evaluation results. Consequently, we suppose that dexketoprofen trometamol does not cause histopathological deterioration in articular cartilage of rabbits, and the increases in biochemical parameters exclusively are not clinically significant.

Investigation of effects of levobupivacaine injection to rabbit knee joint on histopathologic changes of joint cartilage tissue and changes of serum biochemical parameters.

The aim of this study is to evaluate the effects of intra-articular levobupivacaine on rabbit knee articular cartilage and certain biochemical parameters in the blood. A total of 24 New Zealand rabbits were included to study. Blood sampling was carried out in all animals on the first day, then the subjects were randomly allocated either to the control group (Group C, n = 9) or to the levobupivacaine group (Group L, n = 15). Group C underwent each two intra-articular injections of saline, 0.25 mL into the right knee and 0.50 mL into the left one. Group L was injected 0.25 mL (1.25 mg) of levobupivacaine into the right knee and 0.50 mL (2.5 mg) into the left one. The groups were divided randomly into three. Tissue and blood samples for histologic and biochemical examination were collected from Groups C1 and L1 on the first, C2 and L2 on the second, and C3 and L3 on the tenth day of the study. Interleukin-1ß (IL-1 ß), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) levels were analyzed. No statistically significant differences could be detected when comparing either left or right joints within the same groups and with Group C and L (P > 0.05). Significant elevations of biochemical parameters were found in Group C. It is concluded that levobupivacaine does not lead to significant histologic changes in rabbit articular cartilage. Significant elevations of biochemical parameters being generally found in the C Group, it is thought that such elevations are not linked to levobupivacaine. Intra-articular levobupivacaine may be a safe alternative for use in post-operative analgesia.

Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis.

Sepsis is one of the most common infectious conditions in the neonatal period, and continues as a major source of morbidity and mortality. The aim of this study is to determine serum ischemia-modified albumin (IMA) levels in late-onset neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow-up. Also, it is aimed to compare serum IMA levels with serum C-reactive protein (CRP), procalcitonin (PCT) levels and white blood cell count. The study was performed on 33 premature babies with sepsis and 21 healthy premature controls at 7-28 days of age. In the sepsis group, biochemical parameters and blood culture samples were obtained from the blood at the onset and on the fifth day of treatment for each patient. Serum IMA, CRP, PCT and white blood cell count were significantly higher in the sepsis group before treatment when compared with the control group. In addition, the levels of IMA were positively correlated with white blood cell count, CRP and PCT in the sepsis group before treatment. In conclusion, serum IMA levels may be useful in late-onset neonatal sepsis at the time of diagnosis and after therapy. As far as we know this is the first report about the assesment of illness diagnosis and after therapy using serum IMA levels, and further studies are needed to confirm our results in larger groups of patients.

The relationship between the antioxidant system, oxidative stress and dialysis-related amyloidosis in hemodialysis patients.

End-stage renal disease (ESRD) is associated with several complications that are partly due to excess amounts of reactive oxygen species and/or decreased antioxidant activity. Dialysis-related amyloidosis (DRA) has also been linked to increased oxidative stress. The aim of this study was to investigate the relationships between the antioxidant system, including superoxide dismutase (SOD), malonyldialdehyde (MDA), various biochemical parameters and shoulder amyloidosis, in hemodialysis patients. We studied 107 non-diabetic chronic dialysis patients. The SOD levels correlated with right and left biceps tendon thickness (r = -0.219, P = 0.048 and r = -0.236, P = 0.031, respectively), MDA (r = -0.429, P = 0.000) and albumin levels (r = -0.319, P = 0.001). MDA levels correlated with right and left biceps thickness (r = 0.291, P = 0.006 and r = 0.337, P = 0.001, respectively) and ß2 microglobulin levels (r = 0.455, P = 0.000). We also identified the statistically significant relationships between MDA levels and supraspinatus tendon thickening (greater than 7 mm) and right and left biceps tendon thickness (P = 0.022, P = 0.040 and P = 0.005, respectively). Our data suggest the complex relationship between antioxidants and oxidative stress and further support the roles of oxidative stress and antioxidants in DRA.

Obesity is an independent determinant of ischemia-modified albumin.

OBJECTIVE: We have measured ischemia-modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS) and high-sensitivity C-reactive protein (hsCRP) levels in obese and normal-weight subjects to investigate if IMA can be used as a biomarker of oxidative stress and inflammation and if IMA was an independent determinant of obesity or not. METHODS: The study was performed on 92 obese subjects (20 male, 72 female) aged 38 ± 11 years and 78 normal-weight controls (19 male, 59 female) aged 37 ± 11 years. Serum lipids, IMA, TAS, TOS, and hsCRP levels of the subjects were measured. RESULTS: IMA (p < 0.05), TOS (p < 0.001), and hsCRP (p < 0.001) levels of the obese subjects were significantly higher, whereas TAS levels were significantly lower (p < 0.05) than those of the controls after adjustment for age and gender. In the linear regression analysis, waist circumference (r² = 0.139, p < 0.01), BMI (r² = 0.136, p < 0.01) and insulin (r² = 0.120, p < 0.05) were shown to be significant independent determinants of IMA levels. CONCLUSIONS: We have found that oxidative stress and inflammation were increased and antioxidative defense was decreased, which resulted in increased levels of IMA, a biomarker of ischemia, in obese subjects. Also, obesity and insulin were found to be independent determinants of IMA. Thus, obese subjects are under high risk of ischemia, and IMA may be used as a biomarker of oxidative stress and ischemia. Further larger investigations are needed to confirm this opinion.