Ischemia modified albumin: An oxidative stress marker in β-thalassemia major

BackgroundIschemia modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress. This study reports on the levels and clinical significance of IMA in patients with β-thalassemia major.MethodsBlood specimens were collected from 166 subjects (101 β-thalassemia major patients and 65 healthy controls). Serum levels of IMA, ferritin, malondialdehyde (MDA), ferroxidase, transaminases, total protein, and albumin were determined using conventional methods.ResultsSerum levels of IMA (ABSU) were significantly higher in patients than in controls (0.725 ± 0.155 vs 0.554 ± 0.154, p = 0.000). Similarly, higher levels were also observed for ferritin, MDA, ferroxidase, and transaminases. No significant differences were observed between patients and controls with respect to total protein and albumin. Spearman univariate analysis demonstrated significant correlation between IMA and ferritin, MDA, ferroxidase, and transaminases. Multiple linear regression analysis revealed significant association of IMA with ferritin and ferroxidase after adjusting for the other variables (r = 0.343, p = 0.002; r = 0.228, p = 0.029 respectively). MDA however, correlated significantly with ferritin only (r = 0.654, p = 0.000).ConclusionOur findings suggest that increased levels of IMA in thalassemic patients are likely to be a result of iron-induced oxidative stress and hence its potential significance as a new marker of oxidative stress in such patients.

► Levels of ischemia modified albumin (IMA) are increased in β-thalassemia major.
► IMA correlated significantly with ferritin and ferroxidase in thalassemic patients.
► Iron overload and oxidative stress induce the formation of IMA.
► IMA is suggested as an additional marker for oxidative stress in thalassemia.