The role of Ischemia modified albumin in detecting diabetic nephropathy

Background: Ischemia-modified albumin (IMA) is considered a marker of oxidative stress and ischemia. Objectives : In this study, we aimed at establishing an association between IMA and diabetic nephropathy (DN) in type2 Diabetes mellitus (T2DM) patients. Patients and methods : One hundred individual participated in the study.70 T2DM patients, 35 in group A had DN, 35 in group B without DN and 30 healthy individuals, group C as a control group. We used urinary microalbuminuria test and urinary albumin creatinine ratio for assessment of diabetic nephropathy. Results : plasma levels of IMA were higher in T2DM with DN ((122.47±7.23) u/ml than in T2DM without DN(79.60±7.76) u/mlwho were higher than the control group (41.79±1.54)u/ml, p <0.0001.there was positive correlation between IMA and RBG(r=0.72), p=0.001), HBA1c(r=0.71, p=0.001),urinary microalbuminuria(r =0.61,p =0.001),urinary albumin/creatinine ratio(r =0.68, p =0.01) and creatinine(r =0.5,p =0.01) in group A T2DM with DN.ROC curve had high sensitivity and specificity for detecting diabetic nephropathy, the area under curve (AUC) is 0.960 (95% CI 0.900:0.989), p<0.0001, cutoff point>110.5 u/ml (sensitivity=100%, specificity=94.4%, PPV=87.9% NPP=100%). Conclusion : The ischemia modified albumin levels were significantly higher and positively associated with the duration of diabetes, RBS and HbA1c levels in T2DM patients with nephropathy. IMA could be used as a risk marker for Type 2 diabetic nephropathy.