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

Background: Ischemia 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 beta-thalassemia major. Methods: Blood specimens were collected from 166 subjects (101 beta-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. Results: Serum 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). Conclusion: Our 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. (C) 2012 Elsevier B.V. All rights reserved.