Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov;22(6):430-438.
doi: 10.1080/13510002.2017.1301624. Epub 2017 Mar 13.

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

Amira Abdel Moneam Adly  1 , Nayera Hazaa Khalil ElSherif  1 , Eman Abdel Rahman Ismail  2 , Yosra Abdelzaher Ibrahim  3 , Gamal Niazi  3 , Sara Hamed Elmetwally  1
Affiliations

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

Amira Abdel Moneam Adly et al. Redox Rep. 2017 Nov.

Abstract

Background: Ischemia-modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress and an independent predictor of major adverse cardiovascular events.

Objectives: To measure the levels of IMA in 45 children and adolescents with β-thalassemia major (β-TM) compared with 30 healthy controls and assess its relation to lipid peroxidation, vascular complications and subclinical atherosclerosis.

Methods: β-TM patients without symptoms of heart disease were studied focusing on transfusion history, chelation therapy, serum ferritin, malondialdehyde (MDA) and IMA levels. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed.

Results: IMA and MDA levels were significantly higher in β-TM patients compared with controls (p < 0.001). IMA was higher among patients with heart disease, pulmonary hypertension risk and serum ferritin ≥2500 µg/l than those without. TM patients compliant to chelation had significantly lower IMA levels. IMA levels were positively correlated to MDA and CIMT while negatively correlated to ejection fraction and fractional shortening.

Conclusion: Our results highlight the role of oxidative stress in the pathophysiology of vascular complications in thalassemia. IMA could be useful for screening of β-TM patients at risk of cardiopulmonary complications and atherosclerosis because its alteration occurs in early subclinical disease.

Keywords: CIMT; Thalassemia; ischemia-modified albumin; malondialdehyde; oxidative stress; vascular dysfunction.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Ischemia modified albumin (IMA) and malondialdehyde (MDA) levels in patients with β-thalassemia major and controls.
Figure 2.
Figure 2.
Receiver operating characteristic (ROC) curve analysis of the cut off value of IMA for detection of PH risk (A) and for heart disease (B) among patients with β-thalassemia major.
Figure 3.
Figure 3.
Correlation between IMA and serum ferritin (A) and MDA levels (B) among patients with β-thalassemia major.
Figure 4.
Figure 4.
Correlation between IMA echocardiographic parameters among patients with β-thalassemia major. (A) IMA and ejection fraction. (B) IMA and tricuspid regurgitant jet velocity.
Figure 5.
Figure 5.
Correlation between IMA and MDA and carotid intima media thickness among patients with β-thalassemia major.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hahalis G, Kremastinos DT, Terzis G, et al. . Global vasomotor dysfunction and accelerated vascular aging in β-thalassemia major. Atherosclerosis. 2008;198:448–457. - PubMed
    1. Chakraborty D, Bhattacharyya M. Antioxidant defense status of red blood cells of patients with β-thalassemia and Eβ-thalassemia. Clin Chim Acta. 2001;305:123–129. - PubMed
    1. Cabantchik ZI, Breuer W, Zanninelli G, et al. . LPI-labile plasma iron in iron overload. Best Pract Res Clin Haematol. 2005;18:277–287. - PubMed
    1. Kassab-Chekir A, Laradi S, Ferchichi S, et al. . Oxidant, antioxidant status and metabolic data in patients with beta-thalassemia. Clin Chim Acta. 2003;338:79–86. - PubMed
    1. Walter PB, Fung EB, Killilea DW, et al. . Oxidative stress and inflammation in iron overloaded patients with β-thalassaemia or sickle cell disease. Br J Haematol. 2006;135:254–263. - PMC - PubMed

LinkOut - more resources