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. 2024 Feb 17;14(1):3964.
doi: 10.1038/s41598-024-54641-5.

Association between ischemia-modified albumin (IMA) and peripheral endothelial dysfunction in rheumatoid arthritis patients

Gian Luca Erre  1   2 , Ilaria Chessa  3 , Stefania Bassu  3 , Lorenzo Cavagna  4 , Ciriaco Carru  3 , Gianfranco Pintus  3 , Roberta Giordo  3 , Arduino Aleksander Mangoni  5   6 , Giuseppe Damiano Sanna  7 , Angelo Zinellu  8
Affiliations

Association between ischemia-modified albumin (IMA) and peripheral endothelial dysfunction in rheumatoid arthritis patients

Gian Luca Erre et al. Sci Rep. .

Abstract

The identification of circulating biomarkers of endothelial dysfunction (ED), a precursor to atherosclerosis, in rheumatoid arthritis (RA) would facilitate early risk stratification and prevention strategies. Ischemia-modified albumin (IMA) has emerged as a potential biomarker of oxidative stress, ischemia, and ED. However, studies examining the relationship between IMA and ED in RA patients are lacking. We measured serum IMA concentrations by using an albumin cobalt binding test and peripheral vasodilatory capacity by EndoPAT in 113 RA patients without previous cardiovascular events enrolled in the EDRA study (ClinicalTrials.gov: NCT02341066). The mean peripheral vasodilatory capacity, expressed by the log of reactive hyperemia index (logRHI), was 0.82, corresponding to 27% RA patients having ED. The mean plasma concentrations of IMA were 0.478 absorbance units. We observed a significant and inverse association between peripheral vasodilatory capacity and serum IMA concentrations (rho = - 0.22, p = 0.02). In univariate logistic regression, ED was significantly associated with serum IMA concentrations [OR 1173 (95% CI 1.3568 to 101,364), p = 0.040) and higher disease activity. In multivariate logistic regression, the independent association between ED and IMA remained significant after correction for disease activity and other RA-confounders [OR 2252 (95% CI 1.0596 to 4,787,505), p = 0.048 in Model 1; OR 7221 (95% CI 4.1539 to 12,552,859), p = 0.02 in Model 2]. Conclusions: This study suggests that IMA is a promising biomarker of ED in RA. Further research is needed to confirm our findings and determine the clinical utility of IMA in detecting and managing early atherosclerosis in RA patients.

Keywords: Atherosclerosis; Cardiovascular disease; Endothelial dysfunction; Inflammation; Oxidative stress; Pulse amplitude tonometry; Reactive oxygen species; Rheumatoid arthritis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Correlations between serum IMA concentrations and RA disease activity.
Figure 2
Figure 2
Correlations between serum IMA concentrations and peripheral vasodilatory capacity.
See this image and copyright information in PMC

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