Ischemia Modified Albumin (IMA) - A Marker of Glycaemic Control and Vascular Complications in Type 2 Diabetes Mellitus

Introduction: Ischemia modified albumin (IMA) has emerged as a marker for ischemic injury and oxidative damage, particularly in myocardial infarction. There are very few studies on the significance of IMA in other conditions associated with ischemia. The complications of diabetes mellitus (DM) arising out of poor glycaemic control have an underlying ischemic aetiology. Aim: To evaluate correlation of IMA with glycaemic control in type 2 DM (T2DM). Secondary aim was to assess the utility of IMA as a marker for vascular complications in T2DM. Materials and Methods: During this cross-sectional study, a total of 100 diagnosed cases of T2DM were recruited between May 2013 and September 2013. The IMA, HbA1c, lipid profile, creatinine and urine micro-albumin levels were measured and analysed with respect to clinical condition of the patients. Statistical Analysis: The epidemiological software, Epi-Info 7.1.5, was used for the statistical analysis, p-value<0.05 was defined as level of significance. Results: The study subjects were in the age group from 30 to 75 years and 52.4% were males. There was a great degree of variance in the level of glycaemic control and majority (64.6%) had poor or very poor glycaemic control as reflected by their HbA1c levels. The IMA (Mean +/- SEM) levels were found to be higher (62.9 +/- 1.7ABSU) in the patients with poor glycaemic control compared to those with good glycaemic control (54.2 +/- 3.5 ABSU, p-value < 0.05) and correlated with HbA1c levels (r(2) = 0.14). IMA levels also appeared to be related with the changes in lipid profile and increased with increasing total cholesterol levels. The subjects with macro-vascular complications (retinopathy and neuropathy) showed non-significantly higher levels of IMA. The elevation in IMA correlated with the HbA1c and changes in the lipid profile. Conclusion: IMA correlates with poor glycaemic control and dyslipidaemia associated with T2 DM and could serve as an indicator of oxidant stress in these patients.