A novel biochemical marker for community-acquired pneumonia: Ischemia-modified albumin

Am J Emerg Med. 2017 Aug;35(8):1121-1125. doi: 10.1016/j.ajem.2017.03.018. Epub 2017 Mar 10.

Abstract

Introduction: Community-acquired pneumonia (CAP) is a frequent cause of hospitalization and a leading cause of mortality worldwide. Early diagnosis and the initiation of appropriate antibiotic therapy are essential to reduce pneumonia-related morbidity and mortality. CRP is a well-established biomarker in many clinical settings, but has been traditionally considered not specific enough to be a useful guide in the diagnostic process of pneumonia. There is still a need for more specific and practical markers in CAP for diagnosis. The aim of this study was to investigate the diagnostic value of ischemia-modified albumin (IMA) levels in the diagnosis of CAP in the Emergency Department.

Methods: The study included 81 patients admitted with CAP and 81 control patients. Initial hour levels of IMA and CRP were measured. The IMA mean levels were compared between the study and control group. Correlation analyses were performed to investigate the association of serum IMA levels with CRP.

Results: Mean levels of IMA were 0.532±0.117IU/ml in the study group and 0.345±0.082IU/ml in the control group. IMA levels were significantly higher in the study group compared to the control group. The IMA level of 0.442IU/ml had sensitivity of 75.3% and specificity of 91.3% and was positively correlated with CRP levels (r=0.506; p<0.05).

Conclusion: Blood IMA levels significantly increase in adult patients presenting with CAP. IMA may be considered as a novel biomarker in the diagnosis of CAP.

Keywords: C-reactive protein; Community acquired pneumonia; Ischemia modified albumin.

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Community-Acquired Infections / blood*
  • Community-Acquired Infections / pathology
  • Emergency Service, Hospital*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pneumonia / blood*
  • Pneumonia / pathology
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Serum Albumin
  • Serum Albumin, Human

Substances

  • Biomarkers
  • Serum Albumin
  • ischemia-modified albumin
  • C-Reactive Protein
  • Serum Albumin, Human