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Turk, Adem MD*; Nuhoglu, Irfan MD; Mentese, Ahmet MS; Karahan, Süleyman Caner MD; Erdol, Hidayet MD*; Erem, Cihangir MD

doi: 10.1097/IAE.0b013e3181ed8cd1
Original Study

Purpose: To establish the correlation between ischemia-modified albumin (IMA) and malondialdehyde (MDA) and the development of diabetic retinopathy (DRP) in patients with diabetes mellitus.

Methods: Seventy Type 2 diabetic patients, 35 with DRP, and 36 healthy controls were enrolled in this study. Serum IMA and MDA levels were compared statistically. Receiver operating characteristic curve analysis was also performed to calculate the value of IMA and MDA in distinguishing DRP.

Results: Mean serum IMA levels were 0.658 ± 0.128 absorbance units in the non-DRP group, compared with 0.767 ± 0.074 absorbance units in the DRP group and 0.619 ± 0.044 absorbance units in the control group. Mean serum MDA levels were 0.325 ± 0.172 nmol/mL, 0.244 ± 0.152 nmol/mL, and 0.178 ± 0.131 nmol/mL, respectively. The differences in IMA and MDA levels were statistically significant for all groups (P < 0.05 for all). The areas under the receiver operating characteristic curves for the determination of DRP in diabetic patients were 0.789 (95% confidence interval, 0.682-0.896) for IMA and 0.3 (95% confidence interval, 0.175-0.426) for MDA.

Conclusion: Both serum IMA and serum MDA levels were higher in the diabetic patients compared with the control group. In particular, the high sensitivity of IMA toward DRP showed that it reflected retinal vascular complication better than MDA. Ischemia-modified albumin may be a useful marker in monitoring the risk of DRP development.

This study investigated the diagnostic characteristics of ischemia-modified albumin and malondialdehyde for retinopathy in diabetic patients compared with a healthy control group.

From the Departments of *Ophthalmology, †Internal Medicine; and ‡Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.

The authors do not have any proprietary interest to disclose.

Reprint requests: Adem Turk, MD, Department of Ophthalmology, School of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey; e-mail:

© The Ophthalmic Communications Society, Inc.