Is Ischemia-Modified Albumin a Biomarker in Wagner Classification in
Diabetic Foot Ulcers?
Abstract
Background: We aimed to determine the relationship of ischemia-modified
albumin (IMA) with diabetic foot ulcers and its predictive value in the
Wagner classification. Methods: Our cross-sectional study was conducted
in 120 diabetic foot patients and 60 healthy individuals with similar
body mass index and age. Patients with a diabetic foot were classified
according to the Wagner classification. Biochemical parameters,
C-reactive protein (CRP) and IMA levels were measured in all patients
and healthy volunteers. Screening performance characteristics of CRP and
IMA were calculated according to Wagner classes and the presence of
osteomyelitis. Results: CRP and IMA levels in the patient group were
significantly higher than the control group. The highest IMA levels were
detected in Wagner grade 5. CRP had higher sensitivity and specificity
than IMA in the discrimination of other grades, except for grade 4-5
separation. For Wagner grade 4-5 distinction, IMA had 84.6% sensitivity
and 94.7% specificity. Conclusion: IMA may play a role in the
pathogenesis of diabetic foot ulcers and had a higher predictive value
in discrimination of the Wagner grade 4 and 5. In the management of
diabetic foot patients, it may be recommended that IMA is evaluated by
clinicians.