Role of ischemia-modified albumin and total homocysteine in estimating symptomatic lacunar infarction in type 2 diabetic patients

Objective: To investigate whether ischemia-modified albumin (IMA) is reliable for early diagnosing symptomatic lacunar infarction (SLI) in type 2 diabetics. Design and methods: Ninety-seven consecutive diabetic patients, 47 with SLI, and 45 healthy controls were enrolled. Serum IMA and plasma total homocysteine (tHcy) were measured on an autoanalyzer and evaluated in distinguishing SLI. Results: Serum IMA levels were 97.35 +/- 5.25 U/L in the healthy control group, 103.26 +/- 7.43 U/L in the non-SLI group, and 139.84 +/- 20.00 U/L in the SLI group. Plasma tHcy levels were 8.08 +/- 1.82 mu mol/L, 11.31 +/- 3.03 mu mol/L, and 13.10 +/- 3.67 mu mol/L, respectively. The differences in IMA and tHcy levels were statistically significant for all groups (p<0.05). Receiver operating characteristic curve analyses revealed the areas under curve were 0.866 for IMA and 0.352 for tHcy. Conclusion: This study indicates that IMA was significantly elevated in the acute phase of SLI and more sensitive than tHcy in distinguishing SLI. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.