The Efficacy of Ischemia Modified Albumin (IMA) as a Predictor for Postoperative Healing among People with Diabetic Foot Ulcer.

Abstract

The aim of the study is to determine the efficacy of ischemia-modified albumin (IMA) among diabetic foot ulcers (DFU) individuals as a predictor for wound healing based on IMA values at different stages of treatment. In this hospital based cross-sectional follow up study a total of 71 (41 males and 30 females) individuals were recruited and divided into three groups: Group-I- Control without T2DM (n = 20). Group-II -T2DM without any complication (n = 15), Group-III T2DM with DFU (n = 36) DFU group is further subdivided into two with and without peripheral artery disease as PAD and nonPAD. Demographic and Biochemical characteristics were recorded. Serum IMA levels were measured using Human IMA ELISA kit at 4 regular intervals during treatment of ulcer ie Pre and Post Debridement or angiogram/angioplasty, after HBOT therapy and after healing. Mean age of the study participant was 51.6 ± 12.8 years. The clinical parameters were not associated with age, lipid profile, urea, creatinine, eGFR whereas positive association was observed in glucose level, ESR, Total albumin, WBC, HbA1c among the study groups. Serum IMA levels at baseline in the DFU groups were significantly higher than in the T2DM and control groups (P < .001). Whereas IMA levels when compared at 4 regular intervals showed drastic decline in IMA levels at each interval (P = .0059). IMA levels remained constant after HBOT therapy. In conclusion IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this as a biomarker for early detection of wound healing.