Evaluation of ischemia-modified albumin levels and thiol/disulfide balance in patients with acne vulgaris

Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit. The role of oxidative stress in AV remains controversial, with inconsistent findings in previous studies. This study aimed to investigate the relationship between AV and oxidative stress by assessing thiol/disulfide homeostasis parameters and ischemia-modified albumin (IMA) levels as oxidative stress biomarkers. Seventy-five AV patients and 75 age- and sex-matched healthy controls were included in the study. Peripheral blood samples were analyzed for IMA, native thiol (NT), total thiol (TT), NT/TT, disulfide, disulfide/NT, and disulfide/TT. Disease severity was evaluated using the global acne grading system (GAGS), and group comparisons were performed. IMA levels were significantly higher in AV patients than in controls (0.85 ± 0.14 vs. 0.79 ± 0.18, p < 0.05). NT and TT levels were lower in the AV group (317.6 vs. 421.7, p < 0.001; 347.2 vs. 473, p < 0.001), while disulfide/NT and disulfide/TT ratios were higher (5.97 vs. 4.52, p < 0.001; 5.33 vs. 4.15, p < 0.001). No significant differences were observed in disulfide levels (p > 0.05). IMA levels were significantly higher in mild cases compared to moderate cases (0.89 ± 0.2 vs. 0.83 ± 0.21, p < 0.05), whereas thiol/disulfide parameters did not differ between them (p > 0.05). Significant correlations were observed between GAGS scores and IMA, NT, TT, and disulfide levels (r = -0.323, p = 0.005; r = 0.310, p = 0.007; r = 0.304, p = 0.008; r = 0.254, p = 0.028, respectively). The findings indicate oxidative stress contributes to AV pathogenesis, as evidenced by elevated IMA levels and a shift in thiol/disulfide homeostasis toward a more oxidant state. Although statistically significant correlations were found between oxidative stress markers and GAGS scores, the direction of these correlations was contrary to expectations, suggesting that there may not be a direct relationship between oxidative stress and disease severity.