Total Antioxidant Capacity and Ischemia Modified Albumin in Beta Thalassemia

Background: Total antioxidant capacity (TAC) and ischemia modified albumin (IMA) are common parameters used to assess the status of oxidative stress under different conditions. This study reports on TAC and levels of IMA in patients with 13-thalassemia major. Methods: Blood specimens were collected from 98 subjects (55 beta-thalassemia major patients and 43 healthy controls). Serum levels of IMA and TAC were determined using conventional biochemical methods. Serum levels of ferritin, iron, TIBC, ALT, bilirubin, total protein, and albumin were measured using automated chemistry analyzers. Results: Levels of TIBC were significantly lower, and those of ferritin, iron, percentage of transferrin saturation, ALT, total and direct bilirubin were significantly higher in patients than in controls. No significant differences were observed between patients and controls with respect to total protein and albumin. TAC levels, expressed as mM Trolox equivalents, were significantly lower in patients than in controls (0.197 +/- 0.106 vs. 0.274 +/- 0.122, p < 0.01). Serum levels of IMA (ABSU) were significantly higher in patients than in controls (0.543 +/- 0.124 vs. 0.452 +/- 0.085, p < 0.01). Spearman univariate analysis demonstrated significant inverse correlations of TAC with both IMA and ferritin (r = -0.307, p < 0.05 and r = -0.395, p < 0.01, respectively) and significant direct correlation of IMA with ferritin (r = 0.519, p < 0.01). Conclusions: This study demonstrates the presence of a significant inverse correlation between total antioxidant capacity and EWA; this further argues for the inclusion of IMA as one of the oxidative stress markers in thalassemic patients.