Ischemia-Modified Albumin in Diabetic Foot Ulcers: A Systematic Review and Bayesian Meta-Analysis

Area of Science:

• Biomarkers
• Diabetology
• Vascular Medicine

Background:

• Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus.
• DFUs lead to high morbidity, amputation risk, and healthcare costs.
• Identifying reliable biomarkers for DFU is crucial for early diagnosis and management.

Purpose of the Study:

• To systematically review and meta-analyze the association between circulating ischemia-modified albumin (IMA) levels and DFU.
• To evaluate IMA as a potential biomarker for DFU diagnosis and risk stratification.

Main Methods:

• Systematic review and meta-analysis of observational studies.
• Searched PubMed, Scopus, Cochrane Central, and Google Scholar.
• Included studies reporting IMA levels in DFU patients, diabetics without foot ulcers, and healthy controls.
• Used frequentist and Bayesian meta-analysis models with standardized mean differences (SMDs).

Main Results:

• DFU patients showed significantly higher IMA levels than healthy controls (SMD = 3.21, 95% CI: 1.40, 5.03).
• DFU patients also had higher IMA levels than diabetics without foot ulcers (SMD = 1.21, 95% CI: 0.23, 2.20).
• Adjusted analyses confirmed IMA's discriminative value; no significant publication bias was detected.

Conclusions:

• Circulating IMA levels are significantly elevated in patients with DFU.
• IMA shows potential as a biomarker for DFU diagnosis, risk stratification, and monitoring.
• Further research with standardized protocols and larger prospective studies is needed to confirm clinical utility.