Serum Ischemia-modified albumin levels in mild to moderate rosacea: an exploratory case-control study

Rosacea is a chronic inflammatory dermatosis in which oxidative stress has been implicated as a pathogenic factor. Ischemia-modified albumin (IMA) is a serum biomarker of oxidative stress not previously evaluated in rosacea.

To explore serum IMA levels in rosacea patients versus healthy controls and examine associations with disease severity and clinical characteristics.

In this exploratory case-control study, 72 rosacea patients and 72 age- and sex-matched healthy controls were enrolled. Serum IMA was measured by the albumin cobalt-binding (ACB) colorimetric method with concurrent serum albumin measurement. Statistical analysis included between-group comparisons, Benjamini-Hochberg false discovery rate (FDR) correction, and multivariable linear regression.

Mean serum IMA did not differ significantly between rosacea patients (0.72 ± 0.19 ABSU) and controls (0.74 ± 0.14 ABSU; mean difference -0.02 ABSU, 95% CI [-0.08, +0.04]; Cohen's d = 0.12; p = 0.32). Serum albumin was also comparable between groups (p = 0.50). Male patients showed higher IMA than females (0.81 ± 0.13 vs. 0.72 ± 0.17 ABSU; mean difference +0.09 ABSU, 95% CI [+0.01, +0.17]; Cohen's d = 0.55; p = 0.015). A weak positive correlation between persistent erythema severity and IMA was observed (Spearman's r = 0.24, 95% CI [+0.01, +0.45]; p = 0.045), which did not retain significance after FDR correction (p = 0.058). Multivariable regression revealed no independent predictor of IMA.

erum IMA was not significantly elevated in rosacea. Exploratory findings suggest possible associations with male sex and erythema severity, warranting confirmation in larger phenotype-stratified studies.