Background and Objectives: Ischemia-modified albumin (IMA) has previously been identified as a biomarker for early ischemia, rapidly formed by acidosis and free radical modification of the N-terminus of human serum albumin. This study aimed to compare albumin and IMA levels in blood and cerebrospinal fluid (CSF) from 30 patients with spontaneous subarachnoid hemorrhage (SAH) and 15 patients with normal pressure hydrocephalus (NPH) at a single center between 2021 and 2022. Materials and methods: This prospective study included 30 patients diagnosed with subarachnoid hemorrhage (SAH), confirmed radiologically, who were admitted to the Health Sciences University İzmir Bozyaka Training and Research Hospital and constituted the study group. The control group consisted of 15 patients diagnosed with normal pressure hydrocephalus (NPH) without a history or radiological evidence of subarachnoid hemorrhage or any other intracranial hemorrhagic pathology. In the control group, no pathological findings suggestive of hemorrhage or inflammation were detected in serum or cerebrospinal fluid (CSF) analyses. Blood and CSF samples were collected simultaneously from all participants, and albumin and ischemia-modified albumin (IMA) levels were measured. Serum and CSF albumin and IMA levels were compared between the study and control groups. Results: Of the 30 patients included in the study, 19 (63.3%) were male and 11 (36.7%) were female. The albumin level was lower in the patient group compared to the NPH group (3.8 g/dL 1.8–4.7 vs. 4.3 g/dL 3.2–5.0, respectively, p = 0.008). The serum IMA level was higher in the patient group compared to the NPH group (0.36 ABSU 0.30–0.65 vs. 0.25 ABSU 0.05–0.32, respectively, p = 0.010). The serum IMA level was higher in the vasospasm group compared to the group without vasospasm. Conclusions: In patients with SAH, a condition associated with high morbidity and mortality, modified albumin levels were found to be significantly higher in both CSF and blood compared to the NPH group. IMA may be a potential biomarker associated with SAH and vasospasm; however, further large-scale studies with multivariable analysis and external validation are required to confirm its diagnostic and prognostic utility.
Bologur et al. (Wed,) studied this question.