Nigerian Journal of Clinical Practice

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this.features)));n.length>0&&(0,e.R)(36,{targetFeature:r.featureName,missingDependencies:n}),this.features[r.featureName]=new r(this)}))}catch(t){(0,e.R)(22,t);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,R.Zm)();delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.features,delete this.sharedAggregator;return r.ee.get(this.agentIdentifier).abort(),!1}}}({features:[he,w,N,Ne,_e,_,D,ot,ct,je,nt],loaderType:"spa"})})()})();</script><meta charset="utf-8" /><meta name="viewport" content="width=device-width, initial-scale=1" /><meta http-equiv="Expires" content="0" /><meta name="DCSext.FullHTMLview" content="1" /><meta name="WT.cg_n" content="njcp" /><meta name="WT.cg_s" content="Articles,Open Access Articles" /><meta name="wkhealth_journal_title" content="Nigerian Journal of Clinical Practice" /><meta name="wkhealth_journal_title_legacy" content="Nigerian Journal of Clinical Practice" /><meta name="wkhealth_issue" content="12" /><meta name="wkhealth_article_publication_date" content="December 29, 2023" /><meta name="wkhealth_volume" content="26" /><meta name="wkhealth_ovid_accession_number" content="01253091-202326120-00001" /><meta name="wkhealth_issn" content="1119-3077" /><meta name="wkhealth_title" content="Diagnostic Value of Ischemia-Modified Albumin as a Biomarker in Patients with Peripheral Vertigo at Emergency Department of State Hospital in Ankara: A Cross-Sectional Study" /><meta name="wkhealth_authors" content="Karakılıç, E;Çelikel, E;Uysal, PI;Topçuoğlu, C;Turhan, T;Özakın, E" /><meta name="wkhealth_doi" content="10.4103/njcp.njcp_1862_21" /><meta name="wkhealth_abstract_html_url" content="https://journals.lww.com/njcp/abstract/2023/26120/diagnostic_value_of_ischemia_modified_albumin_as_a.1.aspx" /><meta name="wkhealth_fulltext_html_url" content="https://journals.lww.com/njcp/fulltext/2023/26120/diagnostic_value_of_ischemia_modified_albumin_as_a.1.aspx" /><meta name="wkhealth_toc_section" content="Original Article" /><meta name="wkhealth_toc_sub_section" /><meta name="wkhealth_eJpId" content="njcp:2023:26120:00001" /><meta name="wkhealth_firstpage" content="1779" /><meta name="wkhealth_date" content="December 2023" /><meta name="wkhealth_pdf_url" content="https://journals.lww.com/njcp/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=Other&an=01253091-202326120-00001" /><meta name="Description" content="Background: In previous studies, it was shown that ischemia-modified albumin (IMA) is an early ma" /><meta property="og:site_name" content="LWW" /><meta property="og:type" content="article" /><meta property="og:title" content="Diagnostic Value of Ischemia-Modified Albumin as a... : Nigerian Journal of Clinical Practice" /><meta property="og:description" content="ipheral vertigo and that changes in serum albumin levels affect IMA levels. Aim: In this study, we aimed to assess IMA, albumin-adjusted IMA, and albumin levels in patients with peripheral vertigo by comparing a control group. Materials and Methods: This prospective, case-control study included 46 patients aged 18-70 years who presented to emergency department with vertigo. Forty-nine healthy volunteers without known disease were included as controls. Serum albumin and IMA levels were measured, and albumin-adjusted IMA levels were calculated. Data were analyzed by statistical methods. Results: Mean age was 54.0 ± 15.7 in the patient group, whereas 43.8 ± 9.9 years in the control group. Albumin level was found to be significantly lower in patients with peripheral vertigo when compared to controls (P < 0.001). IMA level was found to be higher in the patient group compared to the controls, but it was not statistically significant (P = 0.06). However, albumin-adjusted IMA, which shows the real IMA level, was found to be higher than the control group (P = 0.02). Conclusion: It was observed that IMA level was slightly higher in patients with peripheral vertigo, although not significantly, compared to the control group. However, the albumin-adjusted IMA level, which indicates the real IMA level, was observed to be higher in this group than in the control group. It was determined that the sensitivity of this test was 34%, and the specificity was 87%. Patients with peripheral vertigo had lower albumin levels compared to controls...." /><meta property="og:image" content="https://images.journals.lww.com/njcp/SocialThumb.01253091-202326120-00001.T1.jpeg" /><meta property="og:image:width" content="507" /><meta property="og:image:height" content="237" /><meta property="og:url" content="https://journals.lww.com/njcp/fulltext/2023/26120/diagnostic_value_of_ischemia_modified_albumin_as_a.1.aspx" /><meta property="twitter:card" content="summary" /><meta name="robots" content="index, follow, noarchive" /><meta name="WT.sv" content="ZUSE1PEJPWEB04" /><meta name="Title" content="Nigerian Journal of Clinical Practice" /><style id="SPThemeHideForms" type="text/css">body {opacity:0 !important}</style>  <link href="https://fonts.googleapis.com/css?family=Arvo:400,400i,700|Fira+Sans:300,300i,400,400i,500,500i,600,600i,700,700i&display=swap" rel="stylesheet" /> <script> // temporary workaround for Bug 316328:[Stage][Registration][Regression 05.04] - 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id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_btnContinue" class="primary-button" /> <input type="button" value="No" id="btnCancel" aria-label="close dialog" class="js-close secondary-button" /> </p> </div> </div> </div> </div> </section> </div> </div> </div> </div> </div> <div id="ej-clear-float"> </div> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnSubscribeAlertType" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeMessage" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenTopicalCollectionId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenOvidId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId" /> <script type="text/javascript"> function alerts_ShowUnSubscribeeTOCPopup(title, alertType, journalId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Root(title, journalId, alertType) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Citation(title, journalId, ovidId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Citation'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId').value = ovidId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Topical(title, journalId, topicalCollectionId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Topical'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId').value = topicalCollectionId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCSuccessPopup() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } $('.js-close').on('click', function() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.hide(); } return false; }); </script> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl"></span> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscribeToEtocPopupState" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState" value="showemail" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenConfirmSubscriptionPageUrl" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscriptionType" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType" /> <div id="divPopupOverLay" class="Popup-Overlay" style="display: none; position: fixed; left: 0; top: 0; z-index: 3800; width: 1920px; height: 4517px;"></div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc" class="etoc-popup ej-box-modal-drop-shadow" style="display: none;"> <div tabindex="-1" role="dialog" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal"> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblTitle"></span> </div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-body"> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage"></span></strong> </div> <div class="wk-field-body"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError" style="color:Black;display:none;"> <div class="ej-error-message"> <p class="ej-error-message-icon error-red"> </p> </div> </span> <label for="Email input">Enter your Email address:</label> <div class="wk-field-body"> <input name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$txtEmailAddress" type="text" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress" class="ej-box-modal-style-1-input" /> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue" value="Continue" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue", "", true, "", "", false, false))" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue" class="primary-button" /> <input type="button" value="Cancel" id="btnCancel" class="js-close secondary-button" /> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-body"> <a id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hypPrivacy" href="https://journals.lww.com/njcp/_layouts/oaks.journals/privacy.aspx" target="_blank">Privacy Policy</a> </div> </div> </div> </section> </div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <p> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle"></span> </strong> </p> </div> <p id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pAuthenticatedUserMessage"> </p> </div> </section> </div> </div> </div> <div id="ej-clear-float"> </div> <script type="text/javascript"> function alerts_SaveSubscriptionTypeInHiddenField(url, subscriptionType, journalId, yearId, issueId, articleId) { if (journalId && yearId && issueId && articleId) { logCounterDataAlertWhenCitedSynchronously(journalId, yearId, issueId, articleId); } $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').val(journalId); if (url) window.location = url; else __doPostBack('hypSubscribeToAlerts'); return false; } function alerts_ShowSubscribeeTOCPopup(journalTitle, journalId, subscriptionType, displaySubscriptionType) { $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); var subscribeToEtocPopup = $find('subscribeToEtoc'); subscribeToEtocPopup.show(); document.getElementsByTagName( 'html' )[0].classList.add('no-scroll'); var modelPopupState = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState'); var emailTextBox = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress'); var thanksPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser'); var mainPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain'); var thankYouMessageUnAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage'); var thankYouMessageAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle'); if (!displaySubscriptionType) { displaySubscriptionType = subscriptionType; } if (modelPopupState.value == 'showthanksmessage') { thanksPanel.style.display = "block"; mainPanel.style.display = "none"; thankYouMessageAuthenticated.innerHTML = "Thank you for subscribing to the " + displaySubscriptionType + " for " + journalTitle + "."; } if (modelPopupState.value == 'showemail') { thanksPanel.style.display = "none"; mainPanel.style.display = "block"; thankYouMessageUnAuthenticated.innerHTML = "Thank you for choosing to subscribe to the " + displaySubscriptionType + " for " + journalTitle + "."; } if ($('.etoc-popup') != null) { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').value = journalId; if (modelPopupState.value == 'showemail') emailTextBox.focus(); } } $('.js-close').on('click', function () { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress').value = ""; document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').style.display = "none"; var pageUrl = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl'); var subscribeeTocPopup = $find('subscribeToEtoc'); if (subscribeeTocPopup != null) { subscribeeTocPopup.hide(); document.getElementsByTagName( 'html' )[0].classList.remove('no-scroll'); if (pageUrl.value !== '' && pageUrl.value !== window.location.pathname) window.location = pageUrl.value; } return false; }); </script> <div id="ctl00_ctl51_Header_UserActionTools_eTocTopContainer"> <div id="eTocTop" style="display: none;"> <a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Nigerian Journal of Clinical Practice','njcp','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Nigerian Journal of Clinical Practice','njcp','eTOC', 'eTOC');"><span id="ctl00_ctl51_Header_UserActionTools_alertLinkControlTop_defaultText" class="hideOnFixed">Subscribe to eTOC</span></a> </div> </div> <script> $(function () { //find recent searches link and move container var recentSearchesControl = $("a[id$='RecentSearches']"); if (recentSearchesControl.length) { recentSearchesControl.click(function (e) { e.stopPropagation(); if ($("#ResentSearchContainer").is(":hidden")) { $("#ResentSearchContainer").slideDown("slow"); recentSearchesControl.addClass('open'); } else { $("#ResentSearchContainer").hide(); recentSearchesControl.removeClass('open'); } }); } var eTocAccountLink = $("ul.js-user-action-toolbar__dropdown>li>a[id='SubscribeToEToc']"); if (eTocAccountLink.length) { eTocAccountLink.parent().html($("#eTocTop>a")); } }); </script> <a class="logo-secondary white" href="http://wolterskluwer.com/" target="_blank"> <h3 class="logo-secondary-text">Secondary Logo</h3> </a> <a href="#" class="sticky-search"><i class="fa fa-search"></i></a> </div> <div class="header__layout-bottom wk-grid-page-container"> <a id="hypJournals" class="logo-main" href="https://journals.lww.com/njcp/pages/default.aspx"> <h3 class="logo-main-text">Journal Logo </h3> </a> <div class="search-v2"> <div class="search-wrapper"> <select name="ctl00$ctl51$Header$SearchTopBoxControl$ddlContentScope" id="ctl00_ctl51_Header_SearchTopBoxControl_ddlContentScope"> <option value="All">All</option> <option selected="selected" value="Articles">Articles</option> <option value="Images">Images</option> <option value="Videos">Videos</option> <option value="Podcasts">Podcasts</option> <option value="Blogs">Blogs</option> </select> <div class="input-group" id="globalSearch"> <input name="ctl00$ctl51$Header$SearchTopBoxControl$txtKeywords" type="text" value="Search" id="ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords" class="form-control searchText" /> <span class="input-group-btn"> <button id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier" type="submit" class="btn btn-default"><i class="fa fa-search"></i></button> </span> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$IsAutoCompleteEnabled" id="ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled" value="false" /> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$AutocompleteApiUrl" id="ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl" value="https://platformservices.wolterskluwerhealth.com/autocomplete/njcp/shingle/" /> </div> </div> <div class="advance-search" style=""> <a id="ctl00_ctl51_Header_SearchTopBoxControl_lnkAdvanceSearch" href="https://journals.lww.com/njcp/pages/advancedsearch.aspx">Advanced Search</a> <input type="submit" name="ctl00$ctl51$Header$SearchTopBoxControl$btnGlobalSearch" value="" id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch" disabled="disabled" class="aspNetDisabled btnGlobalSearch" style="display: none;" /> <input name="ctl00$ctl51$Header$SearchTopBoxControl$hfldKeywords" type="hidden" id="ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords" class="hfldKeywords" value="disableButton" /> </div> </div> <script> $(function() { try { var objSearchBox = { btnGlobalSearchMagnifierId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier', searchButtonId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch', txtKeywordsId: 'ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords', hfldKeywordsHiddenId: 'ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords', defaultSearchText: 'Search' }; new Searchbox(objSearchBox).Init(); } catch (e) { console.error(e); } }); //autocomplete functionality for basic search //this functionality will call the SBA url and start suggesting after typing 3rd character var textKeywords = null; var hiddenAutocompleteApiUrl = null; var buttonGlobalSearch = null; $(function () { try { var objAutocomplete = { hiddenIsAutoCompleteEnabled: $('#ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled'), textKeywords: $('#ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords'), hiddenAutocompleteApiUrl: $('#ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl'), buttonGlobalSearch: $('#ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch'), enableNewAutoComplete: true, newAutoCompleteUrl: 'https://dxg-search-na-prd.wkgposvc.cloud/Query.svc/Query_Expand', newAutoCompleteMaxSuggestions: '10', newAutoCompleteDictionaryIds: 'ovid_sted28_mesh22' }; autoComplete(objAutocomplete); } catch (e) { console.error(e); } }); $(function () { let searchSelect = $('select[id$="ddlContentScope"]');; if (searchSelect.length){ searchSelect.selectize(); } }); </script> </div> <div id="main-nav-container-v2"> <nav id="main-nav" class="navbar navbar-default yamm wk-grid-page-container"> <div class="navbar-header"> <button id="fatJuicy" type="button" class="navbar-hamburger-button navbar-toggle collapsed pull-left" data-bs-toggle="collapse" data-bs-target="#zz1_TopNavigationMenu" aria-expanded="false" aria-controls="navbar"> <span class="visually-hidden">Toggle navigation</span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="navbar-hamburger-button__text"></span> </button> </div> <div id="navActionButtons" class="btn-group navbar-hover-color" role="group" aria-label="..."> <a id="ctl00_ctl51_lnkRegister" class="btn btn-default navbar-button" href="https://journals.lww.com/njcp/pages/register.aspx?ContextUrl=%2fnjcp%2ffulltext%2f2023%2f26120%2fdiagnostic_value_of_ischemia_modified_albumin_as_a.1.aspx">Register</a> <button class="user-menu__link user-menu__link--login js-ejp-login-btn btn btn-default navbar-button" type="button" data-config="{"eventName":"login","eventDetail":{},"isNull":false}"> <span>Login</span> </button> </div> <div id="ctl00_ctl51_TopNavigationMenuConfiguration" style="display:none" class="js-top-navigation-menu-configuration" data-config="{"browsingHistory":{"isEnabled":true,"serviceUrl":"https://apim-hlrp-ejp-prod.azure-api.net/ee","pdfDownloadUrl":"/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=HistoryTab"}}"></div> <div id="zz1_TopNavigationMenu" class="navbar-collapse collapse js-top-navigation-menu noindex ms-core-listMenu-horizontalBox"> <ul id="zz2_RootAspMenu" class="root ms-core-listMenu-root static"> <li class="static selected"><a class="static selected menu-item ms-core-listMenu-item ms-displayInline ms-core-listMenu-selected ms-navedit-linkNode" href="/NJCP/pages/default.aspx" accesskey="1"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Home</span><span class="ms-hidden">Currently selected</span></span></a></li><li class="static"><a class="static menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/NJCP/pages/currenttoc.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Current Issue</span></span></a></li><li class="static"><a class="static menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/NJCP/pages/issuelist.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Previous Issues</span></span></a></li><li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">For Authors</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" 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of Ischemia-Modified Albumin as a Biomarker in Patients with Peripheral Vertigo at Emergency Department of State Hospital in Ankara: A Cross-Sectional Study', '12292023', 'E Karakılı\u00E7, E \u00C7elikel, PI Uysal, et al', '26', '12', 'Copyright: \u00A9 2023 Nigerian Journal of Clinical Practice', '01253091-202326120-00001', '', true, ''); } </script> <div id="ArticleContainer"> <article id="ej-article-view" class="js-article-view ej-article-view" xmlns:ssr="http://ssr-eus-go-csi.cloudapp.net/v1/assets" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xhtml="http://www.w3.org/1999/xhtml"><section class="ejp-r-article-subsection"><div class="ejp-r-article-subsection__text">Original Article</div></section><header class="ejp-article-header"><h1 class="ejp-article-title">Diagnostic Value of Ischemia-Modified Albumin as a Biomarker in Patients with Peripheral Vertigo at Emergency Department of State Hospital in Ankara: A Cross-Sectional Study</h1></header><section id="ejp-article-authors"><p id="P7">Karakılıç, E; Çelikel, E<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>; Uysal, PI<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sup>; Topçuoğlu, C<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">3</sup>; Turhan, T<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">3</sup>; Özakın, E</p><section><a href="#" id="ejp-article-authors-link"> Author Information <i class="wk-icon-arrow-down-r"></i></a></section></section><section id="ejp-article-authors-info" class="ejp-article-authors-info ejp-article-authors-info--hidden"><div class="ejp-article-authors-info-holder"> <p id="">Department of Emergency Medicine, Eskisehir Osmangazi University School of Medicine, Eskişehir, Turkey</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>Department of Emergency Medicine, University of Health Sciences Etlik City Hospital, Ankara, Turkey</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sup>Department of Emergency Medicine, University of Health Sciences Gülhane Training and Research Hospital, Ankara, Turkey</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">3</sup>Department of Clinical Biochemistry, University of Health Sciences Ankara City Hospital, Ankara, Turkey</p> <p id="cor1"><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Address for correspondence:</strong> Prof. E Karakılıç, Eskişehir Osmangazi Üniversitesi Tıp F. Acil Tıp Anabilim Dalı - 26040, Odunopazarı/Eskişehir, Turkey. E-mail: <span><a href="/cdn-cgi/l/email-protection#711c10181d051e4b14070710191a1031161c10181d5f121e1c" onclick="javascript:window.open('mailto:mailto:evvahka@gmail.com');return false"><span class="__cf_email__" data-cfemail="7f1a09091e17141e3f18121e1613511c1012">[email protected]</span></a></span></p> <p id="">This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.</p> </div></section><section id="article-journal-info"><div class="ej-journal-info"><span class="ej-journal-name">Nigerian Journal of Clinical Practice </span><span id="ej-journal-date-volume-issue-pg"><a href="/njcp/toc/2023/26120">26(12):p 1779-1783, December 2023.</a></span><span> | </span><span class="ej-journal-doi">DOI: </span>10.4103/njcp.njcp_1862_21<a id="ej-article-indicators-ccl" onmouseover="javascript:Tooltip_CCL('Creative Commons License Information')" onmouseout="javascript:Tooltip_MouseOut()" href="" target="_blank"><span class="ejp-article-indicators__ccl"></span></a></div></section><section id="ejp-article-indicators" class="ejp-article-indicators"><ul class="ejp-article-indicators__list"> <li id="ej-article-indicators-open" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_Open()" onmouseout="javascript:Tooltip_MouseOut()"><span class="ejp-indicator">Open</span></li> </ul><button id="openArticleMetricsPopupButton" type="button" class="wk-button wk-button-ghost wk-button-icon-left ejp-article-metrics-btn" data-articleMetricsEndpoint="//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc" data-articleMetricsDetailsUrl="https://wolterskluwer.altmetric.com/details/" data-doi="10.4103/njcp.njcp_1862_21" data-suiteId="vrs_woltere_journalsglobalvrs" data-articlePublicationDate="2023-12-29" data-articlePublicationDateString="December 29, 2023" data-receivedDate="2021-10-04" data-revisionReceivedDate="2023-11-08" data-acceptedDate="2023-11-09" data-crossrefRefLinkRoot="https://doi.org/" data-medlineRefLinkRoot="http://www.ncbi.nlm.nih.gov/pubmed/" data-pubMedId="38158342"><i class="wk-icon-filled-chart-r"></i><i class="wk-icon-filled-chart-white-r"></i> Metrics </button></section><section class="ejp-article-tabs" id="abstractWrap"><h2 class="ejp-article-tabs-heading">Abstract</h2> <div class="ejp-article-tabs__tabpanel" id="panel1" role="tabpanel" aria-labelledby="tab1"> <div id="article-abstract-content1"> <div class="ejp-article-text-abstract"> <h3>Background: </h3> <p>In previous studies, it was shown that ischemia-modified albumin (IMA) is an early marker of ischemia and different pathologies. However, IMA level change is unknown in patients with peripheral vertigo. It is also known that serum albumin levels can change in some patients with peripheral vertigo and that changes in serum albumin levels affect IMA levels.</p> <h3>Aim: </h3> <p>In this study, we aimed to assess IMA, albumin-adjusted IMA, and albumin levels in patients with peripheral vertigo by comparing a control group.</p> <h3>Materials and Methods: </h3> <p>This prospective, case-control study included 46 patients aged 18-70 years who presented to emergency department with vertigo. Forty-nine healthy volunteers without known disease were included as controls. Serum albumin and IMA levels were measured, and albumin-adjusted IMA levels were calculated. Data were analyzed by statistical methods.</p> <h3>Results: </h3> <p>Mean age was 54.0 ± 15.7 in the patient group, whereas 43.8 ± 9.9 years in the control group. Albumin level was found to be significantly lower in patients with peripheral vertigo when compared to controls (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.001). IMA level was found to be higher in the patient group compared to the controls, but it was not statistically significant (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.06). However, albumin-adjusted IMA, which shows the real IMA level, was found to be higher than the control group (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.02).</p> <h3>Conclusion: </h3> <p>It was observed that IMA level was slightly higher in patients with peripheral vertigo, although not significantly, compared to the control group. However, the albumin-adjusted IMA level, which indicates the real IMA level, was observed to be higher in this group than in the control group. It was determined that the sensitivity of this test was 34%, and the specificity was 87%. Patients with peripheral vertigo had lower albumin levels compared to controls.</p> </div> </div> </div></section><div class="ejp-fulltext-content js-ejp-fulltext-content"><section id="ArticleBody"><h2 class="ejp-article-outline-heading" data-level="1" id="sec1-1">I<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">NTRODUCTION</span></h2> <p id="JCL-P-5">Peripheral vertigo can result from derangement in the vestibular system, semicircular canal, and cranial nerve VIII.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R1">1</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> The etiology of peripheral vertigo includes benign paroxysmal positional vertigo (BPPV), Meniere’s syndrome, vestibular neuritis, labyrinthitis, ototoxic agents, trauma, stress, upper respiratory tract infections, extreme noise, furosemide, salicylates, and anti-hypertensive agents among others. In addition, vertigo may develop as a result of hyperventilation in case of panic attacks or anxiety. Perilymph fistula should be considered if there is history of previous head trauma. The BPPV is of short duration and worsens with head movements.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R1">1</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R2">2</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup></p> <p id="JCL-P-6">Today, several biomarkers are used in the diagnosis or differential diagnosis of many diseases. ischemia-modified albumin (IMA) is one of these biomarkers. Albumin is a protein involved in equilibrium of osmotic pressure, which is synthesized by liver. In addition, it binds endogenous and exogenous toxic substances, drugs, hormones, and some anions and cations.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R3">3</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> Albumin binds transition ions such as cobalt, nickel, and copper at N-terminal. Hypoxia-induced ischemia causes the formation of free oxygen radicals, and the radicals diminish the binding of these ions to albumin. The albumin with structural modification is termed as IMA.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R3">3</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R4">4</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> In many studies, it was shown that IMA is increased as a result of ischemia in cardiac events.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R4 R5 R6">4-6</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> IMA is increased immediately after myocardial infarction and can be detected in blood over 6-12 hours. In addition to cardiac causes, it may increase in conditions resulting in hypoxia and ischemia such as mesenteric ischemia, chronic obstructive pulmonary disease (COPD), pulmonary embolism, sepsis, liver disease, and cerebrovascular events.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R7">7</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R8">8</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> In diabetic patients, it was found that IMA level was increased in ischemia-induced diabetic nephropathy and retinopathy when compared to controls. It was suggested that IMA can be used for early diagnosis of diabetic nephropathy and for early diagnosis and follow-up in diabetic retinopathy.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R9">9</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R10">10</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> IMA level was found to be significantly elevated in pregnant women with hypertension, preeclampsia, or eclampsia since reactive oxygen species are increased due to hypoxia in these conditions.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R11">11</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup></p> <p id="JCL-P-7">Although peripheral vertigo is detected in the majority of patients presenting Emergency Department (ED) with vertigo, it was seen that there is infarction in posterior circulation in 25% of patients with vertigo symptoms. In such patients, differential diagnosis can be challenging due to the low sensitivity of CT scan in detecting ischemic stroke (16%) and the limitation to access MR imaging.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R12">12</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> Moreover, it is unknown how IMA levels are affected in vestibular neuritis or labyrinthitis that causes peripheral vertigo. In patients presenting to ED with vertigo, additional biomarkers may support differential diagnosis when history and physical examination fail to achieve diagnosis. Here, we aimed to investigate the role of ischemia-modified albumin in the diagnosis of peripheral vertigo and the relationship in pathologies with low albumin levels (such as peripheral vertigo) and albumin-adjusted IMA level.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="sec1-2">M<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">ATERIALS AND</span> M<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">ETHODS</span></h2> <p id="JCL-P-8">The study included patients (aged 18-70 years) who presented to ED of Ankara Numune Research and Training Hospital with vertigo. The patients with known chronic disease, pregnancy, previous history of surgery, pulmonary thromboembolism, coronary artery disease, history of cerebrovascular disease, those with findings suggestive of central vertigo in physical examination, and those aged >70 years were excluded. Fifty-two patients who met inclusion criteria and accepted participation were included in the study. However, four patients diagnosed with central vertigo by MR imaging were excluded. In addition, two patients were excluded due to failure in measuring IMA levels because of lipemic serum samples. Finally, 46 patients were included in the study (patient group). The control group included 50 healthy volunteers working in our hospital who had normal physical examination and no history of known disease. Serum IMA measurement failed in one control; thus, 49 healthy individuals were included in the study.</p> <p id="JCL-P-9">Blood samples (7 mL) were drawn from all patients and controls. Sera were stored at -80°C. After the collection of all samples, IMA levels were studied by a single operator.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="sec2-1">Serum IMA assay</h3> <p id="JCL-P-10">Serum IMA level was measured by determining the decrease in albumin cobalt binding using colorimetric method. Briefly, two tubes, including a sample and a blank tube, were prepared by adding 200 µL serum sample and 50 µL cobalt<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">+2</sup> (1.0 g/L) (Sigma, CoCl<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sub>.6H<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sub> O). Then, the tubes were incubated at room temperature for 10 minutes. After incubation, dithiothretiol (DTT; Sigma, 1.5 mg/mL H<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sub>O) was added as colorant for detection of cobalt<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">+2</sup> ions. After incubation at room temperature for over 2 minutes, 1 mL of normal saline was added, and absorbance was measured at 470 nm in METERTECHSP 8001 Spectrophotometer (Metertech, Nangang, Taipei, Taiwan, and ROC). IMA absorbance was calculated by subtracting blank absorbance from sample absorbance (Absorbance Units: ABSU).</p> <p id="JCL-P-11">Serum albumin level (high or low) may affect IMA. Thus, it is recommended to use albumin-adjusted IMA level. In all patients and controls, albumin-adjusted IMA level was calculated by using the following formula:</p> <p id="JCL-P-12">Albumin-adjusted IMA: IMA (ABSU) X (individual albumin concentration/median albumin concentration all participants).</p> <h3 class="ejp-article-outline-heading" data-level="2" id="sec2-2">Ethical consideration</h3> <p id="JCL-P-13">This study was approved by the local Ethics Committee (approval number: 934/2016).</p> <h3 class="ejp-article-outline-heading" data-level="2" id="sec2-3">Statistical analysis</h3> <p id="JCL-P-14">Data were analyzed by IBM SPSS version 21.0 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). In descriptive statistics, continuous variables were expressed as mean and standard deviation, while categorical variables were expressed as count and percentage. For continuous variables, normal distribution was assessed by the Shapiro–Wilk test. Mann–Whitney U test was used to assess differences in continuous variables. Spearman’s correlation analysis was used to assess correlation between continuous variables. A <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> value < 0.05 was considered as statistically significant.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="sec1-3">R<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">ESULTS</span></h2> <p id="JCL-P-15">Mean age was 54.0 ± 15.7 in the patient group, whereas 43.8 ± 9.9 years in the control group. It was seen that mean age was significantly higher in the patient group than controls (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.001). When mean age and serum IMA levels were compared, no correlation was detected in the patient group (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.292). Again, there was no significant correlation in the control group (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.124).</p> <p id="JCL-P-16">Mean albumin level was found to be significantly lower in patients with peripheral vertigo (4.24 ± 0.37) when compared to controls (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.001). When serum albumin level was considered, there was a moderate, negative correlation between age and albumin level in the patient group (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.001).</p> <p id="JCL-P-17">When IMA levels were compared to mean age of patients and controls, no significant correlation was detected between serum IMA levels and age in the patient and control groups (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.52, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.31). In our study, when the serum IMA levels of patients with peripheral vertigo were compared with the control group, although it was slightly higher in patients with peripheral vertigo, no significant relationship was found (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.06). However, albumin-adjusted IMA level was compared, it was found to be higher in the patient group compared to the control group (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.031) [<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('T1', '01253091-202326120-00001');">Table 1</a>]. When age, serum albumin level, and diagnosis of vertigo were assessed in logistic regression analysis, it was found that these factors, alone and in combination, had no effect on albumin-adjusted IMA level (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.802 for age; <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.269 for serum albumin level; <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.518 for vertigo; and <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.114 for combination). Thus, it was concluded that albumin-adjusted IMA was not affected by age, vertigo, or serum albumin level.</p><section class="ejp-r-article-images"><figure class="ejp-r-article-images__figure"><a href="javascript:void(0)" class="ejp-r-article-images__image-link" onclick="showSlideShowByImageID('T1', '01253091-202326120-00001')"><img class="ejp-r-article-images__img js-lazy-load lazy-load" src="javascript:void(0);" data-src="https://images.journals.lww.com/njcp/ArticleViewerPreview.01253091-202326120-00001.T1.jpeg" data-srcset="https://images.journals.lww.com/njcp/ArticleViewerPreview@2.01253091-202326120-00001.T1.jpeg 2x" srcset="" alt="T1"></a><figcaption class="ejp-r-article-images__figcaption"><a href="javascript:void(0)" class="ejp-r-article-images__figcaption-link" onclick="showSlideShowByImageID('T1', '01253091-202326120-00001')">Table 1: </a><div class="ejp-r-article-images__figcaption-text">Relationship between albumin, IMA, and albumin-adjusted IMA level of each group</div></figcaption></figure></section><p id="JCL-P-18">In this study, the Youden index (J) and ROC curve were used to calculate the sensitivity and specificity. It was found that the IMA value was not a significant test to distinguish between patients and healthy individuals (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.063). However, as a result of the ROC analysis performed with the adjusted IMA values, it was determined that the adjusted IMA values could distinguish between patients and healthy individuals (<em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> = 0.029). The area under the ROC curve was determined to be 0.627, and the optimum cutoff point of the adjusted IMA was determined to be 0.460. It was determined that the sensitivity of this test was 34.1%, and the specificity was 87.8%. When the adjusted IMA value is above 0.460, the disease detection rate was found to be below (34.1%), while it was determined that the values below 0.46 would have a high rate of healthy people (87.8%) [<a href="javascript:void(0)" onclick="javascript:showSlideShowByImageID('T2', '01253091-202326120-00001');">Table 2</a>].</p><section class="ejp-r-article-images"><figure class="ejp-r-article-images__figure"><a href="javascript:void(0)" class="ejp-r-article-images__image-link" onclick="showSlideShowByImageID('T2', '01253091-202326120-00001')"><img class="ejp-r-article-images__img js-lazy-load lazy-load" src="javascript:void(0);" data-src="https://images.journals.lww.com/njcp/ArticleViewerPreview.01253091-202326120-00001.T2.jpeg" data-srcset="https://images.journals.lww.com/njcp/ArticleViewerPreview@2.01253091-202326120-00001.T2.jpeg 2x" srcset="" alt="T2"></a><figcaption class="ejp-r-article-images__figcaption"><a href="javascript:void(0)" class="ejp-r-article-images__figcaption-link" onclick="showSlideShowByImageID('T2', '01253091-202326120-00001')">Table 2: </a><div class="ejp-r-article-images__figcaption-text">IMA and Albumin-adjusted IMA cutoff value and ROC analysis</div></figcaption></figure></section><h2 class="ejp-article-outline-heading" data-level="1" id="sec1-4">D<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">ISCUSSION</span></h2> <p id="JCL-P-19">Low serum albumin level is a common condition at advanced ages.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R13">13</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> In our study, mean age was significantly higher in the patients with peripheral vertigo than in the controls. It was found that when compared to controls, serum albumin level was lower in the patient group. In a study by Yuan <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">et al</em>., albumin levels were found to be lower in patients with peripheral vertigo than controls, which is in agreement with our study.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R14">14</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> The role of low serum albumin levels is exactly unknown in the pathophysiology of peripheral vertigo. In addition, the lower albumin level might be due to the higher mean age in the patient group. Further studies are needed in this field.</p> <p id="JCL-P-20">When age and serum IMA levels were compared in the study groups, no significant correlation was detected between serum IMA level and age in the patient and control groups, in agreement with the literature. In several studies, it is shown that age and gender have no effect on serum IMA levels.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R15">15</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">,</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R16">16</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup></p> <p id="JCL-P-21">Serum IMA level is increased in cardiac ischemia, mesenteric ischemia, and ectopic pregnancy where oxidative stress is involved.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R17 R18 R19">17-19</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> In such diagnoses, many pathophysiological changes cause an increase in serum IMA levels. When we look at the literature on IMA level changes in peripheral vertigo, there has been no study on this subject. In this study, we compared serum IMA levels and albumin-adjusted IMA levels between patients with peripheral vertigo and controls. It was observed that serum IMA levels were higher in patients with peripheral vertigo. An increase can occur as a result of pathological events involved in the etiology of peripheral vertigo. However, since the IMA level was influenced by the albumin level, albumin-adjusted IMA, shows the real IMA level, was significantly higher in the peripheral vertigo patients. When logistic regression analysis was performed to determine factors influencing albumin-adjusted IMA level, it was found that age, serum albumin level, and diagnosis of peripheral vertigo, either alone or in combination, had no influence on albumin-adjusted IMA level.</p> <p id="JCL-P-22">IMA is used as a biomarker in the diagnosis of many diseases. When investigating IMA levels in patients, those with low albumin levels should be interpreted with caution. In patients with low albumin levels, such as peripheral vertigo, the albumin-adjusted IMA level should be investigated to determine the true IMA level. In our study, it was found that the level of IMA was not significantly higher in patients with peripheral vertigo, but the level of albumin-adjusted IMA was significantly higher. However, in patients with peripheral vertigo, albumin-adjusted IMA had high specificity and low sensitivity.</p> <p id="JCL-P-23">IMA level, which is a sensitive biomarker of ischemia and oxidative stress, increases in ischemic conditions as well as in many pathological conditions with endothelial or extracellular hypoxia and inflammation.<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">[</sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0"><sup><a class="ejp-citation-link js-ejp-citation-link" data-reference-links="R20 R21 R22">20-22</a></sup></sup><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">]</sup> Although the mechanism by which it increases in peripheral vertigo is unknown, it was found that the level of albumin-adjusted IMA level was also high in this patient group. The increased level of IMA, especially in ischemic events, brings up the question of whether it can be used in the differential diagnosis of peripheral vertigo and central vertigo due to ischemic stroke. This study showed that it is high in patients with peripheral vertigo. Therefore, it cannot be used as a differential diagnosis.</p> <h2 class="ejp-article-outline-heading" data-level="1" id="sec1-5">C<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">ONCLUSION</span></h2> <p id="JCL-P-24">This study showed that albumin-adjusted IMA level was high in patients with peripheral vertigo, but the sensitivity of that is low, while its specificity is high. However, since the albumin level may be low in patients with peripheral vertigo, it would be a more accurate choice to measure the albumin-adjusted IMA level while investigating the serum IMA level in these patients.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="sec2-4">Financial support and sponsorship</h3> <p id="JCL-P-25">Nil.</p> <h3 class="ejp-article-outline-heading" data-level="2" id="sec2-5">Conflicts of interest</h3> <p id="JCL-P-26">There are no conflicts of interest.</p></section><section id="article-references" class="article-references js-article-references"><h2 class="ejp-article-outline-heading" data-level="1" id="JCL-L-0">R<span style="font-variant: small-caps;" xmlns:mrws="http://webservices.ovid.com/mrws/1.0">EFERENCES</span></h2> <div id="R1" class="article-references__item js-article-reference">1. Dommaraju S, Perera E. An approach to vertigo in general practice. 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Niger J Clin Pract 2021;24:680–4.<div> <ul class="article-references__item-links"> <li class="internal-links"><a href="#JCL-P-23"> Cited Here</a> | </li> <li><a href="https://journals.lww.com/plasreconsurg/01253091-202124050-00008.fulltext" onclick="javascript:window.open('https://journals.lww.com/plasreconsurg/01253091-202124050-00008.fulltext');return false">View Full Text</a> | <a href="http://www.ncbi.nlm.nih.gov/pubmed/34018977" onclick="javascript:window.open('http://www.ncbi.nlm.nih.gov/pubmed/34018977');return false">PubMed</a> | <a href="https://doi.org/10.4103%2Fnjcp.njcp_211_20" onclick="javascript:window.open('https://doi.org/10.4103%2Fnjcp.njcp_211_20');return false">CrossRef</a></li> </ul> </div> </div> <div class="article-references__button-container"></div></section><div><strong>Keywords:</strong><p id="">Albumin-adjusted IMA; ischemia-modified albumin; peripheral vertigo; serum albumin</p> </div><section class="ej-article-copyright">Copyright: © 2023 Nigerian Journal 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