Effect of diabetes mellitus on the diagnostic efficacy of ischemia modified albumin in acute stroke

Introduction: Acute stroke is a major cause of disability and death all over the world. Ischemia modified albumin (IMA) carries a potential use in the early diagnosis of acute stroke. Stroke is frequently associated with Diabetes mellitus (DM) which is known to affect the serum IMA level. This study compares the diagnostic efficacy of IMA in stroke patients with and without DM. Materials and Methods: The present study included 60 acute stroke patients with and without DM (30 in each group) and 30 healthy controls. Albumin cobalt binding test was used to estimate IMA. The receiver operating characteristic (ROC) curve was plotted for ‘Stroke with DM' and ‘Stroke without DM' separately and measures of diagnostic efficacy were calculated. Results: Area under the curve (AUC) of serum IMA was 0.968 in ‘Stroke with DM' group as compared to 0.917 in ‘Stroke without DM' group. Sensitivity, specificity, positive predictive value and negative predictive value were 90%, 87%, 87% and 90% respectively in ‘Stroke with DM' group and 87%, 83%, 84% and 86% respectively in ‘Stroke without DM' group. Conclusion: IMA is an excellent marker for the diagnosis of acute stroke in both presence and absence of DM. The presence of DM increases the diagnostic efficacy of IMA in acute stroke patients.