# The assessment of thiol-disulfide homeostasis and ıschemia-modified albumin levels in patients with acromegaly

## TL;DR

This study found signs of increased oxidative stress in patients with acromegaly, which could contribute to the disease and its complications.

## Contribution

The study introduces new evidence linking thiol-disulfide imbalance and ischemia-modified albumin to oxidative stress in acromegaly.

## Key findings

- Acromegaly patients had lower native and total thiol levels and higher IMA levels compared to controls.
- Thiol levels in remission patients were still lower than controls, suggesting ongoing oxidative stress.
- Age negatively impacted thiol levels independently of disease activity.

## Abstract

Data regarding the relationship between acromegaly and oxidative stress (OS) remain limited. Dynamic thiol-disulfide homeostasis (TDH) is vital for antioxidant protection, and ischemia-modified albumin (IMA) serves as a marker of OS. This study aimed to measure serum TDH parameters and IMA levels in acromegaly patients, comparing them with healthy controls.

This cross-sectional study consecutively included 81 patients and 55 controls, matched for age, gender, and body mass index. Serum levels of native thiol, total thiol, and disulfide (TDH parameters) were measured using the automated spectrophotometric method developed by Erel and Neselioglu, along with serum IMA levels.

In patients, serum native and total thiol levels were significantly lower (p = 0.005 and p = 0.007), while serum IMA levels were significantly higher (p = 0.001). Disulfide levels were similar. Patients with active disease (N = 32), patients in remission (N = 49), and controls (N = 55) were compared. In post-hoc analyses; serum TDH parameters and IMA levels were similar in remission and active disease patients. Native and total thiol levels were significantly lower in patients in remission compared to controls (p = 0.01 and p = 0.04). IMA levels were significantly higher in patients in remission compared to controls (p = 0.04). Serum thiol levels positively correlated with serum insulin-like growth factor-1 levels and negatively with age and disease duration, while age independently exerted a negative impact on serum thiol levels.

Our findings may indicate increased OS in the acromegalic process, which may contribute to the development of acromegaly and its related complications and comorbidities.