Higher circulating ischemia-modified albumin (IMA) levels were associated with diabetic foot ulcers, according to a meta-analysis published in The International Journal of Lower Extremity Wounds. The findings indicate a potential biomarker role for IMA in detecting foot ulceration risk in diabetes.

The review included observational studies comparing IMA levels in three groups: individuals with diabetic foot ulcers, individuals with diabetes but no ulcers, and healthy controls. Standardized mean differences were calculated using random-effects models. Publication bias was assessed with PET-PEESE regression. Frequentist and Bayesian analyses were conducted to confirm consistency.

IMA levels were markedly higher in DFU cases than in healthy controls (pooled standardized mean difference 3.21; 95% CI 1.40–5.03). Higher IMA levels were also seen in DFU versus diabetes without ulcers (pooled standardized mean difference 1.21; 95% CI 0.23-2.20). Adjusting IMA for serum albumin preserved these group differences. No significant publication bias was detected.

IMA may support DFU diagnosis and early risk evaluation. However, high heterogeneity and a limited number of studies constrain widespread adoption. Standardized measurement protocols and larger prospective studies are needed to validate clinical cut-offs and confirm its application in routine practice.