A marker for acute cholecystitis severity: thiol-disulfide balance and ischemia-modified albumin.

Abstract

Objective: According to the Tokyo 2018 guidelines, white blood cells (WBCs) are the only markers used in the staging of acute cholecystitis. We aimed to investigate the role of thiol-disulfide and ischemia-modified albumin (IMA), which are used in the diagnosis of inflammatory diseases, in the diagnosis, and severity of acute cholecystitis.

Materials and methods: A total of 108 patients hospitalized with acute cholecystitis and 42 healthy volunteers were included in the study. Plasma total thiol (TT), native thiol (NT), and disulfide levels were measured and IMA was calculated using disulfide/native, disulfide/total, and native/TT ratios.

Results: Significant differences were found in both inflammatory and antioxidant markers, age, and symptom duration between disease stages (Stages I, II, and III) and control group (p < 0.001). Age and symptom duration were negatively correlated with antioxidant parameters (albumin, NT, and TT) (r = -0.321, p < 0.00). C-reactive protein and WBC correlated negatively with albumin and antioxidant parameters and positively with disulfide (r = 0.776, p < 0.001; r = 0.358, p < 0.001).

Conclusion: The oxidative stress markers in our study can be used to assist radiologic examinations in determining the severity of acute cholecystitis.