title: Glycated albumin is a better indicator for glucose excursion than glycated hemoglobin in type 1 and type 2 diabetes.
abstract: To determine the impact of blood glucose profile, involving fluctuation and excursion of blood glucose levels, on glycated proteins, we evaluated the association among the daily profile of blood glucose, and glycated albumin (GA) and HbA1c levels in patients with type 1 diabetes (n = 93) and type 2 diabetes (n = 75). GA levels were strongly correlated with HbA1c levels in type 1 (r = 0.85, P<0.0001) and type 2 diabetes (r = 0.61, P<0.0001), respectively. HbA1c levels were similar between patients with type 1 and type 2 diabetes, while GA levels were significantly higher in type 1 diabetes. Thus the ratio of GA levels to HbA1c levels was significantly higher in type 1 diabetes than that in type 2 diabetes (3.32 0.36 vs. 2.89 0.44, p<0.001). The degrees of GA levels and HbA1c levels correlated with maximum and mean blood glucose levels in patients with type 1 and type 2 diabetes. Stepwise multivariate analysis revealed that GA levels independently correlated with maximum blood glucose levels in type 1 diabetes (F = 43.34, P<0.001) and type 2 diabetes (F = 41.57, P<0.001). HbA1c levels also independently correlated with maximum blood glucose levels in type 1 diabetes (F = 34.78, P<0.001), as well as being correlated with mean blood glucose levels in type 2 diabetes (F = 11.28, P<0.001). In summary, GA could be a better marker for glycemic control than glycated hemoglobin in diabetic patients, especially for evaluating glycemic excursion, which is considered to be a major cause of diabetic angiopathy.
authors.affiliation: Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazutomi
authors.initials: K
authors.lastname: Yoshiuchi
authors.forename: Munehide
authors.initials: M
authors.lastname: Matsuhisa
authors.forename: Naoto
authors.initials: N
authors.lastname: Katakami
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Kenya
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Takaaki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Umayahara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kosugi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneto
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002940:Circadian Rhythm / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis*; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin