Glycated albumin as an improved indicator of glycemic control in hemodialysis patients with type 2 diabetes based on fasting plasma glucose and oral glucose tolerance test.
OBJECTIVE
To compare glycated albumin (GA) with glycated hemoglobin (HbA1c) as an indicator of glycemic control in hemodialysis patients with diabetes mellitus (DM), based on relationships with plasma glucose (PG) after overnight fasting and during 75 g oral glucose tolerance test (OGTT).


METHODS
GA, HbA1c, plasma glucose during 75 g OGTT, and serum pentosidine were determined in DM hemodialysis patients (n=23, male/female 9/14).


RESULTS
Significant positive correlations were found for GA and HbA1c with fasting PG (GA, r=.660, p=0.0006; HbAlc r=0.665, p=0.0004), and with PG at 30, 60 and 120 min after initiation of 75 g OGTT (GA, r=0.584, p=0.0035; r=0.624, p=0.0015; r=0.510, p=0.0129, respectively; HbA1c, r=0.669, p=0.0004; r=0.624, p=0.0011; r=0.509, p=0.0112, respectively). The area under the curve for PG during 75 g OGTT showed strong correlations with GA (r=0.625, p=0.0008) and HbA1c (r=0.671, p=0.0003). GA and HbA1c also correlated positively with serum pentosidine, demonstrating that GA provides a no less significant assay than HbA1c as a reflection of glycemic control in DM hemodialysis patients. However, HbA1c was apparently reduced in DM hemodialysis patients, as reflected by an increase in the GA/HbA1c ratio to 3.58+/-0.62 (mean+/-SD), suggesting underestimation of glycemic control by HbA1c.


CONCLUSIONS
GA and HbA1c exhibited similar correlations with PG during a 75 g OGTT. The dependence of GA, in contrast to HbA1c, on PG does not differ in DM hemodialysis patients from that reported for subjects with normal renal function, suggesting GA as a better marker of glycemic control in DM hemodialysis patients.
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Harumi
H
Nagayama
Masaaki
M
Inaba
Reiko
R
Okabe
Masanori
M
Emoto
Eiji
E
Ishimura
Shuji
S
Okazaki
Yoshiki
Y
Nishizawa
D000368:Aged; D019540:Area Under Curve; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D017127:Glycation End Products, Advanced; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis / Q000378:metabolism*; D000093423:Glycated Serum Albumin
D001120:Arginine; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D008239:Lysine; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C062187:pentosidine