Association of serum glycated albumin to haemoglobin A1C ratio with hepatic function tests in patients with chronic liver disease.
BACKGROUND
In patients with chronic liver disease (CLD), glycated haemoglobin (HbA(1C)) levels have been shown to be apparently lower than real values, whereas serum glycated albumin (GA) levels are apparently higher. The present study was aimed to examine whether both glycaemic indices are influenced by hepatic function.


METHODS
Subjects consisted of 82 patients with CLD. Various indicators for hepatic function as well as HbA(1C) and GA were also measured. Estimated HbA(1C) values were calculated from the mean plasma glucose levels. Two hundred and two type 2 diabetic patients without CLD were studied as controls.


RESULTS
Although GA was strongly correlated with HbA(1C) in patients with CLD as well as diabetic patients, GA levels in patients with CLD were relatively higher than those in diabetic patients. In patients with estimated HbA(1C) < or = 5.8%, GA levels significantly increased but HbA(1C) levels decreased as a function of decreasing hepaplastin test (HPT). The ratio of GA/HbA(1C) (G/H ratio) increased as a function of decreasing HPT. In patients with estimated HbA(1C) > 5.8%, in contrast, GA levels were independent of HPT levels. In the patients with CLD, GA and HbA(1C) were associated with mean plasma glucose levels and some indicators for hepatic function. The multivariate analysis revealed a significant association of G/H ratio with HPT, cholinesterase and direct bilirubin. The G/H ratio was not associated with the mean plasma glucose but with HPT and cholinesterase levels.


CONCLUSIONS
The G/H ratio correlates with hepatic function but not with plasma glucose levels. Therefore, CLD should be suspected for diabetic patients with an elevated G/H ratio.
Bando
Yukihiro
Y
Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui.
Kanehara
Hideo
H
Toya
Daisyu
D
Tanaka
Nobuyoshi
N
Kasayama
Soji
S
Koga
Masafumi
M
D000368:Aged; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D017127:Glycation End Products, Advanced; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000378:metabolism* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D000093423:Glycated Serum Albumin
D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin