title: Nontraditional markers of glycemia: associations with microvascular conditions.
abstract: OBJECTIVE
  To compare the associations of nontraditional (fructosamine, glycated albumin, 1,5-anhydroglucitol [1,5-AG]) and standard (fasting glucose, HbA(1c)) glycemic markers with common microvascular conditions associated with diabetes mellitus.
  
  
  METHODS
  We conducted a cross-sectional study of 1,600 participants (227 with a history of diabetes and 1,323 without) from the Atherosclerosis Risk in Communities (ARIC) Study, a community-based population. We conducted logistic regression analyses of the associations of diabetes-specific tertiles of fructosamine, glycated albumin, 1/(1,5-AG), fasting glucose, and HbA(1c) with prevalence of chronic kidney disease, albuminuria, and retinopathy after adjustment for demographic, clinical, and lifestyle variables.
  
  
  RESULTS
  We observed significant positive trends in the associations of each marker with albuminuria and retinopathy, even after accounting for demographic, clinical, and lifestyle factors (all P trends <0.05). The associations with chronic kidney disease were similar in direction but were only significant for higher glycated albumin (P trend = 0.005), fructosamine (P trend = 0.003), and HbA(1c) (P trend = 0.005) values. After further adjustment for HbA(1c), glycated albumin and fructosamine remained significantly or borderline significantly associated with the microvascular outcomes.
  
  
  CONCLUSIONS
  In cross-sectional analyses, two serum markers of glycemia-glycated albumin and fructosamine-are as, or more strongly, associated with microvascular conditions as HbA(1c). These markers may be useful in settings where whole blood is not available. Whether they might complement or outperform HbA(1c) in terms of long-term predictive value requires further investigation.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore,Maryland, USA. lselvin@jhsph.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.forename: Lesley M A
authors.initials: LM
authors.lastname: Francis
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Brancati
authors.forename: Michael W
authors.initials: MW
authors.lastname: Steffes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000378:metabolism*; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012709:Serum Albumin / Q000378:metabolism; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin