title: Relationship between elevation of glycated albumin to glycated hemoglobin ratio in patients with a high bleeding risk of esophageal varices.
abstract: OBJECTIVE
  Variceal hemorrhaging due to portal hypertension is a severe complication of liver cirrhosis. Although several biomarkers have been reported as predictors of the presence of varices, it is still difficult to assess the risk of variceal bleeding without esophagogastroduodenoscopy (EGD). The ratio of glycated albumin (GA) to glycated hemoglobin (HbA1c) was reported to increase with the progression of liver fibrosis. The aim of the study was to investigate whether the GA/HbA1c ratio is related to the severity and bleeding-risk of the varices.
  
  
  METHODS
  We measured the GA/HbA1c ratio of HCV-related cirrhotic patients with Child-Pugh class A status and analyzed its relationship with the presence and bleeding risk of varices.
  
  
  RESULTS
  The GA/HbA1c ratio was higher in the patients who had the varices with a high risk of hemorrhage than in the patients with a low risk of bleeding. In addition, the GA/HbA1c ratio was higher in patients with varices than that in patients without varices. Furthermore, the GA/HbA1c ratio was the most significantly different parameter of all the factors examined, including the platelet count, prothrombin activity and albumin level.
  
  
  CONCLUSIONS
  The GA/HbA1c ratio is increased in patients with varices and with the bleeding risk of the varices.
authors.affiliation: Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Hirayuki
authors.initials: H
authors.lastname: Enomoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Aizawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Iwata
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Naoto
authors.initials: N
authors.lastname: Ikeda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takashima
authors.forename: Ryo
authors.initials: R
authors.lastname: Takata
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwai
authors.forename: Kazunari
authors.initials: K
authors.lastname: Iwata
authors.forename: Masaki
authors.initials: M
authors.lastname: Saito
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Imanishi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iijima
authors.forename: Hideji
authors.initials: H
authors.lastname: Nakamura
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D012720:Severity of Illness Index; D055815:Young Adult; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human