title: Estimating average glucose levels from glycated albumin in patients with end-stage renal disease.
abstract: OBJECTIVE
  In patients with diabetic end stage renal disease (ESRD), glycated albumin (GA) reflects recent glycemic control more accurately than glycated hemoglobin (HbA1c). We evaluated the relationship between GA and average blood glucose (AG) level and developed an estimating equation for translating GA values into easier-to-understand AG levels.
  
  
  METHODS
  A total of 185 ESRD patients, including 154 diabetic and 31 non-diabetic participants, were enrolled (108 hemodialysis, 77 peritoneal dialysis). Patients were asked to perform four-point daily self-monitoring of capillary blood glucose (SMBG) at least three consecutive days each week for four weeks. Serum levels of GA, HbA1c and other biochemical parameters were checked at baseline, as well as at 4 and 8 weeks.
  
  
  RESULTS
  Approximately 74.3±7.0 SMBG readings were obtained from each participant and mean AG was 169.1±48.2 mg/dL. The correlation coefficient between serum GA and AG levels (r=0.70, p<0.001) was higher than that of HbA1c and AG (r=0.54, p<0.001). Linear regression analysis yielded the following equation: estimated AG (eAG) (mg/dL)=4.71×GA%+73.35, and with this formula, serum GA levels could be easily translated to eAG levels. Multivariate analysis revealed significant contributions of postprandial hyperglycemia (β=0.25, p=0.03) and serum albumin (β=0.17, p=0.04) in determining serum GA level, independent to other clinical parameters.
  
  
  CONCLUSIONS
  Compared to HbA1c, serum GA levels were better correlated with AG levels. Using the estimating equation, an average blood glucose level of 155-160 mg/dL could be matched to a GA value of 18-19% in patients with ESRD.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Jwa-Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.forename: Hyung Jung
authors.initials: HJ
authors.lastname: Oh
authors.forename: Dong Eun
authors.initials: DE
authors.lastname: Yoo
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Seung Hyeok
authors.initials: SH
authors.lastname: Han
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Kyu Hun
authors.initials: KH
authors.lastname: Choi
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D017127:Glycation End Products, Advanced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D055815:Young Adult; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin