title: Optimal glycated albumin cutoff value to diagnose diabetes in Korean adults: a retrospective study based on the oral glucose tolerance test.
abstract: BACKGROUND
  Glycated albumin (GA) reflects short-term status of glycemic control. We suggest a GA cut-off value to diagnose pre-diabetes and diabetes in Korean adults. In addition, we compared the performance of GA for the diagnosis of diabetes with that of glycated hemoglobin (A1c).
  
  
  METHODS
  A total of 852 subjects (498 males, 354 females) aged 20 to 83years (mean: 52.5years) were enrolled. A 75-g oral glucose tolerance test (OGTT) was performed and A1c and GA were measured.
  
  
  RESULTS
  In these enrolled subjects, 88% have glucose intolerance status (pre-diabetes or diabetes). The GA concentrations corresponding to fasting plasma glucose (FPG) of 7.0mmol/l, 2-h plasma glucose during OGTT (PPG2)≥11.1mmol/l, and A1c≥6.5% were 14.6%, 13.7%, and 14.7%, respectively. A meta-analysis of three GA cutoffs revealed a GA cutoff for diabetes of 14.3%. When A1c is used in combination with FPG, the sensitivity and specificity for the diagnosis of OGTT-based diabetes were 72.16% (95% CI: 66.6-72.2) and 96.4% (95% CI: 94.4-97.7), respectively. With the newly developed GA cutoff of 14.3%, GA combined with FPG resulted in a sensitivity and specificity of 77.5% (95% CI: 72.17-82.0) and 89.9% (95% CI: 87.1-92.2), respectively.
  
  
  CONCLUSIONS
  A GA cutoff of >14.3% is optimal for the diagnosis of diabetes in Korean adults. The measurement of FPG and GA may detect diabetes earlier than the measurement of FPG and A1c.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: You-Cheol
authors.initials: YC
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Jung
authors.affiliation: Department of Statistics, Dongguk University, Seoul, Republic of Korea.
authors.forename: Hong-Yup
authors.initials: HY
authors.lastname: Ahn
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
authors.forename: Won Seon
authors.initials: WS
authors.lastname: Jeon
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang-Man
authors.initials: SM
authors.lastname: Jin
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong-Taek
authors.initials: JT
authors.lastname: Woo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea. Electronic address: cydoctor@chol.com.
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Byung-Wan
authors.initials: BW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods / Q000592:standards; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000208:ethnology; D012189:Retrospective 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
keywords: Diabetes; Diagnosis; Glycated albumin; Glycated hemoglobin; Oral glucose tolerance test