title: Glycated albumin is a more accurate glycaemic indicator than haemoglobin A1cin diabetic patients with pre-dialysis chronic kidney disease.
abstract: OBJECTIVE
  Glycated albumin (GA) has been reported to be a more reliable glycaemic indicator than haemoglobin A1c(HbA1c) in patients with diabetes on dialysis. However, the significance of these assays has been less evaluated in patients with diabetes and pre-dialysis chronic kidney disease (CKD).
  
  
  METHODS
  GA, HbA1cand fasting serum glucose were measured simultaneously in 146 patients with diabetes. Based on estimated glomerular filtration rate (eGFR), the subjects were categorized into a pre-dialysis CKD group (eGFR < 60 mL/min per 1.73 m2, n = 97) and a non-CKD group (eGFR ≥ 60 mL/min per 1.73 m2, n = 49).
  
  
  RESULTS
  The glucose/HbA1cand GA/HbA1cratios were significantly higher in the CKD group than those in the non-CKD group. The glucose/GA ratio did not differ significantly between the two groups. In the pre-dialysis CKD group, eGFR was negatively correlated with the glucose/HbA1cratio (r = -0.343, P = 0.001) and the GA/HbA1cratio (r = -0.499, P < 0.001). However, no significant correlation was detected between eGFR and the glucose/GA ratio. In the non-CKD group, eGFR was not correlated with the glucose/HbA1cratio, the glucose/GA ratio, or the GA/HbA1cratio. A multivariate regression analysis showed that eGFR had a significant impact on HbA1cbut no effect on GA in the pre-dialysis CKD group (β = 0.210, P = 0.005). In the non-CKD group, eGFR did not affect HbA1cor GA.
  
  
  CONCLUSIONS
  Our results show that HbA1csignificantly underestimated glycaemic control, whereas GA more accurately reflected glycaemic control in diabetic patients with pre-dialysis CKD.
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Il Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.|Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
keywords: chronic kidney disease; glycated albumin; haemoglobin A1c