title: Relationship between glycated albumin and glycated hemoglobin according to glucose tolerance status: A multicenter study.
abstract: OBJECTIVE
  To determine the relationship between glycated albumin (GA) and glycated hemoglobin (HbA1c) and to explore the association of glycated albumin/glycated hemoglobin (GA/HbA1c) ratio with glucose indices in Chinese subjects with varying glucose tolerance status.
  
  
  METHODS
  This hospital-based, cross-sectional study involved 953 participants without known diabetes from 11 centers in China. Oral glucose tolerance test (OGTT) was used to identify three groups of subjects: normal glucose regulation (n=194), impaired glucose regulation (n=303) and newly diagnosed type 2 diabetes group (n=456). The GA, HbA1c and GA/HbA1c ratio were tested.
  
  
  RESULTS
  GA was positively correlated with HbA1c (r=0.832, P<0.001). After correcting for age, sex and BMI, the correlations remained significant (r=0.824, P<0.001). Linear regression analysis estimated that a 1% increase of HbA1c was associated with a 2.84% increase of GA (GA=2.843×HbA1c-0.203; R(2)=0.692, P<0.001). GA would be 18.3 (16.7-19.9)% and 19.7 (18.0-21.4)% with HbA1c of 6.5% (48mmol/mol) and 7.0% (53mmol/mol). The mean GA/HbA1c ratio was 2.81±0.38, and it significantly increased with the presence of glucose intolerance (all, P<0.05). In the total study population, GA/HbA1c was correlated with BMI, glucose levels and 30-min insulin during OGTT, the homeostatic model assessment of β-cell function (HOMA-β), and ΔI30/ΔG30 (all, P<0.05). Increased glucose at 30min (standardized β=0.221, P<0.001), and decreased BMI (standardized β=-0.114, P=0.008) were associated with elevated GA/HbA1c ratio by multiple linear regression (adjusted R(2)=0.045).
  
  
  CONCLUSIONS
  The relationship between GA and HbA1c was strong. The GA/HbA1c ratio was related to acute postprandial glucose fluctuation and BMI level.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Mo
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xingwu
authors.initials: X
authors.lastname: Ran
authors.affiliation: Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Wenying
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China.
authors.forename: Yongde
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Endocrinology and Metabolism, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, Fudan University Affiliated Zhongshan Hospital, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Endocrinology and Metabolism, The First People's Hospital of Foshan, Foshan, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Luan
authors.affiliation: Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Weiqing
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Diabetic Neurology, Metabolic Disease Hospital, Tianjin Medical University, Tianjin, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China; Department of Endocrinology and Metabolism, Kashgar Prefecture Second People's Hospital, Kashgar, Xinjiang, China. Electronic address: zhoujian@sjtu.edu.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China. Electronic address: wpjia@sjtu.edu.cn.
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D017127:Glycation End Products, Advanced; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism*; D055815:Young Adult; D000093423:Glycated Serum Albumin
chemical_list: D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007328:Insulin; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human
keywords: Glycated albumin; Glycated albumin/glycated hemoglobin; Glycated hemoglobin; Glycemic control