title: Glycated albumin and ratio of glycated albumin to glycated hemoglobin are good indicators of diabetic nephropathy in type 2 diabetes mellitus.
abstract: We investigated the association between serum levels of glycated albumin (GA), glycated hemoglobin (HbA1c), and GA:HbA1cratio and the presence of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).
  
  
  
  Two hundred six consecutive patients with T2DM were enrolled from the endocrinology ward at Shengjing Hospital of China Medical University and classified into 2 groups: DN group (n = 71) and non-diabetic nephropathy (non-DN) group (n = 135).
  
  
  
  The DN group showed significantly higher GA and GA:HbA1cvalues compared with the non-DN group. After univariate logistic regression, GA, GA:HbA1c, HbA1c, age, T2DM duration, systolic blood pressure, diastolic blood pressure, triglycerides, mean blood glucose (from 7 blood glucose checks), and presence of retinopathy were selected for advanced analysis. A multivariate logistic regression analysis was performed to examine the association between the presence of DN and these variables. Glycated albumin, GA:HbA1c, duration, systolic blood pressure, mean blood glucose, and retinopathy (but not HbA1c) were identified as independent variables that predicted the presence of DN. We then fitted the areas under the curve of GA:HbA1cand GA (0.811 and 0.754, respectively) separately using a receiver operating characteristic curve analysis. Both were better than HbA1c(0.580). We defined the cutoff value of GA:HbA1cas 2.71 (sensitivity 0.676, specificity 0.778) and that of GA as 17.5% (sensitivity 0.761, specificity 0.644) for the prediction of DN in patients with T2DM.
  
  
  
  The GA:HbA1cratio and GA may be superior to HbA1cassociated with the presence of DN.
authors.affiliation: Endocrinology Department, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Nana
authors.initials: N
authors.lastname: Wang
authors.affiliation: Laboratory Medicine Department, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Endocrinology Department, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Emergency Department, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Tiegang
authors.initials: T
authors.lastname: Li
mesh_terms: D000368:Aged; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism*; D000093423:Glycated Serum Albumin
chemical_list: D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human
keywords: diabetic nephropathy; glycated albumin; hemoglobin A1c; ratio of glycated albumin to hemoglobin; type 2 diabetes mellitus