title: Glycation gap: An additional tool for glycometabolic monitoring.
abstract: BACKGROUND
  The determination of glycated albumin (GA) has been suggested as an additional parameter having an independent added value respect to that of HbA1c. The determination of glycation gap (gg) has also been proposed, but few studies have addressed its potential impact in the routine evaluation of glycometabolic control.
  
  
  METHODS
  A total of 157 subjects presenting normal whole blood cell count, no hemoglobin variants, normal creatinine levels and serum protein electrophoresis patterns were studied. In a second phase, a total of 205 subjects with no restrictions as those of the first phase study, were analyzed. HbA1cwas measured by capillary electrophoresis, glycated albumin by an enzymatic method and their gg were then calculated.
  
  
  RESULTS
  The correlation between HbA1cand GA for the subjects of phase 1 was strong (r=0.8927) and significant correlation between gg and age was remarked (r=0.4486). We found 17.1% of phase 2 subjects with gg falling outside the 95% prediction intervals. Various clinical conditions seemed to affect these subjects, in our experience mostly often related to impaired renal function.
  
  
  CONCLUSIONS
  The glycation gap may be useful to alert clinicians about patients under unstable glycemic control or when various pre-analytical conditions my affect the reliability of the measurement of GA or HbA1c.
authors.affiliation: Dip. di Fisiopatologia medico-chirurgica e dei trapianti and Centro per la Riferibilità Metrologica in Medicina di Laboratorio (CIRME), Università degli Studi di Milano, Milano, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: Paleari
authors.affiliation: Laboratorio di Standardizzazione, Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milano, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Strollo
authors.affiliation: Laboratorio di Standardizzazione, Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Guerra
authors.affiliation: Laboratorio di Standardizzazione, Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milano, Italy.
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Ceriotti
authors.affiliation: Dip. di Fisiopatologia medico-chirurgica e dei trapianti and Centro per la Riferibilità Metrologica in Medicina di Laboratorio (CIRME), Università degli Studi di Milano, Milano, Italy. Electronic address: andrea.mosca@unimi.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mosca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006031:Glycosylation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis*; D055815:Young Adult; 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: Diabetes; Glycated albumin.; Glycemia; HbA(1c)