title: Association of glycated albumin to HbA1c ratio with diabetic retinopathy but not diabetic nephropathy in patients with type 2 diabetes.
abstract: OBJECTIVE
  The ratio of glycated albumin to HbA1c (GA/HbA1c ratio) is a known indicator that reflects fluctuations in plasma glucose. In this study, the association of the GA/HbA1c ratio to diabetic nephropathy and diabetic retinopathy in patients with type 2 diabetes was investigated.
  
  
  METHODS
  Among patients with type 2 diabetes, 613 patients (364 males and 249 females, aged 63.2±12.5, body mass index (BMI) 25.4±4.8kg/m2) were enrolled. Patients with overt proteinuria, reduced renal function, or anemia were excluded.
  
  
  RESULTS
  In a comparison between patients with and without diabetic nephropathy, significance was observed in insulin therapy, HbA1c, and GA. In addition, in a comparison between patients with and without diabetic retinopathy, the GA/HbA1c ratio along with insulin therapy, HbA1c, and GA showed significant differences. When the GA/HbA1c ratios were divided into three groups and compared, the rates of diabetic nephropathy did not show any significance, while the rate of diabetic retinopathy increased significantly as the GA/HbA1c ratio increased. In multivariable analyses, while insulin therapy and BMI were the significant independent variables for diabetic nephropathy, insulin therapy and the GA/HbA1c ratios were the significant independent variable for diabetic retinopathy.
  
  
  CONCLUSIONS
  The GA/HbA1c ratio was associated with diabetic retinopathy, but not with diabetic nephropathy in patients with type 2 diabetes. These results suggest that the development and progression of diabetic retinopathy is associated with plasma glucose fluctuations.
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Umayahara
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kasai
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Fujiki
authors.affiliation: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hatazaki
authors.affiliation: Department of Internal Medicine, Hakuhokai Central Hospital, Hyogo, Japan. Electronic address: m-koga@kawanishi-city-hospital.com.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Koga
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000209:etiology / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000209:etiology / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Diabetic microangipathy; Diabetic nephropathy; Diabetic retinopathy; Glycated albumin; HbA1c