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Evaluation of the glycated albumin/HbA1c ratio by stage of diabetic nephropathy

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Abstract

HbA1c and glycated albumin (GA) levels are affected not only by plasma glucose levels but also by hemoglobin metabolism and albumin metabolism, respectively. Thus, HbA1c and GA for patients with diabetic nephropathy (DN), with progression of DN stage, are assumed to be affected by renal anemia and proteinuria, respectively. In this investigation, the GA/HbA1c ratio (G/H ratio) was evaluated and compared for DN patients at different stages. This study included 286 patients with diabetes mellitus (DN stage 1, 149; stage 2, 81; stage 3, 30; stage 4, 19; stage 5, 7), for whom HbA1c and GA were measured simultaneously. Patients with malignant diseases, chronic liver diseases, or thyroid disorders, and those with systemic corticosteroid use were excluded. The G/H ratio for DN stage 3 patients was significantly lower than for DN stage 1 patients, and it was significantly higher for DN stage 5 patients than for DN stage 1 patients. For all DN stage 4 patients, the G/H ratio did not differ significantly from that for patients with DN stage 1 and stage 2, but it was significantly higher for patients with anemia and lower for patients with marked proteinuria. In conclusion, for assessment of glycemic control status, HbA1c might be preferable for DN stage 4 patients without severe anemia and for DN stage 3 patients, whereas GA might be preferable for DN stage 4 patients without massive proteinuria and for DN stage 5 patients.

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Authors and Affiliations

  1. Department of Internal Medicine, Kinki Central Hospital, Kuruma-zuka 3-1, Itami, Hyogo, 664-8533, Japan

    Masafumi Koga, Jun Murai & Hiroshi Saito

  2. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Michio Otsuki

  3. Department of Medicine, Nissay Hospital, Osaka, Japan

    Soji Kasayama

Authors
  1. Masafumi Koga
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  2. Jun Murai
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  3. Hiroshi Saito
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  4. Michio Otsuki
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  5. Soji Kasayama
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Correspondence to Masafumi Koga.

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Koga, M., Murai, J., Saito, H. et al. Evaluation of the glycated albumin/HbA1c ratio by stage of diabetic nephropathy. Diabetol Int 2, 141–145 (2011). https://doi.org/10.1007/s13340-011-0033-z

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  • DOI: https://doi.org/10.1007/s13340-011-0033-z

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