Abstract
Objective
Oral glucose tolerance test (OGTT) and glycated haemoglobin (HbA1c) have many limitations in diagnosing prediabetes. Glycated albumin (GA) estimation can be a potential tool for its early diagnosis. The present study aims to analyze the diagnostic efficacy of GA to identify prediabetes.
Methods
Prediabetics (n = 406) and healthy (n = 406) subjects were included. OGTT was used as the diagnostic standard for identifying prediabetes. HbA1c was estimated in a Bio-Rad D-10 analyzer based on the High-Performance Liquid Chromatography (HPLC) method. GA was measured using the enzyme-linked immunosorbent assay (ELISA) technique and was expressed as a percent of total albumin. Total albumin was measured by the modified bromocresol Purple (BCP) dye-binding method in Siemen’s autoanalyzer.
Results
HbA1c (5.83 ± 0.57%) and GA (14.43 ± 1.92%) were significantly higher (p < 0.05) in the prediabetics as compared to healthy individuals. Both HbA1c and GA showed a significantly positive correlation with fasting plasma glucose (FPG) and 2-h plasma glucose. However, the correlation was stronger with 2-h plasma glucose for both parameters. GA and HbA1c also showed a significant positive correlation with each other. HbA1c, at 5.7% cut-off, predicted prediabetes with 74% sensitivity and 90% specificity. At the cut-off of 13.5%, GA showed 66% sensitivity and 85% specificity to identify pre-diabetes. The sensitivity of the combined tests was significantly greater than that for HbA1c alone (84% combined versus 74% HbA1c).
Conclusion
GA, combined with HbA1c, can be used as a screening test for identifying pre-diabetes. Early diagnosis and interventions could prevent disease progression and limit dreadful complications.
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Data availability
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation, to any qualified researcher.
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Acknowledgements
The authors are grateful for financial support from the Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi. This research did not receive any specific grant from funding agencies. The author AR is thankful to the Department of Health Research, Ministry of Health and Family Welfare New Delhi for providing financial assistance in the form of salary when AR was affiliated with the GSVM Medical College Kanpur. The author AR now thank the Brain Pool Program, funded by the Ministry of Science and ICT through the National Research Foundation of Korea (Grant Number 2022H1D3A2A01096346), for supporting this research.
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Informed and written consent from prediabetics as well as healthy subjects was obtained before taking blood samples. An Ethical clearance certificate was obtained from the institutional ethical committee before the conduction of the study (No. JHIEC 08/2018). The present study followed the principles of the declaration of Helsinki.
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Alam, S., Ahmad, F., Tripathi, P. et al. Glycated albumin as a surrogate marker for prediabetes: a cross-sectional study. Int J Diabetes Dev Ctries 44, 379–386 (2024). https://doi.org/10.1007/s13410-023-01250-z
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DOI: https://doi.org/10.1007/s13410-023-01250-z