Skip to main content

Advertisement

Log in

Glycated albumin is a useful glycation index for monitoring fluctuating and poorly controlled type 2 diabetic patients

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Glycated albumin (GA) is recognized as a reliable marker for short-term glycemic monitoring in diabetic patients. We investigated the clinical relevance of GA and the ratio of GA to glycated hemoglobin (A1c) in Korean type 2 diabetic patients. In this retrospective study, we compared A1c, GA, and the GA/A1c ratio and analyzed the relationship between glycemic indices and various parameters in 1,038 Korean type 2 diabetic patients. The patients were divided into two groups: a stably maintained A1c group whose A1c levels did not fluctuate by more than 0.5% for at least 6 months and an unstably maintained A1c group whose A1c levels fluctuated by more than 0.5%. Serum GA was strongly correlated with A1c in both groups. Fasting plasma glucose and postprandial glucose were correlated with GA in unstably maintained A1c group, whereas they were correlated with A1c in stably maintained A1c group. The GA/A1c ratio tended to increase as A1c increased. Postprandial glucose and body mass index affected the GA/A1c ratio. Our data show that serum GA may be a more useful glycation index than A1c for monitoring glycemic control in type 2 diabetic patients with fluctuating and poorly controlled glycemic excursions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Turner RC, Cull CA, Frighi V, Holman RR (1999) Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK prospective diabetes study (UKPDS) group. JAMA 281(21):2005–2012

    Article  PubMed  CAS  Google Scholar 

  2. Holman R, Paul SK, Bethel MA, Matthews DR, Neil HA (2008) 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 359(15):1577–1589

    Article  PubMed  CAS  Google Scholar 

  3. Atkins RC, Zimmet P (2010) Diabetic kidney disease: act now or pay later. Acta Diabetol 47(1):1–4

    Article  PubMed  Google Scholar 

  4. Tarquini R, Lazzeri C, Pala L, Rotella CM, Gensini GF (2010) The diabetic cardiomyopathy. Acta Diabetol. doi:10.1007/s00592-010-0180-x

  5. Lim S, Kim DJ, Jeong IK et al (2009) A Nationwide Survey about the current status of glycemic control and complications in diabetic patients in 2006: the committee of the Korean diabetes association on the epidemiology of diabetes mellitus. Korean Diabetes J 33(1):48–57

    Article  Google Scholar 

  6. Diabetes Control and Complications Trial Group (1995) The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 44(8):968–983

    Article  Google Scholar 

  7. Gaede P, Vedel P, Larsen N, Jensen GV, Parving H, Pedersen O (2003) Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348(5):383–393

    Article  PubMed  Google Scholar 

  8. Goldstein DE, Little R, Lorenz RA et al (2004) Tests of glycemia in diabetes. Diabetes Care 27(7):1761–1773

    Article  PubMed  Google Scholar 

  9. Roohk HV, Zaidi AR (2008) A review of glycated albumin as an intermediate glycation index for controlling diabetes. J Diabetes Sci Technol 2(6):1114–1121

    PubMed  Google Scholar 

  10. Tahara Y (2009) Analysis of the method for conversion between levels of HbA1c and glycated albumin by linear regression analysis using a measurement error model. Diabetes Res Clin Pract 84(3):224–229

    Article  PubMed  CAS  Google Scholar 

  11. Shima K, Abe F, Chikakiyo H, Ito N (1989) The relative value of glycated albumin, hemoglobin A1c and fructosamine when screening for diabetes mellitus. Diabetes Res Clin Pract 7(4):243–250

    Article  PubMed  CAS  Google Scholar 

  12. Kouzuma T, Usami T, Yamakoshi M, Takahashi M, Imamura S (2002) An enzymatic method for the measurement of glycated albumin in biological samples. Clin Chim Acta 324(1–2):61–71

    Article  PubMed  CAS  Google Scholar 

  13. Kouzuma T, Uemastu Y, Usami T, Imamura S (2004) Study of glycated amino acid elimination reaction for an improved enzymatic glycated albumin measurement method. Clin Chim Acta 346(2):135–143

    Article  PubMed  CAS  Google Scholar 

  14. American Diabetes Association (2010) Diagnosis and classification of diabetes mellitus. Diabetes Care 33(Suppl 1):S62–S69

    Article  Google Scholar 

  15. Hu Y, Liu W, Chen Y et al (2010) Combined use of fasting plasma glucose and glycated hemoglobin A1c in the screening of diabetes and impaired glucose tolerance. Acta Diabetol 47(3):231–236

    Article  PubMed  CAS  Google Scholar 

  16. Koga M, Saito H, Mukai M, Matsumoto S, Kasayama S (2009) Influence of iron metabolism indices on glycated haemoglobin but not glycated albumin levels in premenopausal women. Acta Diabetol. doi:10.1007/s00592-009-0123-6

  17. Koga M, Murai J, Saito H, Mukai M, Kasayama S (2010) Serum glycated albumin, but not glycated haemoglobin, is low in relation to glycemia in hyperuricemic men. Acta Diabetol 47(2):173–177

    Article  PubMed  CAS  Google Scholar 

  18. Koga M, Saito H, Mukai M, Otsuki M, Kasayama S (2009) Serum glycated albumin levels are influenced by smoking status, independent of plasma glucose levels. Acta Diabetol 46(2):141–144

    Article  PubMed  CAS  Google Scholar 

  19. Inaba M, Okuno S, Kumeda Y et al (2007) Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol 18(3):896–903

    Article  PubMed  CAS  Google Scholar 

  20. Peacock TP, Shihabi ZK, Bleyer AJ et al (2008) Comparison of glycated albumin and hemoglobin A(1c) levels in diabetic subjects on hemodialysis. Kidney Int 73(9):1062–1068

    Article  PubMed  CAS  Google Scholar 

  21. Hashimoto K, Noguchi S, Morimoto Y et al (2008) A1C but not serum glycated albumin is elevated in late pregnancy owing to iron deficiency. Diabetes Care 31(10):1945–1948

    Article  PubMed  CAS  Google Scholar 

  22. Imai T, Oikawa Y, Shimada A (2007) Improved Monitoring of the Hyperglycemic State in Type 1 Diabetes Patients by Use of the Glycoalbumin/HbA1c Ratio. Rev Diabet Stud 4(1):44–48

    Article  PubMed  Google Scholar 

  23. Takahashi S, Uchino H, Shimizu T et al (2007) Comparison of glycated albumin (GA) and glycated hemoglobin (HbA1c) in type 2 diabetic patients: usefulness of GA for evaluation of short-term changes in glycemic control. Endocr J 54(1):139–144

    Article  PubMed  CAS  Google Scholar 

  24. Paroni R, Ceriotti F, Galanello R et al (2007) Performance characteristics and clinical utility of an enzymatic method for the measurement of glycated albumin in plasma. Clin Biochem 40(18):1398–1405

    Article  PubMed  CAS  Google Scholar 

  25. Koga M, Murai J, Saito H, Kasayama S (2010) Glycated albumin and glycated hemoglobin are influenced differently by endogenous insulin secretion in patients with type 2 diabetes. Diabetes Care 33(2):270–272

    Article  PubMed  CAS  Google Scholar 

  26. Miyashita Y, Nishimura R, Morimoto A, Matsudaira T, Sano H, Tajima N (2007) Glycated albumin is low in obese, type 2 diabetic patients. Diabetes Res Clin Pract 78(1):51–55

    Article  PubMed  CAS  Google Scholar 

  27. Koga M, Otsuki M, Matsumoto S, Saito H, Mukai M, Kasayama S (2007) Negative association of obesity and its related chronic inflammation with serum glycated albumin but not glycated hemoglobin levels. Clin Chim Acta 378(1–2):48–52

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Byung-Wan Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, E.Y., Lee, BW., Kim, D. et al. Glycated albumin is a useful glycation index for monitoring fluctuating and poorly controlled type 2 diabetic patients. Acta Diabetol 48, 167–172 (2011). https://doi.org/10.1007/s00592-010-0242-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-010-0242-0

Keywords

Navigation