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Ku KC, Zhong J, Song E, Fong CHY, Lam KSL, Xu A, Lee CH, Cheung CYY. Clinical utility of glycated albumin and 1,5-anhydroglucitol in the screening and prediction of diabetes: A multi-center study. World J Diabetes 2025; 16:102867. [DOI: 10.4239/wjd.v16.i4.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 12/24/2024] [Accepted: 02/12/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND Despite being the gold standard, the use of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) for diagnosing dysglycemia is imperfect. In particular, a low level of agreement between HbA1c and FPG in detecting prediabetes and diabetes has led to difficulties in clinical interpretation. Glycated albumin (GA) and 1,5-anhydroglucitol (1,5-AG) may potentially serve as biomarkers for the detection and prediction of diabetes, as well as glycemic monitoring.
AIM To explore the diagnostic performance of GA and 1,5-AG for screening dysglycemia; assess whether they can be used for glycemic monitoring in Chinese morbidly-obese patients; and examine their predictive ability for incident diabetes in a Chinese community-based cohort.
METHODS GA and 1,5-AG concentrations were measured in 462 morbidly-obese patients from the Obese Chinese Cohort (OCC). A sub-group of diabetes subjects (n = 24) was prospectively followed-up after bariatric surgery. Differences between baseline and post-surgery biomarker values were converted to percentage change from baseline to assess the response to glycemic control. Predictive ability of the biomarkers was assessed in 132 incident diabetes cases and 132 matched non-diabetes controls in the community-based Cardiovascular Risk Factor Prevalence Study (CRISPS). A prediction model was developed and compared with clinical models based on conventional risk factors.
RESULTS GA exhibited an excellent diagnostic value with an area under the receiver operating characteristic curve (AUC) of 0.919 (95%CI: 0.884-0.955) for identifying diabetes and a high agreement in the classification of diabetes with both FPG and HbA1c in the OCC. GA demonstrated the fastest response to glycemic control. In CRISPS, the ‘B3A’ prediction model, which consisted of body mass index (BMI) and 3 biomarkers (HbA1c, GA and 1,5-AG), achieved a comparable predictive value [AUC (95%CI): 0.793 (0.744-0.843)] to that of a clinical model comprising BMI, HbA1c, FPG and 2-hour glucose (2hG) [AUC (95%CI): 0.783 (0.733-0.834); DeLong P value = 0.736]. The ‘B3A’ was significantly superior to a clinical model including BMI, HbA1c, FPG and triglycerides [AUC (95%CI): 0.729 (0.673-0.784); DeLong P value = 0.027].
CONCLUSION GA and 1,5-AG have the potential to act as robust biomarkers for the screening and risk prediction of diabetes. FPG and 2hG may be replaced by GA and 1,5-AG in future diabetes predictions.
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Affiliation(s)
- Kam-Ching Ku
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Junda Zhong
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Erfei Song
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Carol Ho-Yi Fong
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Karen Siu-Ling Lam
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Aimin Xu
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Chi-Ho Lee
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
| | - Chloe Yu-Yan Cheung
- Department of Medicine, University of Hong Kong, Hong Kong 999077, China
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong 999077, China
- Guangdong-Hong Kong Joint Institute of Metabolic Medicine, University of Hong Kong, Hong Kong 999077, China
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Aihara M, Yano K, Irie T, Nishi M, Yachiku K, Minoura I, Sekimizu K, Sakurai Y, Kadowaki T, Yamauchi T, Kubota N. Salivary glycated albumin could be as reliable a marker of glycemic control as blood glycated albumin in people with diabetes. Diabetes Res Clin Pract 2024; 218:111903. [PMID: 39447680 DOI: 10.1016/j.diabres.2024.111903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 10/14/2024] [Accepted: 10/21/2024] [Indexed: 10/26/2024]
Abstract
AIMS Measurements of diabetes-related biomarkers are necessary to assess glycemic control. The commonly used finger-prick blood glucose and HbA1c measurements are invasive, as is blood glycated albumin (GA) measurement. Therefore, we developed a non-invasive method, namely, measurement of the salivary GA with high accuracy using a high-performance liquid chromatography (HPLC) method. METHODS We recruited participants with diabetes mellitus admitted to The University of Tokyo Hospital. Blood and saliva samples were collected at three time points (fasting and 2-hour postprandial at admission and fasting at discharge). After partial purification using an antibody-based column, the samples were subjected to GA measurement by HPLC method. RESULTS Among the 56 participants with diabetes mellitus enrolled in the study, there was a correlation between the GA levels measured in blood and saliva at the three time points described above (n = 45, R2 = 0.985, P < 0.001; n = 48, R2 = 0.973, P < 0.001; n = 51, R2 = 0.979, P < 0.001). Multiple regression analysis revealed the associations were maintained even after adjustments for age, BMI, and nephropathy stage. CONCLUSIONS This exploratory research revealed that the salivary GA levels by this method were accurate and might be able to replace blood GA measurement. The home salivary GA measurement is expected to be developed that may reduce the burden and complications in people with diabetes mellitus and improve the quality of life.
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Affiliation(s)
- Masakazu Aihara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kouji Yano
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Tomoko Irie
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Mitsumi Nishi
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kenji Yachiku
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Itsushi Minoura
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Koshin Sekimizu
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshitaka Sakurai
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Department of Metabolic Medicine, Faculty of Life Science, Kumamoto University, Kumamoto 860-8556, Japan.
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Stickle DF, DiNatale GJ, Molinaro R. Minimal mathematical model for glycation of albumin. Clin Biochem 2024; 133-134:110830. [PMID: 39353501 DOI: 10.1016/j.clinbiochem.2024.110830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 09/20/2024] [Accepted: 09/28/2024] [Indexed: 10/04/2024]
Abstract
BACKGROUND Glycated albumin (GA) is often described as a reflection of glucose exposure over the past 2-4 weeks. We examined the scale of the operative interval for changes in %GA from the perspective of a theoretical model for GA formation, by simulating the time course of changes in %GA after changes in glucose. METHODS Probability of survival of albumin (A) was according to first-order elimination based on t1/2 of 17 days. Probability of formation of GA from A per unit time was proportional to glucose (G) and a glycation rate constant, k, deduced from reference values for %GA vs. G. We then simulated the kinetics of changes in %GA for conditions in which a prior steady-state (constant G) was followed by a step change in G. RESULTS The glycation rate constant k was 9.79e-4/d/(mmol/L). We simulated changes in %GA for two scenarios involving step changes in G at time = 0: A. from 10 mmol/L to 15 mmol/L (%GA ultimately moves from 19.3% to 26.4%); B. from 15 mmol/L to 10 mmol/L (%GA ultimately moves from 26.4% to 19.3%). For both scenarios, the fractional transition of %GA between respective starting points and ultimate endpoints was after 30 days approximately 80% of the ultimate full transition. CONCLUSIONS Model-based calculations support the description of %GA as a reflection of G over the past 4-6 weeks, longer than the period of 2-4 weeks that is commonly cited.
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Affiliation(s)
| | | | - Ross Molinaro
- Siemens Healthcare Diagnostics, Inc., Tarrytown, NY, USA
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Al-Lahham Y, Volanski W, Signorini L, do Prado AL, Valdameri G, Moure VR, Welter M, Alves AC, Sari MHM, Rego FGDM, Picheth G. Reference Interval for Glycated Albumin, 1,5-AG/GA, and GA/HbA1c Ratios and Cut-Off Values for Type 1, Type 2, and Gestational Diabetes: A Cross-Sectional Study. Biomedicines 2024; 12:2651. [PMID: 39767558 PMCID: PMC11673511 DOI: 10.3390/biomedicines12122651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/16/2024] [Accepted: 11/19/2024] [Indexed: 01/11/2025] Open
Abstract
Background/Objectives: Glycated albumin (GA) serves as a biomarker for short-term glycemic control (2-3 weeks), playing a role in diabetes management. Our goal was to establish reference intervals (RIs) for serum GA, and the ratios of 1,5-anhydroglucitol to GA (AGI) and GA to HbA1c in a Euro-Brazilian pediatric population (10 y, n = 299), adults (43.5 y; n = 290), and pregnant women (26 y, n = 406; 26.5 ± 3.1 gestation weeks). Methods: Receiver operating characteristic curve analysis was employed to determine RIs for type 1 diabetes (T1D) in children (n = 148) and adults (n = 81), type 2 diabetes (T2D, n = 283), and gestational diabetes mellitus (GDM, n = 177). Results: Both non-pregnant and pregnant women exhibited GA RIs of 10.0-13.3% and 10.6-14.7%, respectively. The AGI ratio varied from 1.2-4.3 in children, 0.9-3.6 in adults, and 0.8-3.1 in pregnant women. Meanwhile, the GA/HbA1c ratio ranged from 1.8-2.6 in children and adults to 2.3-3.6 in pregnant women. GA and AGI ratios accurately differentiated between T1D and T2D, demonstrating high sensitivity (>84%) and specificity (>97%), with AGI showing superior performance (AUC > 0.99). The GA/HbA1c ratio exhibited moderate discriminatory power (AUC > 0.733) but was less effective in distinguishing adult-onset T1D and T2D, suggesting its limited utility in certain groups. Conclusions: The proposed RIs are consistent with those of other Caucasian populations, affirming their relevance for Euro-Brazilian patients. The GA and AGI ratios emerge as valuable diagnostic tools for T1D and T2D, though their reduced sensitivity in diagnosing GDM warrants further investigation. Clinicians might leverage GA and AGI ratios for more tailored diabetes management, especially when HbA1c results are not optimal.
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Affiliation(s)
- Yusra Al-Lahham
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Waldemar Volanski
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
- Laboratory Division, Curitiba City Hall, Curitiba 80530-908, Brazil
| | - Liana Signorini
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
- Laboratory Division, Curitiba City Hall, Curitiba 80530-908, Brazil
| | - Ademir Luiz do Prado
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
- Federal Institute of Parana, Colombo 83403-515, Brazil
| | - Glaucio Valdameri
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Vivian Rotuno Moure
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Marciane Welter
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Alexessander C. Alves
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
| | - Marcel Henrique Marcondes Sari
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Fabiane Gomes de Moraes Rego
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
| | - Geraldo Picheth
- Graduate Program in Pharmaceutical Sciences, Federal University of Paraná, Curitiba 80210-170, Brazil (W.V.); (L.S.); (G.V.); (V.R.M.); (M.H.M.S.); (F.G.d.M.R.)
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Jinnouchi H, Yoshida A, Taniguchi M, Yamauchi E, Kurosawa D, Yachiku K, Minoura I, Kadowaki T, Yamauchi T, Aihara M, Kubota N, Sekimizu K. Efficacy of Self-Review of Lifestyle Behaviors with Once-Weekly Glycated Albumin Measurement in People with Type 2 Diabetes: A Randomized Pilot Study. Diabetes Ther 2024; 15:1561-1575. [PMID: 38753121 PMCID: PMC11211309 DOI: 10.1007/s13300-024-01599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/25/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Lifestyle management, including appropriate modifications of nutrition, exercise, and medication behaviors, is essential for optimal glycemic control. The absence of appropriate monitoring methods to validate the lifestyle change may hinder the modification and continuation of behaviors. In this study, we evaluated whether once-weekly glycated albumin (GA) measurement received via a smartphone application could improve glycemia management in patients with type 2 diabetes mellitus by supporting self-review and modification of lifestyle behaviors. METHODS This open-label, randomized controlled, single-center study in Japan with an 8-week intervention period was conducted in individuals with type 2 diabetes mellitus and HbA1c levels between 7.0 and 9.0% (53‒75 mmol/mol). The intervention was once-weekly home monitoring of GA with a daily self-review of lifestyle behaviors using a smartphone application, in addition to conventional treatment. RESULTS A total of 98 participants (72.0% males; age 63.2 ± 11.4 years; HbA1c 7.39 ± 0.39% [57.3 ± 4.3 mmol/mol]) were randomly assigned to the intervention or control group. Significant decreases of the GA and HbA1c levels from the baseline to the last observation day were observed in the intervention group (- 1.71 ± 1.37% [- 39.1 ± 31.3 mmol/mol] and - 0.32 ± 0.32% [- 3.5 ± 3.5 mmol/mol], respectively). Significant decreases of the body weight, waist circumference, and caloric expenditure (p < 0.0001 and p = 0.0003, p = 0.0346, respectively), but not of the caloric intake (p = 0.678), were also observed in the intervention group as compared with the control group. CONCLUSIONS Self-review of lifestyle behaviors in combination with once-weekly GA home testing received via a smartphone application might potentially benefit glycemic management in people with type 2 diabetes mellitus. TRIAL REGISTRATION jRCTs042220048.
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Affiliation(s)
| | - Akira Yoshida
- Jinnouchi Hospital Diabetes Care Center, Kumamoto, Japan
| | | | | | - Daisuke Kurosawa
- Provigate, Inc., R/m 302, University of Tokyo Entrepreneur Plaza, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kenji Yachiku
- Provigate, Inc., R/m 302, University of Tokyo Entrepreneur Plaza, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Itsushi Minoura
- Provigate, Inc., R/m 302, University of Tokyo Entrepreneur Plaza, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Toranomon Hospital, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masakazu Aihara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Metabolic Medicine, Faculty of Life Science, Kumamoto University, Kumamoto, Japan
| | - Koshin Sekimizu
- Provigate, Inc., R/m 302, University of Tokyo Entrepreneur Plaza, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113-0033, Japan.
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Hatada M, Pavlidis S, Sode K. Development of a glycated albumin sensor employing dual aptamer-based extended gate field effect transistors. Biosens Bioelectron 2024; 251:116118. [PMID: 38382273 DOI: 10.1016/j.bios.2024.116118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
Glycated albumin (GA), defined as the percentage of serum albumin glycation, is a mid-term glycemic control marker for diabetes. The concentrations of both glycated human serum albumin (GHSA) and total human serum albumin (HSA) are required to calculate GA. Here, we report the development of a GA sensor employing two albumin aptamers: anti-GHSA aptamer which is specific to GHSA and anti-HSA aptamer which recognizes both glycated and non-glycated HSA. We combine these aptamers with extended gate field effect transistors (EGFETs) to realize GA monitoring without the need to pretreat serum samples, and therefore suitable for point of care and home-testing applications. Using anti-GHSA aptamer-immobilized electrodes and EGFETs, we measured GHSA concentrations between 0.1-10 μM within 20 min. The sensor was able to measure GHSA concentration in the presence of BSA for a range of known GA levels (5-29%). With anti-HSA aptamer-immobilized electrodes and EGFETs, we measured total HSA concentrations from 1-17 μM. Furthermore, GHSA and total HSA concentrations of both healthy and diabetic-level samples were determined with GHSA and HSA sensors. The measured GHSA and total HSA concentrations in three samples were used to determine respective GA percentages, and our calculations agreed with GA levels determined by reference methods. Thus, we developed simple and rapid dual aptamer-based EGFET sensors to monitor GA through measuring GHSA and total HSA concentration, without the need for sample pretreatment, a mandatory step in the current standard of enzymatic GA monitoring.
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Affiliation(s)
- Mika Hatada
- Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, 27599, USA
| | - Spyridon Pavlidis
- Department of Electrical & Computer Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Koji Sode
- Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, 27599, USA.
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Kinoshita M, Shimomura D, Shimada M, Kamioka M, Koga M. Two patients with α-chain hemoglobin variant Hb Q-Iran detected by measuring hemoglobin A1c using the variant mode of the HA-8180V HPLC analyzer. Diabetol Int 2024; 15:302-306. [PMID: 38524927 PMCID: PMC10959901 DOI: 10.1007/s13340-023-00682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/29/2023] [Indexed: 03/26/2024]
Abstract
Hemoglobin variants are often discovered when hemoglobin A1c (HbA1c) levels measured with a high-performance liquid chromatography (HPLC) system in fast mode are found to be low. The HA-8180V HPLC analyzer by Arkray offers two measurement modes: fast mode (FM) and variant mode (VM). Two Japanese patients with α-chain variant Hb Q-Iran detected incidentally after analyses with the HA-8180V in VM showed an abnormal peak, are presented. The first patient was a man in his 70 s, and the second patient was a man in his 50 s. Both were non-diabetic, but their results from HbA1c measurement in VM showed an abnormal peak. The VM-HbA1c, FM-HbA1c, and HbA1c measured by enzymatic assay and glycated albumin levels of the two patients were all within the reference ranges. They were diagnosed as having Hb Q-Iran (α2-75Asp → His) by globin gene analysis. It is difficult to detect α-chain hemoglobin variants based on abnormal FM-HbA1c levels, but measuring HbA1c in VM is useful for efficiently detecting hemoglobin variants.
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Affiliation(s)
- Maki Kinoshita
- Department of Laboratory Medicine, Tenri Hospital, Nara, Japan
| | - Daiki Shimomura
- Department of Laboratory Medicine, Tenri Hospital, Nara, Japan
| | - Masashi Shimada
- Department of Laboratory Medicine, Tenri Hospital, Nara, Japan
| | - Mikio Kamioka
- Department of Laboratory Medicine, Tenri Hospital, Nara, Japan
| | - Masafumi Koga
- Department of Internal Medicine, Hakuhokai Central Hospital, 4-23-1 Higashisonodacho, Amagasaki, Hyogo 661-0953 Japan
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Choi YJ, Lee NY, Ahn MB, Kim SH, Cho WK, Cho KS, Jung MH, Suh BK. Usefulness of glycated albumin level as a glycemic index complementing glycosylated hemoglobin in diabetic children and adolescents. Ann Pediatr Endocrinol Metab 2023; 28:289-295. [PMID: 38173383 PMCID: PMC10765020 DOI: 10.6065/apem.2244202.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Glycated albumin (GA) is a glycemic marker reflecting the average serum glucose of the previous 2 weeks. This study aimed to evaluate the usefulness of GA as a glycemic index to complement glycosylated hemoglobin (HbA1c) in children and adolescents. METHODS Fifty-four children and adolescents with diabetes mellitus (DM) and 97 children and adolescents without DM (NDM) were enrolled. The correlation between mean blood glucose (MG) and GA compared to HbA1c was investigated in the DM group. The correlation between fasting glucose (FG) and GA compared to HbA1c was investigated in the NDM group. Factors affecting GA, HbA1c, and GA/HbA1c were analyzed. RESULTS In the DM group, positive correlations were observed between MG and GA (P=0.003), between MG and HbA1c (P=0.001), and between GA and HbA1c (P<0.001). The correlation coefficient between MG and GA did not differ from that between MG and HbA1c in the DM group (P=0.811). Among patients with DM, those whose standardized body mass index standard deviation score (BMI SDS) was ≥2 had a lower GA/HbA1c compared with those whose BMI SDS was <2 (P=0.001). In the NDM group, there were no significant correlations between FG and GA, between FG and HbA1c, or between GA and HbA1c. The NDM subjects whose BMI SDS was ≥2 had a lower GA/HbA1c than did the NDM subjects whose BMI SDS was <2 (P=0.003). CONCLUSION GA is comparable with HbA1c in reflecting glycemic control in children and adolescents with DM. GA is affected by obesity in children and adolescents with or without DM.
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Affiliation(s)
- Young Ju Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Na Yeong Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shin Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Soon Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Mossine VV, Mawhinney TP. 1-Amino-1-deoxy-d-fructose ("fructosamine") and its derivatives: An update. Adv Carbohydr Chem Biochem 2023; 83:1-26. [PMID: 37968036 DOI: 10.1016/bs.accb.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
1-Amino-1-deoxy-d-fructose (fructosamine, FN) derivatives are omnipresent in all living organisms, as a result of non-enzymatic condensation and Amadori rearrangement reactions between free glucose and biogenic amines such as amino acids, polypeptides, or aminophospholipids. Over decades, steady interest in fructosamine was largely sustained by its role as a key intermediate structure in the Maillard reaction that is responsible for the organoleptic and nutritional value of thermally processed foods, and for pathophysiological effects of hyperglycemia in diabetes. New trends in fructosamine research include the discovery and engineering of FN-processing enzymes, development of advanced tools for hyperglycemia monitoring, and evaluation of the therapeutic potential of both fructosamines and FN-recognizing proteins. This article covers developments in the field of fructosamine and its derivatives since 2010 and attempts to ascertain challenges in future research.
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Affiliation(s)
- Valeri V Mossine
- Department of Biochemistry, University of Missouri, Columbia, MO, United States
| | - Thomas P Mawhinney
- Department of Biochemistry, University of Missouri, Columbia, MO, United States.
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Aihara M, Hayashi T, Koizumi C, Sakurai Y, Sawada M, Kubota T, Kadowaki T, Yamauchi T, Kubota N. Bi-weekly Glycated Albumin Measurement was Useful to Encourage Behavioral Changes in People with Type 2 Diabetes Mellitus. Diabetes Ther 2023; 14:1711-1721. [PMID: 37568043 PMCID: PMC10499715 DOI: 10.1007/s13300-023-01452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/13/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Hemoglobin A1c (HbA1c), representing the average blood glucose over 1-2 months, is the most commonly used glycemic marker in people with diabetes. Glycated albumin (GA) reflects the average blood glucose over the most recent 1-2 weeks. We considered whether the faster response of GA compared with HbA1c could make people with diabetes realize their glycemic control intuitively and effectively. METHODS We randomized 61 people with diabetes into the control and intervention groups. Blood samples were collected from both every fortnight over an 8-week period (five times; visit 1-5). Only the intervention group was notified of the GA levels on the same day. At the beginning and end of the study, International Physical Activity Questionnaire and Eating Behavior Questionnaire assessments, and body composition measurements were conducted. RESULTS The body weight change was significantly lower in the intervention group at visit 2 and visit 5. The percent body fat change was lower, while the percent skeletal muscle mass change at visit 5 was higher in the intervention group. Increasing GA trend was observed in the control group, but not in the intervention group. The fasting plasma glucose and HbA1c changes at visit 5 were similar in the two groups. Physical activity level change tended to be higher in the intervention group. The YN Eating Behavior Questionnaire score changes were similar in the two groups. CONCLUSION Bi-weekly GA measurement over an 8-week period in people with type 2 diabetes induced behavioral changes. Development of this method is expected to improve diabetes management. TRIAL REGISTRATION UMIN000037795.
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Affiliation(s)
- Masakazu Aihara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takanori Hayashi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Clinical Nutrition, Health and Nutrition (NIBIOHN), National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Tokyo, Japan
| | - Chie Koizumi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshitaka Sakurai
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mika Sawada
- Department of Clinical Nutrition Therapy, The University of Tokyo Hospital, Tokyo, Japan
| | - Tetsuya Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Clinical Nutrition, Health and Nutrition (NIBIOHN), National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Tokyo, Japan
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
- Division of Cardiovascular Medicine, Toho University, Ohashi Hospital, Tokyo, Japan
| | | | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- Department of Clinical Nutrition, Health and Nutrition (NIBIOHN), National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Tokyo, Japan.
- Department of Clinical Nutrition Therapy, The University of Tokyo Hospital, Tokyo, Japan.
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11
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Seniya KM, Baiju KV, Ambili R. Evaluation of salivary glycated albumin in periodontitis patients with and without type 2 diabetes mellitus and its changes with non-surgical periodontal therapy. Niger J Clin Pract 2023; 26:1257-1263. [PMID: 37794537 DOI: 10.4103/njcp.njcp_503_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Bidirectional relationship exists between diabetes mellitus and periodontitis. Glycated albumin is an emerging biomarker to assess intermediate glycemic control. Salivary glycated albumin has not been evaluated in periodontitis. Aim The aim of the study was to compare salivary glycated albumin in periodontitis patients with and without diabetes mellitus before and after periodontal therapy. Materials and Methods This comparative cross-sectional study was conducted in the Department of Periodontics. Ninety subjects (mean age 41.8 ± 6.82) were categorized into three groups. Clinical examination and saliva sample collection were done at baseline and 4 weeks after scaling and root debridement. Salivary glycated albumin levels were estimated using an enzyme-linked immunosorbent assay. One-way analysis of variance with post hoc test and paired t-test was done for inter- and intra-group comparison. The optimal cut-off value was calculated using the receiver operating characteristic curve and by maximization of the Youden index. Results Mean salivary glycated albumin was the highest in diabetic patients followed by non-diabetic periodontitis patients and least in healthy controls. All the intergroup comparisons were significant. A cut-off value of 72.19 ng/ml of salivary glycated albumin could predict diabetic status with a sensitivity and specificity of 75%. Salivary glycated albumin was significantly reduced in a similar manner in both groups after periodontal therapy (19.4% and 18.5%). Conclusion Periodontitis patients with diabetes mellitus were presented with the highest salivary glycated albumin. Non-surgical periodontal therapy resulted in a similar reduction of salivary glycated albumin in periodontitis with and without diabetes mellitus.
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Affiliation(s)
- K M Seniya
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - K V Baiju
- Department of Statistics, Government college for women, Trivandrum, Kerala, India
| | - R Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
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Song Y, Zhai X, Bai Y, Liu C, Zhang L. Progress and indication for use of continuous glucose monitoring in patients with diabetes in pregnancy: a review. Front Endocrinol (Lausanne) 2023; 14:1218602. [PMID: 37680884 PMCID: PMC10482265 DOI: 10.3389/fendo.2023.1218602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Gestational diabetes mellitus is one of the most common endocrine diseases that occur during pregnancy. Disorders of blood glucose metabolism during pregnancy can increase the risk of adverse pregnancy outcomes, such as pregnancy-related hypertension, preeclampsia, eclampsia, miscarriage, macrosomia, and neonatal hypoglycemia. Continuous glucose monitoring (CGM) can safely and effectively monitor blood glucose changes in patients with gestational hyperglycemia, thereby reducing adverse pregnancy outcomes. Hence, this article aimed to provide a comprehensive review of the progress and indications for using CGM in pregnant patients with diabetes. CGM can reduce blood glucose fluctuations and the occurrence of serious hypoglycemia and hyperglycemia events and can provide time in range (TIR). TIR is an important indicator of blood glucose level. Patients with a higher TIR during pregnancy have better gestational outcomes.
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Affiliation(s)
| | | | | | | | - Le Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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13
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Lee SH, Sohn JH, Kim C, Kim YJ, Jeon JP, Yang J, Park SY, Choi HJ. Pre-stroke glycemic variability estimated by glycated albumin predicts hematoma expansion and poor outcomes in patients with spontaneous intracerebral hemorrhage. Sci Rep 2023; 13:12848. [PMID: 37553363 PMCID: PMC10409739 DOI: 10.1038/s41598-023-40109-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023] Open
Abstract
Glycemic variability has been shown to be correlated more with oxidative stress than chronic hyperglycemia. We evaluated the impact of pre-stroke glycemic variability measured using glycated albumin (GA) on hematoma expansion and clinical outcomes following spontaneous intracerebral hemorrhage (ICH). We consecutively enrolled 343 patients with ICH for 72 months using a single-center registry database. The primary outcome measure was hematoma expansion. The secondary outcome measures were early neurological deterioration (END), 1-month mortality, and 3-month poor functional outcomes (modified Rankin scale score of 4-6). The patients were divided into two groups based on pre-stroke glycemic variability: a higher GA group (GA ≥ 16.0%) and a lower GA group (GA < 16.0%). During the study period, there were 63 (18.4%) events of hematoma expansion, 61 (17.8%) of END, 45 (13.1%) of 1-month mortality, and 45 (13.1%) of 3-month poor functional outcomes after ICH. The higher GA group (36.4%) had higher rates of hematoma expansion, END, 1-month mortality, and 3-month poor functional outcomes than the lower GA group. Multivariate analysis showed that a higher GA level was significantly associated with increased hematoma expansion (adjusted odds ratio 5.83; 95% confidence interval [CI] 2.58-13.19, p < 0.001). The area under the receiver operating characteristic curve of GA (0.83; 95% CI 0.48-0.65) for predicting hematoma expansion was higher than that of glycated hemoglobin (0.57; 95% CI 0.48-0.65, p for DeLong's pairwise comparison < 0.001). Higher GA levels could be a reliable marker for predicting hematoma expansion and poor outcomes following ICH.
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Affiliation(s)
- Sang-Hwa Lee
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
| | - Jong-Hee Sohn
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
| | - Chulho Kim
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
| | - Yeo Jin Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Jin Pyeong Jeon
- Department of Neurosurgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
| | - Jinseo Yang
- Department of Neurosurgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - So Young Park
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul, South Korea
| | - Hyuk Jai Choi
- Department of Neurosurgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.
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Koga M, Kameyama M, Okumiya T. Estimation of mean erythrocyte age using HbA1c or HbA1c/glycated albumin for evaluation of anemia severity. J Clin Lab Anal 2023; 37:e24947. [PMID: 37518970 PMCID: PMC10492451 DOI: 10.1002/jcla.24947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/02/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Hemoglobin A1c (HbA1c) levels are low in patients with hemolytic anemia, as HbA1c reflects mean erythrocyte age (MRBC ). Erythrocyte creatine (EC) is a hemolytic indicator that also reflects MRBC . We previously reported an equation for estimating MRBC using EC (EC-MRBC ). AIMS In this study, EC-MRBC was compared to the HbA1c level expressed in the International Federation of Clinical Chemistry and Laboratory Medicine units (iA1c) and to the iA1c/glycated albumin (GA) ratio to estimate MRBC . METHODS This study included 238 subjects, including patients with hemolytic anemia and/or type 2 diabetes mellitus (T2DM). RESULTS In non-diabetic individuals, both iA1c and iA1c/GA showed a strong positive correlation with EC-MRBC (p < 0.0001). The equations to estimate iA1c-MRBC and iA1c/GA-MRBC derived from the regression equations between EC-MRBC and iA1c, and EC-MRBC and iA1c/GA in nondiabetic individuals were 1.45 × iA1c and 20.0 × iA1c/GA, respectively. iA1c-MRBC and iA1c/GA-MRBC in non-diabetic individuals without hemolytic anemia were 57.6 ± 4.0 and 57.1 ± 6.4 days, respectively, and iA1c/GA-MRBC in T2DM patients without hemolytic anemia was 56.0 ± 8.8 days.; no significant difference was seen in the comparisons. CONCLUSIONS The MRBC can be estimated using iA1c or iA1c/GA in non-diabetic individuals, and iA1c/GA in T2DM patients.
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Affiliation(s)
- Masafumi Koga
- Department of Internal MedicineHakuhokai Central HospitalAmagasakiJapan
| | - Masahi Kameyama
- Research Team for NeuroimagingTokyo Metropolitan Institute for Geriatrics and GerontologyTokyoJapan
| | - Toshika Okumiya
- Department of Medical Laboratory Science, Faculty of Health SciencesKochi Gakuen UniversityKochiJapan
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Sugawara D, Makita E, Matsuura M, Sato H, Kuwata T, Ichihashi K. Prepregnancy body mass index and glycated albumin in the third trimester may predict infant complications in gestational diabetes mellitus: a retrospective cohort study. Diabetol Int 2023; 14:280-287. [PMID: 37397905 PMCID: PMC10307751 DOI: 10.1007/s13340-023-00631-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/03/2023] [Indexed: 07/04/2023]
Abstract
Background Maternal hyperglycemia, obesity, and hypertension with gestational diabetes mellitus (GDM) are risk factors for infant complications. This study aimed to investigate maternal factors and glycemic control indicators that affect infant complications in GDM. Methods We conducted a retrospective cohort study including 112 mothers with GDM and their infants. Multivariate logistic regression analysis was used to investigate the variables associated with good and adverse infant outcomes. We determined the cutoff values of variables that showed a significant difference in the multivariate logistic regression analysis for predicting infant complications by performing receiver operating characteristic curve analysis. Results In the multivariate logistic regression analysis, prepregnancy BMI and GA in the third trimester were significantly related to good and adverse infant outcomes (adjusted odds ratios [aORs], 1.62; 95% CIs 1.17-2.25, p = 0.003 and aORs, 2.77; 95% CIs 1.15-6.64, p = 0.022, respectively). The cutoff values for prepregnancy BMI and GA in the third trimester were 25.3 kg/m2 and 13.5%, respectively. Conclusions The importance of weight control before pregnancy and the usefulness of GA in the third trimester to predict infant complications were suggested in this study.
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Affiliation(s)
- Daisuke Sugawara
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
| | - Eishi Makita
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
| | - Misa Matsuura
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
| | - Hiroaki Sato
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
| | - Tomoyuki Kuwata
- Department of Obstetrics and Gynecology, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
| | - Ko Ichihashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-Cho, Saitama, 330-8503 Japan
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Aihara M, Irie T, Yasukawa K, Minoura I, Miyauchi N, Nishi M, Katayama N, Yachiku K, Jinnouchi H, Kadowaki T, Yamauchi T, Yatomi Y, Kubota N, Sekimizu K. Development of a high-performance liquid chromatographic glycated albumin assay using finger-prick blood samples. Clin Chim Acta 2023; 542:117272. [PMID: 36858193 DOI: 10.1016/j.cca.2023.117272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Home blood glucose monitoring can be effective for the self-management of diabetic patients. Hemoglobin A1c (HbA1c) is a widely used marker that reflects the average blood glucose within 1-2 months but does not sensitively respond to behavioral changes. Self-monitoring of blood glucose, continuous glucose monitoring, and flush glucose monitoring are sensitive; however, the cost and invasiveness of these tests prevent their widespread use. We focused on glycated albumin (GA), which reflects the average blood glucose levels over 1-2 weeks, and established a GA measurement method for self-sampling, finger-prick blood, which may be submitted for testing through postal service to receive weekly results. METHODS A high-performance liquid chromatography assay was established to measure GA levels in finger-prick blood samples from 103 diabetic patients and the results were compared with venous blood measurements using an enzymatic method. Furthermore, conditions for sending blood samples by mail were evaluated. Under these conditions, samples from 27 healthy and 32 patient volunteers sent through postal service were compared with samples stored in the laboratory. RESULTS GA levels were measured in samples containing > 20 μg albumin, which resulted in a CV less than 0.3%. The correlation between the GA levels of finger-prick blood measured using HPLC and the GA levels of venous blood measured using the enzymatic method was R2 = 0.988 with the slope ∼ 1.0, suggesting that the two were nearly equivalent. GA levels were stable for four days at 30 °C and two days at 37 °C. Mail-delivered samples exhibited a high correlation with samples that were not sent (R2 > 0.99). CONCLUSIONS We established a method to measure GA levels in self-sampled, finger-prick blood sent through postal service in Japan. The method is applicable for weekly feedback of GA levels, which is potentially useful for motivating behavioral changes. In addition to markers such as HbA1c and blood glucose, GA can be used as a marker for assessing dietary and physical activities. This study highlighted the importance of GA monitoring by developing a suitable measurement method for weekly monitoring of GA levels.
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Affiliation(s)
- Masakazu Aihara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoko Irie
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Keiko Yasukawa
- Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Itsushi Minoura
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Noriko Miyauchi
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Mitsumi Nishi
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Norikazu Katayama
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kenji Yachiku
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hideaki Jinnouchi
- Jinnouchi Hospital, Kuhonji 6-2-3, Chuo-ku, Kumamoto 862-0976, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo 105-8470, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
| | - Koshin Sekimizu
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Tang X, Wang Y, Simó R, Stehouwer CDA, Zhou JB. The Association Between Diabetes Duration and Domain-Specific Cognitive Impairment: A Population-Based Study. J Alzheimers Dis 2023; 91:1435-1446. [PMID: 36641674 DOI: 10.3233/jad-220972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Diabetes is a risk factor for cognitive impairment, and disease duration is associated with geriatric decline and functional disabilities. OBJECTIVE This study aimed to examine the association of diabetes duration with domain-specific cognitive impairment in elderly. METHODS A total of 3,142 participants from the National Health and Nutrition Examination Survey (NHANES) from the period between 2011 and 2014 were included. We assessed cognitive function using the Digit Symbol Substitution Test (DSST), the CERAD Word Learning (CERAD-WL) test, the CERAD Delayed Recall (CERAD-DR) test and animal fluency (AF) test. RESULTS After adjusting for age, sex, race/ethnicity, education level, and annual household income, we found that diabetes with a duration longer than 20 years were at 3.32-fold increased risk of DSST impairment (OR = 3.32, 95% CI: 1.95 to 5.67), 1.72-fold increased risk of CERAD-WL impairment (OR = 1.72, 95% CI: 1.13 to 2.62), and 1.76-fold increased risk of AF impairment (OR = 1.76, 95% CI: 1.23 to 2.53), compared with those with no diabetes. Associations were generally stronger in women than in men. Participants with diabetes, who were diagnosed at 50-59 years old were at increased risk of DSST impairment, CERAD-WL impairment, CERAD-DR impairment, and AF impairment per 5 years longer duration of diabetes. CONCLUSION Longer diabetes duration was associated with the increased risk of cognitive impairment, especially in processing speed and attention. The presence of chronic kidney disease was associated with the increased risk of DSST impairment.
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Affiliation(s)
- Xingyao Tang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Endocrinology and Metabolism Department, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Coen D A Stehouwer
- Department of Internal Medicine and CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jian-Bo Zhou
- Endocrinology and Metabolism Department, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Lee SH, Mo HJ, Kim Y, Park SY, Kim YJ, Lee M, Sohn JH, Kim C. Predicting Role of Prestroke Glycemic Variability Estimated by Glycated Albumin for Reperfusion and Prognosis after Endovascular Treatment. Cerebrovasc Dis 2023; 52:44-51. [PMID: 35537405 DOI: 10.1159/000524481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Glycated hemoglobin is widely used for the diagnosis of diabetes, but it is not accurately correlated with blood glucose fluctuations. We evaluated the impact of prestroke glycemic variability, measured by glycated albumin (GA) on reperfusion rate and stroke outcomes after endovascular treatment (EVT). METHODS We consecutively collected 310 EVT-treated patients for 60 months using a multicenter registry database. Primary outcome was unsuccessful reperfusion defined by modified Thrombolysis in Cerebral Infarction grade 0 to 2a. Secondary outcomes were occurrence of early neurologic deterioration (END), symptomatic hemorrhagic transformation (SHT) and a 3-month poor outcome (modified Rankin Scale >2). GA was measured in the morning after hospital admission with overnight fasting and determined to reflect high prestroke glycemic variability (GA ≥16.0%). RESULTS Over the median follow-up of 60 months of 310 patients, there were 64 (20.6%) events of unsuccessful reperfusion, 66 (21.3%) of END, 21 (6.8%) of SHT, and 180 (58.1%) of 3-month poor outcome. In the higher GA group (130, 41.9%), proportion of unsuccessful reperfusion, END, SHT, and poor outcome were higher than lower GA group. The multivariate analysis showed that higher GA was associated with unsuccessful reperfusion after EVT (adjusted odds ratio 4.13; 95% confidence interval [CI], 1.93-8.85). The area under the receiver operating characteristic of GA (0.644; 95% CI: 0.634-0.740) for predicting poor outcome was better than that of glycated hemoglobin (0.586; 95% CI: 0.529-0.642, p for DeLong's pairwise comparison = 0.005). CONCLUSION GA, reflecting prestroke glycemic variability, could be a reliable parameter for predicting reperfusion rate and acute ischemic stroke outcome in this study.
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Affiliation(s)
- Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute of New Frontier Research Team, Hallym University, Chuncheon, Republic of Korea
| | - Hee Jung Mo
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - So Young Park
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Jong-Hee Sohn
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute of New Frontier Research Team, Hallym University, Chuncheon, Republic of Korea
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute of New Frontier Research Team, Hallym University, Chuncheon, Republic of Korea
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Nagao M, Sasaki J, Sugihara H, Tanimura-Inagaki K, Harada T, Sakuma I, Oikawa S. Efficacy and safety of sitagliptin treatment in older adults with moderately controlled type 2 diabetes: the STREAM study. Sci Rep 2023; 13:134. [PMID: 36599895 DOI: 10.1038/s41598-022-27301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Sitagliptin has been suggested as a treatment option for older adults with type 2 diabetes (T2D). However, no randomized controlled trial has been performed to evaluate the efficacy and safety of sitagliptin treatment in older Japanese patients with T2D. The STREAM study was a multicenter, open-label, randomized controlled trial. T2D outpatients aged 65-80 years with moderately controlled glycemic levels (HbA1c 7.4-10.4%) under lifestyle interventions without or with oral anti-diabetic drugs excluding DPP4 inhibitors or GLP-1 receptor agonists were recruited (n = 176). The participants were randomized into sitagliptin group (n = 88) who received sitagliptin as an initial or an additive anti-diabetic drug and control group (n = 88) who did not. The treatment goal was HbA1c level < 7.4%. Efficacy and safety during 12-month treatment period were investigated. The mean (± SD) ages were 70.6 ± 3.9 and 71.9 ± 4.4 years old in sitagliptin and control groups, respectively. According to a mixed-effects model analysis, average changes from baseline over the treatment period in fasting plasma glucose (FPG), HbA1c, and glycated albumin (GA) were - 27.2 mg/dL, - 0.61%, and - 2.39%, respectively, in sitagliptin group, and 0.50 mg/dL, - 0.29%, and - 0.93%, respectively, in control group. The reductions in FPG, HbA1c, and GA were significantly greater in sitagliptin group (P < 0.0001, P < 0.01, and P < 0.0001, respectively). There were no differences in the incidence of adverse effects, except for cystatin C elevation and platelet count reduction in sitagliptin group. Sitagliptin treatment effectively improved the glycemic profile without any serious adverse effects in older T2D patients.Trial registration number: UMIN000010376.
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Affiliation(s)
- Mototsugu Nagao
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Sasaki
- International University of Health and Welfare, Fukuoka, Japan
| | - Hitoshi Sugihara
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kyoko Tanimura-Inagaki
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Taro Harada
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Hokkaido, Japan
| | - Shinichi Oikawa
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. .,Diabetes and Lifestyle-Related Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan.
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20
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Sakanaka A, Katakami N, Furuno M, Nishizawa H, Omori K, Taya N, Ishikawa A, Mayumi S, Inoue M, Tanaka Isomura E, Amano A, Shimomura I, Fukusaki E, Kuboniwa M. Salivary metabolic signatures of carotid atherosclerosis in patients with type 2 diabetes hospitalized for treatment. Front Mol Biosci 2022; 9:1074285. [PMID: 36619162 PMCID: PMC9815705 DOI: 10.3389/fmolb.2022.1074285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Atherosclerosis is a life-threatening disease associated with morbidity and mortality in patients with type 2 diabetes (T2D). This study aimed to characterize a salivary signature of atherosclerosis based on evaluation of carotid intima-media thickness (IMT) to develop a non-invasive predictive tool for diagnosis and disease follow-up. Metabolites in saliva and plasma samples collected at admission and after treatment from 25 T2D patients hospitalized for 2 weeks to undergo medical treatment for diabetes were comprehensively profiled using metabolomic profiling with gas chromatography-mass spectrometry. Orthogonal partial least squares analysis, used to explore the relationships of IMT with clinical markers and plasma and salivary metabolites, showed that the top predictors for IMT included salivary allantoin and 1,5-anhydroglucitol (1,5-AG) at both the baseline examination at admission and after treatment. Furthermore, though treatment induced alterations in salivary levels of allantoin and 1,5-AG, it did not modify the association between IMT and these metabolites (p interaction > 0.05), and models with these metabolites combined yielded satisfactory diagnostic accuracy for the high IMT group even after treatment (area under curve = 0.819). Collectively, this salivary metabolite combination may be useful for non-invasive identification of T2D patients with a higher atherosclerotic burden in clinical settings.
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Affiliation(s)
- Akito Sakanaka
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Furuno
- Department of Biotechnology, Osaka University Graduate School of Engineering, Suita, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazuo Omori
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naohiro Taya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Asuka Ishikawa
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shota Mayumi
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Moe Inoue
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Emiko Tanaka Isomura
- First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Eiichiro Fukusaki
- Department of Biotechnology, Osaka University Graduate School of Engineering, Suita, Japan
| | - Masae Kuboniwa
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan,*Correspondence: Masae Kuboniwa,
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21
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A case of a novel hemoglobin variant, Hb A2-Karatsu, discovered following a falsely elevated HbA1c value. Clin Chim Acta 2022; 537:154-157. [DOI: 10.1016/j.cca.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022]
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22
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Mohammadinejad A, Heydari M, Kazemi Oskuee R, Rezayi M. A Critical Systematic Review of Developing Aptasensors for Diagnosis and Detection of Diabetes Biomarkers. Crit Rev Anal Chem 2022; 52:1795-1817. [DOI: 10.1080/10408347.2021.1919986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Arash Mohammadinejad
- Targeted Drug Delivery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Heydari
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Kazemi Oskuee
- Targeted Drug Delivery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Rezayi
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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23
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Jyothsna P, Suchitra MM, Kusuma Kumari M, Chandrasekhar C, Rukmangadha N, Alok S, Siddhartha Kumar B. Effect of Iron Deficiency Anemia on Glycated Albumin Levels: A Comparative Study in Nondiabetic Subjects with Iron Deficiency Anemia. J Lab Physicians 2022. [DOI: 10.1055/s-0042-1757589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Objective Glycated hemoglobin A1c (HbA1c), used for monitoring glycemia control, is altered in iron deficiency anemia (IDA). Glycated albumin (GA) is considered an alternate biomarker to HbA1c. However, effect of IDA on GA needs to be studied.
Materials and Methods Thirty nondiabetic cases with IDA and 30 healthy controls were included. Fasting plasma glucose (FPG), creatinine, urea, albumin, total protein, ferritin, iron, unsaturated iron binding capacity, hemoglobin (Hb), HbA1c, complete hemogram, and GA were estimated. Transferrin saturation and total iron binding capacity (TIBC) were calculated. Statistical analysis was done using unpaired two-tailed t-test/Mann–Whitney U-test and Pearson's correlation/Spearman-rank correlation, as appropriate.
Results Total protein, albumin, Hb, iron, ferritin, and transferrin saturation were significantly lower while FPG, GA, TIBC, and HbA1c were significantly higher in cases compared to controls. HbA1C and GA have a significant negative correlation with iron, transferrin saturation, and ferritin. Significant negative correlations of GA with albumin (r = –0.754; p < 0.001) and Hb (r = –0.435; p = 0.001) and that of HbA1c with albumin (r = –0.271; p = 0.03) and Hb (r = –0.629; p < 0.001) while significant positive correlation of Hb with albumin (r = 0.395; p = 0.002) and HbA1c with FPG (r = 0.415; p = 0.001) were observed.
Conclusion Low albumin levels increase plasma protein glycation, including albumin. Hence, elevated GA levels indicate false elevation of GA in scenario of lowered albumin observed in IDA, similar to HbA1c. Thus, using GA in diabetes mellitus with IDA should be avoided or used with caution to prevent potentially inappropriate treatment intensification and risk of hypoglycemia.
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Affiliation(s)
- Pralayakaveri Jyothsna
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Musturu M. Suchitra
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Medooru Kusuma Kumari
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - C. Chandrasekhar
- Department of Hematology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Nandyala Rukmangadha
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Sachan Alok
- Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Lin XL, Li QY, Zhao DH, Liu JH, Fan Q. Serum glycated albumin is associated with in-stent restenosis in patients with acute coronary syndrome after percutaneous coronary intervention with drug-eluting stents: An observational study. Front Cardiovasc Med 2022; 9:943185. [PMID: 36237913 PMCID: PMC9551162 DOI: 10.3389/fcvm.2022.943185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies have confirmed the predicted value of serum glycated albumin (GA) in atherosclerotic cardiovascular disease. However, the relationship between GA and the development of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation has not been verified in patients with acute coronary syndrome (ACS). Materials and methods In this study, 797 patients diagnosed with ACS who underwent re-coronary angiography more than 6 months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models and the net reclassification improvement and integrated differentiation improvement risk models were constructed to assess the relationship between the GA and DES-ISR in patients with ACS. Results The GA was significantly associated with an increased risk of DES-ISR, upon adjusting for confounding factors (as nominal variate: OR 1.868, 95% CI 1.191-2.932, P = 0.007; as continuous variate: OR 1.109, 95% CI 1.040-1.183, P = 0.002). The addition of GA to a baseline risk model had an incremental effect on the predictive value for DES-ISR (AUC: GA vs. baseline model, 0.714 vs. 0.692, comparison P = 0.017; category-free net reclassification improvement (NRI) 0.080, P = 0.035; integrated discrimination improvement (IDI) 0.023, P < 0.001). Conclusion GA level was significantly associated with a high risk of DES-ISR in patients with ACS treated with PCI. Moreover, the addition of the GA to a baseline risk model has an incremental effect on the predictive potential for DES-ISR.
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Affiliation(s)
| | | | | | | | - Qian Fan
- Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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25
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Toft JH, Dalen I, Skadberg Ø, Gøransson L, Økland I, Bleskestad IH. Glycated albumin and continuous glucose monitoring metrics across pregnancy in women with pre-gestational diabetes. Endocrinol Diabetes Metab 2022; 5:e376. [PMID: 36121204 PMCID: PMC9659665 DOI: 10.1002/edm2.376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Glycated albumin (GA), a biomarker reflecting short-term glycaemia, may be useful to assess glycaemic control in pregnancy. We examined the association between GA and continuous glucose monitoring (CGM) metrics across gestation. METHODS In this prospective cohort study including 40 women with pre-gestational diabetes, blood samples for analysis of GA and glycated haemoglobin A1c (HbA1c) were collected at pregnancy week 12, 20, 24, 28, 32 and 36. In the CGM-group (n = 19), CGM data were collected from first trimester until pregnancy week 36. Receiver operating characteristic (ROC) curves were used to assess the accuracy of GA and HbA1c to detect poor glycaemic control, using CGM metrics as the reference standard. This study was conducted at Stavanger University Hospital, Norway, in 2016-2018. RESULTS Glycaemic control improved across gestation with more time spent in target range, coinciding with decreased glycaemic variability and lower mean GA level. There was statistically significant correlation between GA and most CGM metrics. The area under the ROC curves (AUC) for detecting time in range <70% and time above range >25% for the pregnancy glucose target 63-140 mg/dl (3.5-7.8 mmol/L) were 0.78 and 0.82 for GA, whereas AUCs of 0.60 and 0.72 were found for HbA1c, respectively. CONCLUSIONS Higher GA levels were associated with less time spent in target range, more time spent in the above range area and increased glycaemic variability. GA was more accurate than HbA1c to detect time above range >25% and time in range <70%.
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Affiliation(s)
- Johanne Holm Toft
- Department of Obstetrics and GynecologyStavanger University HospitalStavangerNorway,Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Ingvild Dalen
- Section of Biostatistics, Department of ResearchStavanger University HospitalStavangerNorway
| | - Øyvind Skadberg
- Department of Medical BiochemistryStavanger University HospitalStavangerNorway
| | - Lasse Gunnar Gøransson
- Department of Internal MedicineStavanger University HospitalStavangerNorway,Department of Clinical MedicineUniversity of BergenBergenNorway
| | - Inger Økland
- Department of Obstetrics and GynecologyStavanger University HospitalStavangerNorway,Department of Caring and EthicsUniversity of StavangerStavangerNorway
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26
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Rescalli A, Varoni EM, Cellesi F, Cerveri P. Analytical Challenges in Diabetes Management: Towards Glycated Albumin Point-of-Care Detection. BIOSENSORS 2022; 12:bios12090687. [PMID: 36140073 PMCID: PMC9496022 DOI: 10.3390/bios12090687] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022]
Abstract
Diabetes mellitus is a worldwide-spread chronic metabolic disease that occurs when the pancreas fails to produce enough insulin levels or when the body fails to effectively use the secreted pancreatic insulin, eventually resulting in hyperglycemia. Systematic glycemic control is the only procedure at our disposal to prevent diabetes long-term complications such as cardiovascular disorders, kidney diseases, nephropathy, neuropathy, and retinopathy. Glycated albumin (GA) has recently gained more and more attention as a control biomarker thanks to its shorter lifespan and wider reliability compared to glycated hemoglobin (HbA1c), currently the “gold standard” for diabetes screening and monitoring in clinics. Various techniques such as ion exchange, liquid or affinity-based chromatography and immunoassay can be employed to accurately measure GA levels in serum samples; nevertheless, due to the cost of the lab equipment and complexity of the procedures, these methods are not commonly available at clinical sites and are not suitable to home monitoring. The present review describes the most up-to-date advances in the field of glycemic control biomarkers, exploring in particular the GA with a special focus on the recent experimental analysis techniques, using enzymatic and affinity methods. Finally, analysis steps and fundamental reading technologies are integrated into a processing pipeline, paving the way for future point-of-care testing (POCT). In this view, we highlight how this setup might be employed outside a laboratory environment to reduce the time from measurement to clinical decision, and to provide diabetic patients with a brand-new set of tools for glycemic self-monitoring.
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Affiliation(s)
- Andrea Rescalli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
- Correspondence: (A.R.); (E.M.V.)
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
- Correspondence: (A.R.); (E.M.V.)
| | - Francesco Cellesi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milan, Italy
| | - Pietro Cerveri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
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Zhang L, Meng Z, Jiang Z, Liu Z, Hou L, Cai G, Ou H, Huang S, Song Q, Fang J, Liang L. Indicators of glucose dysregulation and the relationship with iron overload in Chinese children with beta thalassemia major. Pediatr Diabetes 2022; 23:562-568. [PMID: 34453777 DOI: 10.1111/pedi.13260] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/06/2021] [Accepted: 08/16/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Patients with beta thalassemia major (TM) have a higher risk of diabetes and an abnormal oral glucose tolerance test (OGTT), but there is no single agree monitoring parameter that reflects glycemic status. The possible mechanisms include iron overload and blood transfusion, but they require further investigation. PURPOSE This study explored the role of glycated hemoglobin A1c (HbA1c), fructosamine, and glycated albumin (GA) in evaluating the glucose dysregulation and to determine the potential relationship between iron deposition and glucose metabolism disorder in beta TM. METHODS A cross-sectional study was performed on 118 patients with beta TM and the control group consisted of 33 healthy children with no statistical differences in age, sex, and body mass index (BMI). Fast plasma glucose (FPG), fast insulin (FINS), insulin resistance index (HOMA-IRI), and insulin sensitivity index (HOMA-ISI) were compared between the patient and control groups. HbA1c, GA, fructosamine, and serum ferritin (SF) were measured in the patient group. OGTT, as well as heart and liver magnetic resonance imaging (MRI) T2*, was performed. For all statistical analyses, SPSS 21.0 was used and p < 0.05 was accepted as statistically significant. RESULTS FPG, FINS, and HOMA-IRI were significantly increased while HOMA-ISI decreased in the beta TM patients when compared with those in the control group. In patients with beta TM, 17 (14.41%) of patients had been diagnosed with diabetes, while 48 (40.68%) had both impaired fasting glucose and impaired glucose tolerance. HbA1c, GA, and fructosamine were increased according to the degree of abnormal glucose metabolism. Statistically significant differences were found in age, SF, and cardiac T2* between the abnormal and normal OGTT groups. CONCLUSION HbA1c may be used as a significant measure for monitoring glycemic levels in patients with beta TM. Furthermore, GA and fructosamine were alternative indicators of glucose status. Patients with heart iron deposition or an SF > 4000 μg/L were prone to abnormal glucose metabolism, so chelation therapy should be reinforced.
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Affiliation(s)
- Lina Zhang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhe Meng
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuannan Jiang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Pediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, China
| | - Zulin Liu
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lele Hou
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guiyi Cai
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Ou
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Siqi Huang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingfang Song
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianpei Fang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liyang Liang
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Tao X, Koguma R, Nagai Y, Kohzuma T. Analytical performances of a glycated albumin assay that is traceable to standard reference materials and reference range determination. J Clin Lab Anal 2022; 36:e24509. [PMID: 35595963 PMCID: PMC9280011 DOI: 10.1002/jcla.24509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/25/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Glycated albumin (GA) is an intermediate-term marker for monitoring glycemic control (preceding 2-3 weeks) in patients with diabetes mellitus. We evaluated the performance of Lucica Glycated Albumin-L, a new GA assay that is traceable to standard reference materials and determined the reference range in healthy subjects without diabetes. METHODS The performance and reference range studies were conducted in accordance with Clinical and Laboratory Standards Institute (CLSI) Guidelines. The traceability was established using reference material recommended by the Japan Society of Clinical Chemistry (JSCC). RESULTS The coefficient of variation (CV) of overall repeatability, within-laboratory precision, and overall reproducibility values of GA values were not more than 2.6%, 3.3%, and 1.6%, respectively, among laboratories. The GA values showed good linearity from 173 to 979 mmol/mol (9.4%-54.9%) across the assay range. The GA reference range in 262 healthy subjects was between 183 and 259 mmol/mol (9.9%-14.2%) while that of subjects with diabetes was 217-585 mmol/mol (11.8-32.6%). The reagent was stable for 2 months on the bench at room temperature. The limits of blank, detection, and qualification were 6.9, 7.9, and 9.7 μmol/L for GA concentration, and 3.8, 7.0, and 21.8 μmol/L for albumin concentration, respectively. Hemoglobin slightly affected the assay, while other classical interfering substances had no significant impact. CONCLUSIONS The present GA assay shows comparable performance to current clinical assays and could be used for intermediate-term monitoring of glycemic control in diabetes patients.
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Affiliation(s)
- Xinran Tao
- Diagnostics DepartmentAsahi Kasei Pharma Corporation, IVD Kit Product GroupYurakuchoJapan
| | - Ryosuke Koguma
- Diagnostics DepartmentAsahi Kasei Pharma Corporation, IVD Kit Product GroupYurakuchoJapan
| | - Yoko Nagai
- Diagnostics DepartmentAsahi Kasei Pharma Corporation, IVD Kit Product GroupYurakuchoJapan
| | - Takuji Kohzuma
- Diagnostics DepartmentAsahi Kasei Pharma Corporation, IVD Kit Product GroupYurakuchoJapan
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Shimizu N, Ogawa A, Hayashi A, Shichiri M. Discordance in the reduction rate between glycated albumin and glycated hemoglobin levels in type 2 diabetes patients receiving SGLT2 inhibitors. J Diabetes Complications 2022; 36:108225. [PMID: 35690574 DOI: 10.1016/j.jdiacomp.2022.108225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
AIMS Although the difference in HbA1c reduction between sodium-glucose cotransporter 2 (SGLT2) inhibitors and other oral glucose-lowering agents is relatively small, SGLT2 inhibitors exhibit beneficial cardiorenal protection. This study was based on the hypothesis that changes of HbA1c in patients treated with SGLT2 inhibitors may not accurately reflect an improved glycemic profile. METHODS Two studies were conducted: 1) a retrospective cohort study of 3039 patients administered with either an SGLT2 or a dipeptidyl peptidase-4 (DPP4) inhibitor for 12 months comparing the changes in glycated albumin (GA) and HbA1c levels and 2) a pilot study of 10 patients whose glycemic dynamics were evaluated using flash glucose monitoring at baseline and 2 months after treatment with an SGLT2 inhibitor. RESULTS SGLT2 inhibitors reduced GA more markedly than HbA1c in both studies. DPP4 inhibitors decreased both GA and HbA1c to a comparable degree. The mean glucose levels and glycemic standard deviation were significantly reduced after treatment with an SGLT2 inhibitor, in concordance with GA decline, although the lowering of HbA1c was marginal. CONCLUSIONS Changes in HbA1c levels underestimated the glucose-lowering effect and the diminished glycemic fluctuation induced by SGLT2 inhibitors. Thus, the distinct biomarker roles of GA and HbA1c should be reevaluated.
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Affiliation(s)
- Naoya Shimizu
- Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Akifumi Ogawa
- Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Akinori Hayashi
- Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Masayoshi Shichiri
- Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan; Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo 153-8934, Japan.
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30
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Ijima H, Hiratani K, Jinnnouchi H, Ono Y, Kameyama M, Okumiya T, Koga M. Measurement of erythrocyte creatine might be useful for diagnosing latent hemolysis. Clin Biochem 2022; 107:50-54. [DOI: 10.1016/j.clinbiochem.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
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Sugawara D, Sato H, Makita E, Kuwata T, Takagi K, Ichihashi K. Clinical usefulness of glycated albumin and glycated albumin-to-glycated hemoglobin ratio of gestational diabetes mellitus in late pregnancy for predicting infant complications. Pediatr Neonatol 2022; 63:239-246. [PMID: 35185003 DOI: 10.1016/j.pedneo.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/01/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) with poorly controlled glycemia is associated with poor pregnancy outcomes. However, adequate markers for glycemic control in GDM have not been fully evaluated. METHODS We retrospectively studied 77 patients with GDM and their infants. Mean glycated albumin (GA), glycated hemoglobin (HbA1c), and GA/HbA1c in GDM were compared between two groups stratified by the presence or absence of infant complications (complications or non-complications). We assessed the predictability of infant complications in GA, HbA1c, and GA/HbA1c of women with GDM by receiver operating characteristic analysis (ROC). RESULTS In complications and non-complications, GA and GA/HbA1c were significantly associated with neonatal hypoglycemia (13.9% vs. 13.0%, p < 0.001 and 2.49 vs. 2.33, p < 0.001, respectively), respiratory disorders (13.7% vs. 13.2%, p = 0.013 and 2.48 vs. 2.34, p < 0.001, respectively), myocardial hypertrophy (14.5% vs. 13.0%, p < 0.001 and 2.59 vs. 2.33, p < 0.001, respectively), and large for gestational age (14.5% vs. 13.1%, p < 0.001 and 2.58 vs. 2.34, p < 0.001, respectively). Compared with each infant complication in ROC, GA and GA/HbA1c had higher area under the curve than HbA1c. Especially, GA and GA/HbA1c had highest AUC in predicting myocardial hypertrophy and large for gestational age (GA; 0.92 and 0.92, GA/HbA1c; 0.91 and 0.86, respectively). Although statistically significant positive correlations were found between GA and GA/HbA1c and the number of infant complications (GA: r = 0.417, p < 0.001; GA/HbA1c: r = 0.408, p < 0.001), their correlations were weak. CONCLUSION Compared with HbA1c, GA and GA/HbA1c of GDM in late pregnancy might be useful for predicting infant complications arising from GDM.
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Affiliation(s)
- Daisuke Sugawara
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan.
| | - Hiroaki Sato
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan
| | - Eishi Makita
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan
| | - Tomoyuki Kuwata
- Department of Obstetrics and Gynecology, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan
| | - Kenjiro Takagi
- Department of Obstetrics and Gynecology, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan
| | - Ko Ichihashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Saitama 330-8503, Japan
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Zhang J, Du Y, Hu C, Liu Y, Liu J, Gao A, Zhao Y, Zhou Y. Elevated Glycated Albumin in Serum Is Associated with Adverse Cardiac Outcomes in Patients with Acute Coronary Syndrome Who Underwent Revascularization Therapy. J Atheroscler Thromb 2022; 29:482-491. [PMID: 33642440 PMCID: PMC9090483 DOI: 10.5551/jat.61358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS The associations between increased glycated albumin (GA) in the serum and diabetic complications and mortality have been revealed in the general population. However, less is known regarding the prognostic value of GA in patients diagnosed with acute coronary syndrome (ACS). METHODS In this study, all patients admitted for ACS who underwent a successful percutaneous coronary intervention (PCI) at our center from January 2018 to February 2019 were retrospectively examined. Clinical characteristics, laboratory results (e.g., serum GA levels), and procedural details were collected. The primary outcome included a composite of major adverse cardio-cerebral events (MACCE), such as death, myocardial infarction, stroke, and unplanned revascularization. The association between serum GA levels and clinical outcomes was tested in three multivariable models using Cox proportional hazard analysis. Subgroup analysis was performed in patients who were diagnosed with diabetes versus patients without diabetes. RESULTS A total of 1,806 ACS patients (mean age of 59.4 years; 77.8% were men; 44.9% were diagnosed with diabetes) were enrolled in this study, where the majority exhibited unstable angina (81.6%) and showed preserved left ventricular systolic function. Patients in the high GA level group were commonly female and were more likely to have metabolic disorders and to exhibit severe CAD (all p＜0.05). MACCE occurred in 126 patients (7.0%) during a mean follow-up time of 17.2 months. The cumulative risk of MACCE at the 18-month follow-up visit significantly increased in a stepwise fashion along with increased GA levels (log-rank p=0.018) in the serum. The association between serum GA levels and MACCE was further determined after adjusting traditional risk factors and hemoglobin A1c (HbA1c) (GA, per 1% increase: hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.06-1.13; GA, higher vs. lower tertial: HR 1.92, 95% CI 1.01-3.67). In a subgroup analysis, the prognostic role of serum GA only existed in diabetic patients, even when adjusting for traditional risk factors and HbA1c levels. CONCLUSIONS Elevated GA levels in the serum were associated with poor intermediate-term outcomes in low-risk ACS patients who underwent PCI, especially in patients with preexisting diabetes.
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Affiliation(s)
- Jianwei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yu Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Chengping Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Jinxing Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Ang Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yingxin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
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Kijewska M, Zawadzka M, Włodarczyk K, Stefanowicz P. HPLC-free method of synthesis of isotopically labeled deoxyfructosylated peptides. Anal Bioanal Chem 2022; 414:3803-3811. [PMID: 35316349 DOI: 10.1007/s00216-022-04022-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/28/2022] [Accepted: 03/15/2022] [Indexed: 12/01/2022]
Abstract
The biomarker strategy, based on multiple specific glycation sites in plasma proteins, could essentially increase the efficiency of glycemic control and disease prediction. Besides glycated albumin being a potential biomarker of early states of diabetes mellitus and control of short-term, it has been shown that the glycation of fibrinogen may also impact the formation of the fibrin network, while quantification of glycation of the CD59 protein allows for early detection of glucose intolerance in pregnant women. A different level of glycation of individual lysine residues in proteins has a crucial influence on the stages of the disease. The quantification of new biomarkers of different stages of diabetes requires appropriate isotope-labeled analogs that may improve biomarker search by providing more accurate quantitative data and by more robust detection/quantitation of low-abundance biomarkers. In the presented work, we proposed a fast and simple protocol for the synthesis of isotopically labeled and bi-labeled deoxyfructosylated peptide based on a combination of microwave-assisted synthesis and boronic affinity chromatography using functionalized resin (PhB-Lys(PhB)-ChemMatrix® Rink resin) developed by us. Our method is focused on the synthesis of glycated peptides identified in glycated albumin (GA) after enzymatic hydrolysis catalyzed by trypsin after arginine residues. Thereby, the standard peptides comprised [13C6]-deoxyfructose attached to lysine residue side chain, a dabcyl moiety for determination of standard amounts, and a cleavable linker. Moreover, we applied bi-labeled deoxyfructosylated peptide to determine the concentration of appropriate analog in a sample of human serum albumin glycated in vitro.
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Affiliation(s)
- Monika Kijewska
- Faculty of Chemistry, University of Wrocław, Joliot-Curie 14, 50-383, Wrocław, Poland.
| | - Michalina Zawadzka
- Faculty of Chemistry, University of Wrocław, Joliot-Curie 14, 50-383, Wrocław, Poland
| | - Karolina Włodarczyk
- Faculty of Chemistry, University of Wrocław, Joliot-Curie 14, 50-383, Wrocław, Poland
| | - Piotr Stefanowicz
- Faculty of Chemistry, University of Wrocław, Joliot-Curie 14, 50-383, Wrocław, Poland
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Toft JH, Bleskestad IH, Skadberg Ø, Gøransson LG, Økland I. Glycated albumin in pregnancy: LC-MS/MS-based reference interval in healthy, nulliparous Scandinavian women and its diagnostic accuracy in gestational diabetes mellitus. Scandinavian Journal of Clinical and Laboratory Investigation 2022; 82:123-131. [PMID: 35148229 DOI: 10.1080/00365513.2022.2033827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Glycated albumin (GA) may be a useful biomarker of glycemia in pregnancy. The aim of this study was to establish the reference interval (RI) for GA, analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), in healthy, nulliparous pregnant women. In addition, we assessed the accuracy of GA and glycated hemoglobin A1c (HbA1c) in the diagnosis of gestational diabetes mellitus (GDM). Finally, we explored the prevalence of GDM in healthy nulliparas, comparing three diagnostic guidelines (WHO-1999, WHO-2013 and the Norwegian guideline). The study was carried out at Stavanger University Hospital, Norway, and included a study population of 147 pregnant nulliparous women. An oral glucose tolerance test (OGTT) was performed and used as the gold standard for GDM diagnosis. Blood samples for analysis of GA and HbA1c were collected at pregnancy week 24-28. A nonparametric approach was chosen for RI calculation, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of GA and HbA1c. The established RI for GA in 121 pregnant women was 7.1-11.6%. The area under the ROC curves (AUCs) were 0.531 (GA) and 0.627 (HbA1c). According to the WHO-1999, WHO-2013 and the Norwegian guideline, respectively, 24 (16%), 36 (24%) and 21 (14%) women were diagnosed with GDM. Only nine women (6%) fulfilled the GDM-criteria of all guidelines. In conclusion, we established the first LC-MS/MS-based RI for GA in pregnant women. At pregnancy weeks 24-28, neither GA nor HbA1c discriminated between those with and without GDM. Different women were diagnosed with GDM using the three guidelines.
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Affiliation(s)
- Johanne Holm Toft
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Øyvind Skadberg
- Department of Medical Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - Lasse Gunnar Gøransson
- Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Inger Økland
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.,Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
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35
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High glycemic albumin representing prestroke glycemic variability is associated with hemorrhagic transformation in patients receiving intravenous thrombolysis. Sci Rep 2022; 12:615. [PMID: 35022517 PMCID: PMC8755722 DOI: 10.1038/s41598-021-04716-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 12/30/2021] [Indexed: 01/04/2023] Open
Abstract
We evaluated the impact of prestroke glycemic variability estimated by glycated albumin (GA) on symptomatic hemorrhagic transformation (SHT) in patients with intravenous thrombolysis (IVT). Using a multicenter database, we consecutively enrolled acute ischemic stroke patients receiving IVT. A total of 378 patients were included in this study. Higher GA was defined as GA ≥ 16.0%. The primary outcome measure was SHT. Multivariate regression analysis and a receiver operating characteristic curve were used to assess risks and predictive ability for SHT. Among the 378 patients who were enrolled in this study, 27 patients (7.1%) had SHT as defined by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SHTSITS). The rate of SHTSITS was higher in the higher GA group than in the lower GA group (18.0% vs. 1.6%, p < 0.001). A higher GA level (GA ≥ 16.0%) significantly increased the risk of SHTSITS (adjusted odds ratio [OR], [95% confidence interval, CI], 12.57 [3.08–41.54]) in the logistic regression analysis. The predictive ability of the GA level for SHTSITS was good (AUC [95% CI]: 0.83 [0.77–0.90], p < 0.001), and the cutoff value of GA in SHT was 16.3%. GA was a reliable predictor of SHT after IVT in acute ischemic stroke in this study.
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36
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Belsare S, Tseng D, Ozcan A, Coté G. Monitoring gestational diabetes at the point-of-care via dual glycated albumin lateral flow assays in conjunction with a handheld reader. Analyst 2022; 147:5518-5527. [DOI: 10.1039/d2an01238c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A dual assay cartridge was developed and used in conjunction with a handheld reader for sensing % glycated albumin to monitor gestational diabetes at home.
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Affiliation(s)
- Sayali Belsare
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Derek Tseng
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA, USA
| | - Aydogan Ozcan
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA, USA
- Bioengineering Department, University of California, Los Angeles, CA, USA
| | - Gerard Coté
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
- Texas Engineering Experiment Station Centre for Remote Health Technologies and Systems, College Station, TX, USA
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Noguchi-Shinohara M, Yuki-Nozaki S, Abe C, Mori A, Horimoto M, Yokogawa M, Ishida N, Suga Y, Ishizaki J, Ishimiya M, Nakamura H, Komai K, Nakamura H, Shibata M, Ohara T, Hata J, Ninomiya T, Yamada M. Diabetes Mellitus, Elevated Hemoglobin A1c, and Glycated Albumin Are Associated with the Presence of All-Cause Dementia and Alzheimer's Disease: The JPSC-AD Study. J Alzheimers Dis 2021; 85:235-247. [PMID: 34806607 DOI: 10.3233/jad-215153] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Glucose dysmetabolism is an important risk factor for dementia. OBJECTIVE We investigated the associations of diabetes mellitus, the levels of glycemic measures, and insulin resistance and secretion measures with dementia and its subtypes in a cross-sectional study. METHODS In this study, 10,214 community-dwelling participants were enrolled. Hemoglobin A1c (HbA1c), the homeostasis model assessment (HOMA) for insulin resistance (HOMA-IR), the HOMA of percent β-cell function (HOMA-β), and the glycated albumin (GA) was evaluated. The associations of each measure with Alzheimer's disease (AD) and vascular dementia (VaD) were investigated. RESULTS The multivariable-adjusted odds ratios (ORs) of AD were significantly higher in participants with diabetes mellitus than in those without diabetes (1.46 [95% CI: 1.08-1.97]). Higher HbA1c levels were significantly associated with AD at diabetes (≥6.5%) and even at prediabetes (5.7 %-6.4 %) levels; multivariable-adjusted ORs for AD in participants at the diabetes level were 1.72 (95% CI: 1.19-2.49), and those in participants at the prediabetes level were 1.30 (95% CI: 1.00-1.68), compared with those in normal participants. Moreover, higher GA levels were associated with AD. No associations were observed between the diabetic status or the levels of glycemic measures and VaD. In addition, no significant relationships were observed between insulin resistance and secretion measurements and AD and VaD. CONCLUSION Our findings indicate that diabetes mellitus and hyperglycemia are significantly associated with AD, even in individuals at the prediabetes level.
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Affiliation(s)
- Moeko Noguchi-Shinohara
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.,Department of Preemptive Medicine for Dementia, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Sohshi Yuki-Nozaki
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Chiemi Abe
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.,Department of Preemptive Medicine for Dementia, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Ayaka Mori
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Mai Horimoto
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.,Department of Preemptive Medicine for Dementia, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masami Yokogawa
- Department of Physical Therapy, Division of Health Sciences, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Natsuko Ishida
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University, Kanazawa, Japan
| | - Yukio Suga
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University, Kanazawa, Japan
| | - Junko Ishizaki
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University, Kanazawa, Japan
| | - Mai Ishimiya
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.,Department of Oral and Maxillofacial Surgery, Ryukyu University Graduate School of Medical Science, Nishihara, Japan
| | - Kiyonobu Komai
- Department of Neurology, Hokuriku Brain and Neuromuscular Disease Center, National Hospital Organization Iou National Hospital, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Public Health, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, Kanazawa, Japan.,Kanazawa University Advanced Preventive Medical Sciences Research Center, Kanazawa, Japan.,Department of Environmental and Preventive Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.,Kudanzaka Hospital, Tokyo, Japan
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A case of α-chain variant hemoglobin (Hb Chad) with falsely high HbA1c levels measured by immunoassay. Diabetol Int 2021; 13:330-335. [DOI: 10.1007/s13340-021-00529-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/06/2021] [Indexed: 02/05/2023]
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Ohigashi M, Osugi K, Kusunoki Y, Washio K, Matsutani S, Tsunoda T, Matsuo T, Konishi K, Katsuno T, Namba M, Koyama H. Association of time in range with hemoglobin A1c, glycated albumin and 1,5-anhydro-d-glucitol. J Diabetes Investig 2021; 12:940-949. [PMID: 33058513 PMCID: PMC8169363 DOI: 10.1111/jdi.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION Hemoglobin A1c (HbA1c), glycated albumin (GA) and 1,5-anhydro-d-glucitol (1,5-AG) are used as indicators of glycemic control, whereas continuous glucose monitoring (CGM) is used to assess daily glucose profiles. The aim of this study was to investigate the relationships between CGM metrics, such as time in range (TIR), and glycemic control indicators. MATERIALS AND METHODS We carried out retrospective CGM and blood tests on 189 outpatients with impaired glucose tolerance (n = 22), type 1 diabetes mellitus (n = 67) or type 2 diabetes mellitus (n = 100). RESULTS In type 1 diabetes mellitus and type 2 diabetes mellitus patients, HbA1c and GA were negatively correlated with TIR, whereas 1,5-AG was positively correlated with TIR. In type 1 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 6.9% (95% confidence interval [CI] 6.5-7.2%), 20.3% (95% CI 19.0-21.7%) and 6.0 µg/mL (95% CI 5.1-6.9 µg/mL), respectively. In type 2 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 7.1% (95% CI 7.0-7.3%), 19.3% (95% CI 18.7-19.9%) and 10.0 µg/mL (95% CI 9.0-11.0 µg/mL), respectively. TIR values corresponding to HbA1c levels of 7.0% were 56.1% (95% CI 52.3-59.8%) and 74.2% (95% CI 71.3-77.2%) in type 1 diabetes mellitus and type 2 diabetes mellitus patients, respectively. CONCLUSIONS The results of this study showed that the estimated HbA1c corresponding to a TIR of 70% was approximately 7.0% for both type 1 diabetes mellitus and type 2 diabetes mellitus patients, and that the estimated 1,5-AG calculated from the TIR of 70% might be different between type 1 diabetes mellitus and type 2 diabetes mellitus patients.
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Affiliation(s)
- Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Kahori Washio
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Satoshi Matsutani
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Toshihiro Matsuo
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Tomoyuki Katsuno
- Department of Occupational TherapySchool of RehabilitationHyogo University of Health SciencesKobeHyogoJapan
| | - Mitsuyoshi Namba
- Department of Diabetes MellitusTakarazuka City HospitalTakarazukaHyogoJapan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
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40
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Kim Y, Lee SH, Kang MK, Kim TJ, Jeong HY, Lee EJ, Bae J, Jeon K, Nam KW, Yoon BW. Glycated Albumin, a Novel Biomarker for Short-Term Functional Outcomes in Acute Ischemic Stroke. Brain Sci 2021; 11:brainsci11030337. [PMID: 33800924 PMCID: PMC8000654 DOI: 10.3390/brainsci11030337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/06/2023] Open
Abstract
Background: There is growing interest in the use of new biomarkers such as glycated albumin (GA), but data are limited in acute ischemic stroke. We explored the impact of GA on short-term functional outcomes as measured using the modified Rankin Scale (mRS) at 3 months compared to glycated hemoglobin (HbA1c). Methods: A total of 1163 AIS patients from two hospitals between 2016 and 2019 were included. Patients were divided into two groups according to GA levels (GA < 16% versus GA ≥ 16%). Results: A total of 518 patients (44.5%) were included in the GA ≥ 16% group. After adjusting for multiple covariates, the higher GA group (GA ≥ 16%) had a 1.4-fold risk of having unfavorable mRS (95% CI 1.02–1.847). However, HbA1c was not significantly associated with 3-month mRS. In addition, GA ≥ 16% was independently associated with unfavorable short-term outcomes only in patients without diabetes. Conclusions: In light of these results, GA level might be a novel prognostic biomarker compared to HbA1c for short-term stroke outcome. Although the impact of GA is undervalued in the current stroke guidelines, GA monitoring should be considered in addition to HbA1c monitoring.
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Affiliation(s)
- Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea
- Correspondence: (Y.K.); (B.-W.Y.); Tel.: +82-2-2224-2206 (Y.K.); +82-2-2072-2237 (B.-W.Y.)
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea;
| | - Min Kyoung Kang
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeonbu-si 11759, Korea;
| | - Tae Jung Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (T.J.K.); (E.-J.L.); (J.B.); (K.J.)
| | - Han-Yeong Jeong
- Emergency Medical Center, Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Eung-Joon Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (T.J.K.); (E.-J.L.); (J.B.); (K.J.)
| | - Jeonghoon Bae
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (T.J.K.); (E.-J.L.); (J.B.); (K.J.)
| | - Kipyoung Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea; (T.J.K.); (E.-J.L.); (J.B.); (K.J.)
| | - Ki-Woong Nam
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul 03080, Korea;
| | - Byung-Woo Yoon
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeonbu-si 11759, Korea;
- Correspondence: (Y.K.); (B.-W.Y.); Tel.: +82-2-2224-2206 (Y.K.); +82-2-2072-2237 (B.-W.Y.)
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Serum Glycated Albumin Levels Are Affected by Alcohol in Men of the Jinuo Ethnic Group in China. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:6627074. [PMID: 33628351 PMCID: PMC7889368 DOI: 10.1155/2021/6627074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 01/25/2023]
Abstract
AIM To investigate the effects of alcohol on serum glycated albumin (GA) levels in Chinese men. METHODS A total of 2314 male subjects from the Jinuo ethnic group in China were enrolled. Of these, 986 subjects drank alcohol frequently and 404 subjects did not. Lifestyle information was gathered by using a questionnaire, and measurements of blood pressure, body mass index, blood glucose level, liver function, and kidney function were collected. GA was measured by using an enzymatic method. Frequent drinking was defined as a history of drinking ethanol > 80 g/d within the past two weeks. Nondrinking was defined as no alcohol consumption in the past three months. Subjects with an alcohol intake between 0 and 80 g/d in the past two weeks were included in the drinking-occasionally group. Analysis of variance (ANOVA), correlation analysis, and linear regression were used to evaluate the effects of drinking on serum GA levels. Decision tree regression (DTR) algorithm was used to evaluate the effect of features (variables) on GA levels. RESULTS We found that male subjects who drank frequently had significantly lower serum GA levels than subjects who did not drink (13.0 ± 1.7 vs. 14.1 ± 3.7, p < 0.05). Spearman's correlation analysis calculated a coefficient of -0.152 between drinking and GA (p < 0.005). Linear regression established that drinking was an independent predictor for GA levels with a standardized regression coefficient of -0.144 (p < 0.05). Decision tree regression showed that the effect of drinking on GA levels (0.0283) is five times higher than that of smoking (0.0057). CONCLUSIONS Frequent alcohol consumption could result in decreased GA levels in men of the Jinuo ethnic group in China.
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Development of an Interdigitated Electrode-Based Disposable Enzyme Sensor Strip for Glycated Albumin Measurement. Molecules 2021; 26:molecules26030734. [PMID: 33572552 PMCID: PMC7866809 DOI: 10.3390/molecules26030734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Abstract
Glycated albumin (GA) is an important glycemic control marker for diabetes mellitus. This study aimed to develop a highly sensitive disposable enzyme sensor strip for GA measurement by using an interdigitated electrode (IDE) as an electrode platform. The superior characteristics of IDE were demonstrated using one microelectrode of the IDE pair as the working electrode (WE) and the other as the counter electrode, and by measuring ferrocyanide/ferricyanide redox couple. The oxidation current was immediately reached at the steady state when the oxidation potential was applied to the WE. Then, an IDE enzyme sensor strip for GA measurement was prepared. The measurement of fructosyl lysine, the protease digestion product of GA, exhibited a high, steady current immediately after potential application, revealing the highly reproducible measurement. The sensitivity (2.8 nA µM−1) and the limit of detection (1.2 µM) obtained with IDE enzyme sensor strip were superior compared with our previously reported sensor using screen printed electrode. Two GA samples, 15 or 30% GA, corresponding to healthy and diabetic levels, respectively, were measured after protease digestion with high resolution. This study demonstrated that the application of an IDE will realize the development of highly sensitive disposable-type amperometric enzyme sensors with high reproducibility.
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Xu J, Zhong Z, Deng Y. Unexpected HbA 1c results in the presence of three rare hemoglobin variants. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 81:59-64. [PMID: 33315479 DOI: 10.1080/00365513.2020.1852599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hemoglobin (Hb) variants, characterized by structural abnormalities in the globin chains, are among the most common inherited disorders. It has been shown that Hb variant remains an important cause of erroneous HbA1c results. Thus, it is important to be aware of the extent of the interference of each Hb variant encountered to avoid reporting unreliable results. However, the effects of many types of Hb variants on the measurement of HbA1c remain unclear. Here, we describe three rare Hb variants, Hb J-Tashikuergan [HBA2: c.59 C > A], Hb Pyrgos [HBB: c.251G > A], and Hb Hope [HBB: c.410 G > A], which lead to extremely high values (>25%) determined by Variant II Turbo 2.0. We further investigated their effects on HbA1c measurement by an HPLC system (Bio-Rad D100), a CE system (Sebia Capillarys 3 TERA), a boronate affinity chromatography system (Premier Hb9210), and an immunoassay method (Roche Diagnostics), and found that these Hb variants severely interfered with HbA1c measurement by Variant II Turbo 2.0 and Bio-Rad D100. This study demonstrates that patients with abnormally high HbA1c levels should be highly suspected of carrying Hb variants. When the HbA1c results are considered unreliable, other indicators such as glycated albumin may be a possible alternative to HbA1c in diabetic patients.
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Affiliation(s)
- Jianfeng Xu
- Department of Laboratory Medicine, Zhuhai Hospital of Guangdong Province Traditional Chinese Medical Hospital, Zhuhai, People's Republic of China
| | - Zhijuan Zhong
- Department of Laboratory Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People's Republic of China
| | - Yukui Deng
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
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Lee SH, Kim Y, Park SY, Kim C, Kim YJ, Sohn JH. Pre-Stroke Glycemic Variability Estimated by Glycated Albumin Is Associated with Early Neurological Deterioration and Poor Functional Outcome in Prediabetic Patients with Acute Ischemic Stroke. Cerebrovasc Dis 2020; 50:26-33. [DOI: 10.1159/000511938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Whether glycemic variability prior to stroke increases the risk of stroke outcomes in prediabetic patients presenting with acute ischemic stroke is still unclear. We evaluated whether pre-stroke glycemic variability, estimated by glycated albumin (GA), increased early neurological deterioration (END) and functional outcomes in prediabetic patients with acute ischemic stroke. <b><i>Methods:</i></b> A total of 215 acute ischemic stroke patients with prediabetes were evaluated. The primary outcome was END, defined as an incremental increase in the National Institutes of Health Stroke Scale score by ≥1 point in motor power or ≥2 points in the total score within the 7 days after admission. The secondary outcome was poor functional status defined by a modified Rankin Scale at 3 months. Higher GA (≥16.0%) was determined to reflect glycemic fluctuation prior to ischemic stroke. <b><i>Results:</i></b> Of the 215 prediabetic patients, 77 (35.8%) were in the higher GA group. In prediabetic patients, END occurrence and poor functional status were higher in the higher GA group than in the lower GA group. The multivariate analysis showed that a higher GA was associated with an increased risk of END occurrence and poor functional outcomes at 3 months (adjusted odds ratio [95% confidence interval], 4.58 [1.64–12.81], <i>p</i> = 0.004 and 2.50 [1.19–5.25], <i>p</i> = 0.02, respectively). <b><i>Conclusion:</i></b> Pre-stroke glycemic variability estimated by GA was associated with END occurrence and poor functional outcome after ischemic stroke in patients with prediabetes.
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Copur S, Onal EM, Afsar B, Ortiz A, van Raalte DH, Cherney DZ, Rossing P, Kanbay M. Diabetes mellitus in chronic kidney disease: Biomarkers beyond HbA1c to estimate glycemic control and diabetes-dependent morbidity and mortality. J Diabetes Complications 2020; 34:107707. [PMID: 32861562 DOI: 10.1016/j.jdiacomp.2020.107707] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). Optimal glycemic control contributes to improved outcomes in patients with DM, particularly for microvascular damage, but blood glucose levels are too variable to provide an accurate assessment and instead markers averaging long-term glycemic load are used. The most established glycemic biomarker of long-term glycemic control is HbA1c. Nevertheless, HbA1c has pitfalls that limit its accuracy to estimate glycemic control, including the presence of altered red blood cell survival, hemoglobin glycation and suboptimal performance of HbA1c assays. Alternative methods to evaluate glycemic control in patients with DM include glycated albumin, fructosamine, 1-5 anhydroglucitol, continuous glucose measurement, self-monitoring of blood glucose and random blood glucose concentration measurements. Accordingly, our aim was to review the advantages and pitfalls of these methods in the context of CKD.
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Affiliation(s)
- Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Emine M Onal
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Avd. Reyes Católicos 2, 28040 Madrid, Spain
| | - Daniel H van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, location VUMC, Amsterdam, the Netherlands
| | - David Z Cherney
- Toronto General Hospital Research Institute, UHN, Toronto, Canada; Departments of Physiology and Pharmacology and Toxicology, University of Toronto, Ontario, Canada
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark; University of Copenhagen, Copenhagen, Denmark
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
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Zhao X, Li Q, Tu C, Zeng Y, Ye Y. High glycated albumin is an independent predictor of low response to clopidogrel in ACS patients: a cross-sectional study. Cardiovasc Diabetol 2020; 19:171. [PMID: 33036613 PMCID: PMC7545941 DOI: 10.1186/s12933-020-01146-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Glycated albumin (GA) is a marker of short-term glycemic control and is strongly associated with the occurrence of diabetes. Previous studies have shown an association between GA and the effect of clopidogrel therapy on ischemic stroke. However, limited information is available regarding this relationship in acute coronary syndrome (ACS) patients. In this study, we evaluated the effect of GA on platelet P2Y12 inhibition by clopidogrel in patients with ACS. METHODS Consecutive Chinese patients with ACS who received loading or maintenance doses of clopidogrel in addition to aspirin were recruited. At least 12 h after the patient had taken the clopidogrel dose, thromboelastography (TEG) and light transmittance aggregometry (LTA) were used to calculate the quantitative platelet inhibition rate to determine clopidogrel-induced antiplatelet reactivity. A prespecified cutoff of the maximum amplitude of adenosine diphosphate (ADP)-induced platelet-fibrin clot strength > 47 mm plus an ADP-induced platelet inhibition rate < 50% assessed by TEG or ADP-induced platelet aggregation > 40% assessed by LTA to indicate low responsiveness to clopidogrel were applied for evaluation. Patients were categorized into two groups based on a GA level of 15.5%, the cutoff point indicating the development of early-phase diabetes. Multivariate linear regression analysis was used to assess the interaction of GA with clopidogrel antiplatelet therapy. RESULTS A total of 1021 participants were evaluated, and 28.3% of patients (289 of 1021) had low responsiveness to clopidogrel assessed by TEG. In patients with elevated GA levels, low responsiveness to clopidogrel assessed by TEG was observed in 33.7% (139 of 412) of patients, which was a significantly higher rate than that in the lower-GA-level group (24.6%, P = 0.002). According to multivariate linear regression analysis, a GA level > 15.5% was independently associated with low responsiveness to clopidogrel after adjustment for age, sex and other conventional confounding factors. This interaction was not mediated by a history of diabetes mellitus. A GA level ≤ 15.5% was associated with a high positive value [75.4%, 95% CI 73.0-77.6%] for predicting a normal responsiveness to clopidogrel. CONCLUSIONS GA could be a potential biomarker to predict the effects of clopidogrel antiplatelet therapy in ACS patients and might be a clinical biomarker to guide DAPT de-escalation.
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Affiliation(s)
- Xiliang Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Quan Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Chenchen Tu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yong Zeng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Yicong Ye
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
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Belsare S, Coté G. Development of a colorimetric paper fluidic dipstick assay for measurement of glycated albumin to monitor gestational diabetes at the point-of-care. Talanta 2020; 223:121728. [PMID: 33303171 DOI: 10.1016/j.talanta.2020.121728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 12/14/2022]
Abstract
Gestational diabetes mellitus (GDM) affects between 2 and 14% of pregnant women in the United States every year. Currently, glucose and hemoglobin A1c (HbA1c) are the standard biomarkers used to monitor GDM but HbA1c is representative of 2-3 months of glycemic data and is too infrequent for managing clinical impact of GDM while glucose provides multiple daily readings which arguably are not entirely necessary for mild to moderate GDM and often result in non-compliance from the patient's side. Thus, there is a need for an intermediate biomarker which can be used effectively to monitor the glycemic status of GDM patients. Serum albumin, the most abundant protein in blood, undergoes non-enzymatic glycation in the bloodstream. Owing to its half-life of ~21 days, it can effectively be used as an intermediate biomarker. Normal level of glycation of albumin is between 10 and 16% whereas in diabetic patients it is much higher, between 16 and 40%. Thus, a point-of-care (POC) monitoring system to detect glycated albumin (GA) as a % of total serum albumin has been developed here. Specifically, a dipstick paper fluidic test to measure % glycated albumin has been developed that used an aptamer assay with gold nanoparticles to produce colorimetric measurements. Both the glycated and unglycated versions of albumin were measured in their relevant physiological concentration ranges - 50 μM-300 μM with a limit of detection (LoD) of 6.5 μM for glycated albumin and 500 μM-750 μM with a LoD of 21 μM for unglycated serum albumin. The use of aptamers as recognition elements, instead of commonly used antibodies, not only provided the required sensitivity, specificity, and dynamic range but they also have the added advantage of being stable at room temperature for an extended period of time providing the potential for these dipstick tests to be used for GDM monitoring at the point-of-care (POC).
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Affiliation(s)
- Sayali Belsare
- Department of Biomedical Engineering, Texas A&M University, MS 3120 College Station, TX, 77843-3120, USA.
| | - Gerard Coté
- Department of Biomedical Engineering, Texas A&M University, MS 3120 College Station, TX, 77843-3120, USA; Center for Remote Health Technologies and Systems, Texas A&M Engineering Experimentation Station, 600 Discovery Drive, MS 3006, College Station, TX, 77843-3006, USA
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Yousefpour P, Varanko A, Subrahmanyan R, Chilkoti A. Recombinant Fusion of Glucagon‐Like Peptide‐1 and an Albumin Binding Domain Provides Glycemic Control for a Week in Diabetic Mice. ADVANCED THERAPEUTICS 2020. [DOI: 10.1002/adtp.202000073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Parisa Yousefpour
- Department of Biomedical Engineering Duke University Durham NC 27708 USA
| | - Anastasia Varanko
- Department of Biomedical Engineering Duke University Durham NC 27708 USA
| | | | - Ashutosh Chilkoti
- Department of Biomedical Engineering Duke University Durham NC 27708 USA
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Hamasaki H, Morimitsu S. Association of Glucagon With Obesity, Glycemic Control and Renal Function in Adults With Type 2 Diabetes Mellitus. Can J Diabetes 2020; 45:249-254. [PMID: 33129755 DOI: 10.1016/j.jcjd.2020.08.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In this study, we used a double-antibody sandwich enzyme-linked immunosorbent assay to assess the association between blood glucagon levels and indices of obesity, glycemic control and renal function in patients with type 2 diabetes mellitus (T2DM). METHODS This investigation was a cross-sectional study on inpatients with T2DM who had plasma glucagon levels measured during hospitalization. Associations of fasting glucagon levels (G0), 120-minute postbreakfast plasma glucagon (G120), fasting glucagon/C-peptide ratio (G0/CPR0) and postbreakfast glucagon/C-peptide ratio (G120/CPR120) with clinical data were evaluated using multiple regression analysis. RESULTS A total of 345 patients were enrolled in the study. G0, and G120 were significantly and positively associated with serum C-peptide levels. Moreover, G0 and G120 were positively associated with waist circumference, and G0 was negatively associated with duration of diabetes mellitus. Interestingly, both G0 and G120 were negatively associated with the estimated glomerular filtration rate. In addition, G120/CPR120 was positively associated with duration of diabetes mellitus and glycoalbumin levels. CONCLUSIONS The balance between glucagon and insulin secretion is significantly associated with abdominal obesity and important for maintaining glucose homeostasis. Postprandial hyperglucagonemia could also be related to deterioration of renal function.
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Affiliation(s)
- Hidetaka Hamasaki
- Hamasaki Clinic, Kagoshima, Japan; Department of Diabetes, Imakiire General Hospital, Kagoshima, Japan.
| | - Shingo Morimitsu
- Department of Diabetes, Imakiire General Hospital, Kagoshima, Japan
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50
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Lee J, Oh JS, Zhu JH, Hong S, Park SH, Kim JH, Kim H, Seo M, Kim K, Lee DH, Jung HH, Park J, Oh YM, Choi S, Choi KH. High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study. Scand J Trauma Resusc Emerg Med 2020; 28:88. [PMID: 32883318 PMCID: PMC7470436 DOI: 10.1186/s13049-020-00782-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/27/2020] [Indexed: 02/04/2023] Open
Abstract
Background To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature management (TTM). Methods This single-center retrospective cohort study included adult OHCA survivors who underwent hypothermic TTM from December 2011 to December 2019. High HbA1c at admission was defined as a level higher than 6%. Poor neurological outcomes were defined as cerebral performance category scores of 3–5. The primary outcome was 6-month mortality. The secondary outcome was the 6-month neurological outcome. Descriptive statistics, log-rank tests, and multivariable regression modeling were used for data analysis. Results Of the 302 patients included in the final analysis, 102 patients (33.8%) had HbA1c levels higher than 6%. The high HbA1c group had significantly worse 6-month survival (12.7% vs. 37.5%, p < 0.001) and 6-month outcomes (89.2% vs. 73.0%, p = 0.001) than the non-high HbA1c group. Kaplan-Meier analysis and the log-rank test showed that the survival time was significantly shorter in the patients with HbA1c > 6% than in those with HbA1c ≤6%. In the multivariable logistic regression analysis, HbA1c > 6% was independently associated with 6-month mortality (OR 5.85, 95% CI 2.26–15.12, p < 0.001) and poor outcomes (OR 4.18, 95% CI 1.41–12.40, p < 0.001). Conclusions This study showed that HbA1c higher than 6% at admission was associated with increased 6-month mortality and poor outcomes in OHCA survivors treated with hypothermic TTM. Poor long-term glycemic management may have prognostic significance after cardiac arrest.
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Affiliation(s)
- Junhaeng Lee
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Joo Suk Oh
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea.
| | - Jong Ho Zhu
- Department of Emergency Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sungyoup Hong
- Department of Emergency Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Sang Hyun Park
- Department of Emergency Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Hoon Kim
- Department of Emergency Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Republic of Korea
| | - Hyungsoo Kim
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Mingu Seo
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Kiwook Kim
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Doo Hyo Lee
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Hyun Ho Jung
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Jungtaek Park
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Young Min Oh
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Semin Choi
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
| | - Kyoung Ho Choi
- Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
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