Association of glycated albumin, but not glycated hemoglobin, with peripheral vascular calcification in hemodialysis patients with type 2 diabetes

Yamada, Shinsuke; Inaba, Masaaki; Shidara, Kaori; Okada, Shigeki; Emoto, Masanori; Ishimura, Eiji; Nishizawà, Yoshiki

doi:10.1016/j.lfs.2008.08.001

Cited by 45 publications

(29 citation statements)

References 28 publications

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“…Some previous studies have shown the prognostic value of GA levels and the association between GA levels and progression of atherosclerosis in diabetic dialysis patients (20)(21)(22)(23). In the present study, the question of which is a better marker, HbA1c or GA, in diabetic CKD patients was not investigated.…”

Section: Discussionmentioning

confidence: 81%

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

et al. 2011

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Background Glycated albumin (GA), which is an alternative glycemic marker, is influenced by factors associated with albumin turnover, and it is not clear whether proteinuria influences GA values in diabetic patients with chronic kidney disease (CKD). Methods We enrolled 94 diabetic patients with CKD stages 3 to 5. GA, glycated hemoglobin, and urinary protein excretion (UP) levels were consecutively obtained in each patient. The correlations between GA and UP and those between changes in GA and UP were examined. Results There was a significant correlation between GA and UP in all cases (r=-0.46, p<0.0001), however no significant correlation was found in cases with UP of 0-3.49 g/day (r=0.01). GA values in cases with UP "3.5 g/day were significantly lower than those in cases with UP <3.5 g/day [UP "3.5 g/day and serum albumin (Alb) !3 g/dL; 12.0 ± 1.3%, UP "3.5 g/day and Alb >3 g/dL; 17.8 ± 4.3%, 0" UP <3.5 g/day; 21.2 ± 4.2%], while no significant difference in HbA1c or glucose levels was found. In cases with a minimum of UP "0.5 g/day, no significant correlation was found between the difference in GA and the difference in UP at the point of maximum UP and minimum UP (r=0.04). Conclusion Nephrotic-range proteinuria decreases GA values independent of the glycemic state, while nonnephrotic range proteinuria has no significant influence on GA values in diabetic CKD patients.

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Section: Discussionmentioning

confidence: 81%

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

et al. 2011

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“…HbA1c associations with mortality were stronger in nonanemic patients and those with higher serum albumin [37]. To date, all studies comparing GA with HbA1c in patients with ESRD revealed that GA, as opposed to HbA1c, associates with patient survival, hospitalization, and vascular calcification [4,15,17,18]. …”

Section: Discussionmentioning

confidence: 99%

“…GA predominantly reflects glycemic control over the prior 17 days [14]. GA levels also positively associate with altered bone and mineral metabolism and vascular calcification, findings not observed with HbA1c [15,16]. Relative to unadjusted HbA1c, GA appears to be superiorly linked to mortality and overall hospitalizations in patients with diabetes on dialysis [17,18].…”

Section: Introductionmentioning

confidence: 99%

Glycated Albumin, Not Hemoglobin A1c, Predicts Cardiovascular Hospitalization and Length of Stay in Diabetic Patients on Dialysis

Murea

Moran²,

Russell³

et al. 2012

Am J Nephrol

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Background: The utility of glycated hemoglobin (HbA1c) and glycated albumin (GA) in diabetic dialysis patients remains unknown. GA was previously associated with all-cause hospitalization and patient survival. Relationships between GA, HbA1c, and casual plasma glucose (PG) with cause-specific cardiovascular (CV) disease, infectious disease (ID), and vascular access- (VA) related hospitalization rates and length of stay (LOS) were assessed. Methods: 444 prevalent diabetic dialysis patients had monthly PG, quarterly GA, and all HbA1c values recorded for 2.33 years; hospitalizations within 17 and 30 days of testing were evaluated. Best-fit, time-dependent Cox models were constructed in unadjusted, case-mix-adjusted (age, sex, race, BMI, diabetes duration, dialysis vintage), and case-mix- plus lab-adjusted (hemoglobin, albumin, phosphorus) models. Results: Mean ± SD diabetes duration was 18.5 ± 10.8 years and dialysis vintage 2.9 ± 2.6 years. In fully adjusted models, CV hospitalization rates were associated with increasing GA (HR 1.32; 95% CI 1.11–1.57; p = 0.002 at 17 days; HR 1.21; p = 0.02 at 30 days) and PG (HR 1.10; 95% CI 1.02–1.17; p = 0.01 at 17 days; HR 1.07; p = 0.03 at 30 days), not HbA1c (HR 1.24; 95% CI 0.89–1.73; p = 0.21 at 17 days; HR 1.26; p = 0.10 at 30 days). LOS for CV admissions was positively associated with GA (HR 1.18; 95% CI 1.01–1.39; p = 0.03), not PG (HR 1.04; 95% CI 0.99–1.10; p = 0.15) or HbA1c (HR 1.03; 95% CI 0.92–1.15; p = 0.21). Admissions due to ID and VA complications (and LOS) did not correlate with these assays. Conclusions: Improved glycemic control based on GA and PG predicted CV-related hospitalizations; GA also predicted CV hospitalization LOS. HbA1c did not predict cause-specific hospitalizations in dialysis populations.

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“…Several studies have shown the association between mortality, the development of cardiovascular disease, and GA values in these patients (9,10). Other studies have shown the association between arterial stiffness, peripheral vascular calcification, and high GA values in these patients (11,12). Therefore, GA is of value for the assessment of glycemic control in diabetic ESRD patients.…”

Section: Several Studies Have Shown the Association Between Poor Glycmentioning

confidence: 98%

Influence of Age and Nutritional Status on Glycated Albumin Values in Hemodialysis Patients

et al. 2009

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Association of glycated albumin, but not glycated hemoglobin, with peripheral vascular calcification in hemodialysis patients with type 2 diabetes

Cited by 45 publications

References 28 publications

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

Influence of Proteinuria on Glycated Albumin Values in Diabetic Patients with Chronic Kidney Disease

Glycated Albumin, Not Hemoglobin A1c, Predicts Cardiovascular Hospitalization and Length of Stay in Diabetic Patients on Dialysis

Influence of Age and Nutritional Status on Glycated Albumin Values in Hemodialysis Patients

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