Clinical impact of glycated albumin as another glycemic control marker

Abstract

Abstract. It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Currently, among these glycated proteins, glycated hemoglobin (HbA 1C ) is used as the gold standard index of glycemic control in clinical practice for diabetes treatment. However, HbA 1C does not accurately reflect the actual status of glycemic control in some conditions where plasma glucose changes during short term, and in patients who have diseases such as anemia and variant hemoglobin. In comparison, another index of glycemic control, glycated albumin (GA), more accurately reflects changes in plasma glucose during short term and also postprandial plasma glucose. Although GA is not influenced by disorders of hemoglobin metabolism, it is affected by disorders of albumin metabolism. This review summarizes diseases and pathological conditions where GA measurement is useful. These include the status of glycemic control changes during short term, diseases which cause postprandial hyperglycemia, iron deficiency anemia, pregnancy, chronic liver disease (liver cirrhosis), chronic renal failure (diabetic nephropathy), and variant hemoglobin.

The ratio of glycated albumin to hemoglobin A1c measured in IFCC units accurately represents the glycation gap

“…GA is formed by the attachment of glucose to albumin. Fructosamine is formed by the covalent attachment of glucose to total serum proteins, primary albumin [14,15]. GA is not affected by other glycated proteins in serum, compared with fructosamine which is including glycated proteins other than albumin.…”

“…We used GA, a glycated product of albumin, instead of fructosamine to measure glycated proteins in serum (of which glycated albumin is the main component) [14,15]. Although the GA assay has not yet been approved by the Food and Drug Administration (FDA) and may not be available in the United States of litus used carbohydrate counting and changed insulin dose in each meal.…”

Glycated albumin: a potential biomarker in diabetes

“…Hemolytic anemias and bleeding episodes reduce the A1C values, while iron deficiency anemias, thalassemias, and hemoglobinopathies may elevate its results (6,11,38). During the fetal period, the main type of Hb in the red blood cells is the fetal Hb (HbF), which is gradually replaced by HbA after birth.…”

“…Glycated albumin (GA) is a laboratory test that has gained some importance for glycemic monitoring in DM in the last decades (10,11). GA is one of the fructosamines, but it has the advantage of not being influenced by the concentration of other serum proteins since it is specific to the albumin glycation rates (12).…”

“…Compared to A1C, GA is not affected by the presence of hemolytic processes and abnormal Hb (13). Besides, in conditions such as anemia, pregnancy, postprandial hyperglycemia and DM using insulin, GA seems to be a better glycemic marker than A1C (11) and also it is especially indicated for diabetic patients on hemodialysis (14,15). Recently, studies on type 1 (16) and type 2 DM patients (17) reported an association of GA with the chronic complications of the disease.…”