Usefulness of glycated albumin as a biomarker for glucose control and prognostic factor in chronic kidney disease patients on dialysis (CKD-G5D)

Dozio, Elena; Corradi, Valentina; Proglio, Marta; Vianello, Elena; Menicanti, Lorenzo; Rigolini, Roberta; Caprara, Carlotta; Cal, Massimo de; Romanelli, Massimiliano Marco Corsi; Ronco, Claudio

doi:10.1016/j.diabres.2018.03.017

Cited by 15 publications

(11 citation statements)

References 70 publications

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“…Considering that GA is a product of glycation that reflects early changes in glycemic control [33], the increased levels observed in DM should be considered a direct consequence of a worsened glycemic control and oxidative stress. Furthermore, GA seems a more reliable marker for glycemic control in CKD patients in which HbA1c suffers some limits, because it can both under-and over-estimate a patient's glycaemia, depending on the disease state and drug therapy [22]. Differently from previous studies in dialysis patients [22], we found no evidence of association of GA with all-cause mortality, although not so far from statistical significance.…”

Section: Discussioncontrasting

confidence: 89%

“…Furthermore, GA seems a more reliable marker for glycemic control in CKD patients in which HbA1c suffers some limits, because it can both under-and over-estimate a patient's glycaemia, depending on the disease state and drug therapy [22]. Differently from previous studies in dialysis patients [22], we found no evidence of association of GA with all-cause mortality, although not so far from statistical significance. Therefore, our data cannot definitively exclude that GA may have a prognostic role on mortality in CKD patients not yet on dialysis.…”

Section: Discussioncontrasting

confidence: 89%

“…Recently, we reported an association between higher levels of sRAGE and mortality in hemodialysis and peritoneal dialysis patients [15]. Likely, glycated albumin (GA), an early precursor of AGE that is associated with the overall prognosis of patients in dialysis [22], may influence the prognosis of patients with advanced CKD.…”

Section: Introductionmentioning

confidence: 99%

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Advanced Glycation End Products (AGE) and Soluble Forms of AGE Receptor: Emerging Role as Mortality Risk Factors in CKD

et al. 2020

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Advanced glycation end-products (AGE) can promote chronic kidney disease (CKD) progression and CKD-related morbidities. The soluble receptor for AGE (sRAGE) is a potential biomarker of inflammation and oxidative stress. Here, we explored the role of AGE, glycated albumin, sRAGE and its different forms, cRAGE and esRAGE, as prognostic factors for mortality in 111 advanced CKD patients. The median follow-up time was 39 months. AGE were quantified by fluorescence, sRAGE and its forms by ELISA. Malnutrition was screened by the Malnutrition Inflammation Score (MIS). The Cox proportional hazards regression model was used to assess the association of variables with all-cause mortality. Mean levels of sRAGE, esRAGE and cRAGE were 2318 ± 1224, 649 ± 454 and 1669 ± 901 pg/mL. The mean value of cRAGE/esRAGE was 2.82 ± 0.96. AGE were 3026 ± 766 AU and MIS 6.0 ± 4.7. eGFR correlated negatively with AGE, sRAGE, esRAGE and cRAGE, but not with cRAGE/esRAGE. Twenty-eight patients died. No difference was observed between diabetic and non-diabetic patients. Starting dialysis was not associated with enhanced risk of death. AGE, esRAGE and cRAGE/esRAGE were independently associated with all-cause mortality. AGE, esRAGE and cRAGE/esRAGE may help to stratify overall mortality risk. Implementing the clinical evaluation of CKD patients by quantifying these biomarkers can help to improve patient outcomes.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussioncontrasting

confidence: 89%

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Advanced Glycation End Products (AGE) and Soluble Forms of AGE Receptor: Emerging Role as Mortality Risk Factors in CKD

et al. 2020

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“…As GA is not affected by the same limitations as hemoglobin, it may be an acceptable alternative biomarker of glycemic control when HbA1c is unreliable as in CKD, particularly during hemodialysis [302]. It also seems to be a better predictor of cardiovascular complications and risk of hospitalization or death in these patients when HbA1c is especially unreliable in the presence of anemia or erythropoietin administration [303,304].…”

Section: Glycated Albuminmentioning

confidence: 99%

Review of methods for detecting glycemic disorders

Bergman

Abdul‐Ghani

Manco

et al. 2020

Diabetes Research and Clinical Practice

134

101

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Highlights A 1-hour plasma glucose (1-h PG) threshold >155 mg/dl (8.6 mmol/L) during an oral glucose tolerance test (OGTT) may be a suitable biomarker for identifying normal glucose tolerant (NGT) individuals at risk for future type 2 diabetes (T2D). A one-hour, non-fasting, 50g Glucose Challenge Test (GCT) performed during a routine health care visit has potential for practical screening of glucose disorders. The shape of the glucose curve reflects the cumulative effect of insulin sensitivity and response on glucose concentrations with prospective studies warranted to evaluate its prognostic utility. The continuous glucose monitor (CGM) has facilitated insight into the pathophysiology of prediabetes and phenotypes of T2D and holds promise for detecting glycemic disorders. Metabolomic profiling including amino acids, lipids, carbohydrates and other metabolites may be useful for early diagnosis of glycemic disorders. Non-classical markers for assessing glycemic disorders including fructosamine, glycated albumin, and 1,5-anhydroglucitol that evaluate shorter periods of glucose exposure than HbA1c have potential use as adjunctive tools.

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“…Both fructosamine and GA are the markers of choice when glycemic control needs to be assessed in patients with severe chronic kidney disease (CKD) (stages 4 and 5)[80]. Additionally, in stage 5 CKD patients on hemodialysis, GA can be used as a predictor of overall survival and cardiovascular mortality[81]. Due to the reduced production and lifespan of red blood cells and to erythropoietin treatment in CKD patients, HbA1c cannot be used as reliable marker, as it can significantly underestimate the true glycemic status in these patients[82].…”

Section: Glycated Proteinsmentioning

confidence: 99%

Update on biomarkers of glycemic control

Krhač¹,

Lovrenčić²

2019

WJD

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Attaining and maintaining good glycemic control is a cornerstone of diabetes care. The monitoring of glycemic control is currently based on the self-monitoring of blood glucose (SMBG) and laboratory testing for hemoglobin A1c (HbA1c), which is a surrogate biochemical marker of the average glycemia level over the previous 2-3 mo period. Although hyperglycemia is a key biochemical feature of diabetes, both the level of and exposure to high glucose, as well as glycemic variability, contribute to the pathogenesis of diabetic complications and follow different patterns in type 1 and type 2 diabetes. HbA1c provides a valuable, standardized and evidence-based parameter that is relevant for clinical decision making, but several biological and analytical confounders limit its accuracy in reflecting true glycemia. It has become apparent in recent years that other glycated proteins such as fructosamine, glycated albumin, and the nutritional monosaccharide 1,5-anhydroglucitol, as well as integrated measures from direct glucose testing by an SMBG/continuous glucose monitoring system, may provide valuable complementary data, particularly in circumstances when HbA1c results may be unreliable or are insufficient to assess the risk of adverse outcomes. Long-term associations of these alternative biomarkers of glycemia with the risk of complications need to be investigated in order to provide clinically relevant cut-off values and to validate their utility in diverse populations of diabetes patients.

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Usefulness of glycated albumin as a biomarker for glucose control and prognostic factor in chronic kidney disease patients on dialysis (CKD-G5D)

Cited by 15 publications

References 70 publications

Advanced Glycation End Products (AGE) and Soluble Forms of AGE Receptor: Emerging Role as Mortality Risk Factors in CKD

Advanced Glycation End Products (AGE) and Soluble Forms of AGE Receptor: Emerging Role as Mortality Risk Factors in CKD

Review of methods for detecting glycemic disorders

Update on biomarkers of glycemic control

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