Glycated albumin as an improved indicator of glycemic control in hemodialysis patients with type 2 diabetes based on fasting plasma glucose and oral glucose tolerance test - 02/03/09
, Reiko Okabe a, b, Masanori Emoto a, b, Eiji Ishimura a, b, Shuji Okazaki a, b, Yoshiki Nishizawa a, b
Corresponding author. Department of Metabolism, Endocrinology and Molecular Medicine, Internal Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. Tel.: +81 6 6645 3806; fax: +81 6 6645 3808.Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Aims |
To compare glycated albumin (GA) with glycated hemoglobin (HbA1c) as an indicator of glycemic control in hemodialysis patients with diabetes mellitus (DM), based on relationships with plasma glucose (PG) after overnight fasting and during 75g oral glucose tolerance test (OGTT).
Methods |
GA, HbA1c, plasma glucose during 75g OGTT, and serum pentosidine were determined in DM hemodialysis patients (n=23, male/female 9/14).
Results |
Significant positive correlations were found for GA and HbA1c with fasting PG (GA, r=.660, p=0.0006; HbAlc r=0.665, p=0.0004), and with PG at 30, 60 and 120min after initiation of 75g OGTT (GA, r=0.584, p=0.0035; r=0.624, p=0.0015; r=0.510, p=0.0129, respectively; HbA1c, r=0.669, p=0.0004; r=0.624, p=0.0011; r=0.509, p=0.0112, respectively). The area under the curve for PG during 75g OGTT showed strong correlations with GA (r=0.625, p=0.0008) and HbA1c (r=0.671, p=0.0003). GA and HbA1c also correlated positively with serum pentosidine, demonstrating that GA provides a no less significant assay than HbA1c as a reflection of glycemic control in DM hemodialysis patients. However, HbA1c was apparently reduced in DM hemodialysis patients, as reflected by an increase in the GA/HbA1c ratio to 3.58±0.62 (mean±SD), suggesting underestimation of glycemic control by HbA1c.
Conclusion |
GA and HbA1c exhibited similar correlations with PG during a 75g OGTT. The dependence of GA, in contrast to HbA1c, on PG does not differ in DM hemodialysis patients from that reported for subjects with normal renal function, suggesting GA as a better marker of glycemic control in DM hemodialysis patients.
Le texte complet de cet article est disponible en PDF.Keywords : Glycated albumin (GA), Glycated hemoglobin (HbA1c), 75g Oral glucose tolerance test (OGTT), Glycemic control, Hemodialysis, Diabetes mellitus
Abbreviations : GA, HbA1c, OGTT, DM, AUC, PG, PWV, WHO
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Vol 63 - N° 3
P. 236-240 - mars 2009 Retour au numéro
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