Evaluation of biological variation of glycated albumin (GA) and fructosamine in healthy subjects

Montagnana, Martina; Paleari, Renata; Danese, Elisa; Salvagno, Gian Luca; Lippi, Giuseppe; Guidi, Gian Cesare; Mosca, Andrea

doi:10.1016/j.cca.2013.04.003

Cited by 34 publications

(27 citation statements)

References 36 publications

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“…Fructosamine is not affected by anemia or variant hemoglobins but the level is influenced by the concentrations of serum protein, bilirubin, uric acid, and low molecular weight substances coexisting in the blood [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

Lee

Fujii

et al. 2014

BioMed Research International

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Objective. This study investigated the use of the estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to screen for β-cell function in pediatric diabetes. Methods. Glycated hemoglobin (HbA1c), glycated albumin (GA), fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c (GA/A1c ratio) was calculated, and the homeostasis model assessment of β-cell function (HOMA-β) was determined. Results. Median values of C-peptide, insulin, and HOMA-β levels were significantly higher in patients with an increased eAG/fPG ratio than in those with a decreased eAG/fPG ratio. C-peptide and HOMA-β levels were more closely correlated with the eAG/fPG ratio than with GA, HbA1c, the GA/A1c ratio, and fructosamine. In contrast, body mass index was significantly associated with GA, GA/A1c ratio, and fructosamine, but not with the eAG/fPG ratio and HbA1c levels. To test the diagnostic accuracies of the eAG/fPG ratio for identifying HOMA-β > 30.0% in patients with type 2 diabetes, the area under the ROC curve of the eAG/fPG ratio was significantly larger than that of the GA/A1c ratio [0.877 (95% CI, 0.780–0.942) versus 0.775 (95% CI, 0.664–0.865), P = 0.039]. Conclusions. A measurement of the eAG/fPG ratio may provide helpful information for assessing β-cell function in pediatric patients with diabetes.

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Section: Introductionmentioning

confidence: 99%

The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

Lee

Fujii

et al. 2014

BioMed Research International

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“…After incubation for a fixed time, an enzyme-conjugated polyclonal antibody directed against human albumin is added. After the reaction is stopped, the intensity of the color is read in an enzyme-linked immunosorbent assay reader at 450 nm [6, 9, 20]. The GA value was calculated as the percentage of GA relative to total albumin, which was measured with new bromocresol purple method using the same serum sample.…”

Section: Study Population and Methodsmentioning

confidence: 99%

“…This assay uses proteinase K to digest serum proteins into low-molecular-weight glycated protein fragments and uses Diazyme’s specific fructosaminase, a microorganism-originated amadoriase, to catalyze the oxidative degradation of Amadori product glycated protein fragments to yield protein fragments or amino acids, glucosone, and H 2 O 2 . The H 2 O 2 released is measured by a colorimetric Trinder endpoint reaction [6, 9, 20]. The absorbance at 546 nm is proportional to the concentration of GSP.…”

Section: Study Population and Methodsmentioning

confidence: 99%

Comparison of Glycemic Markers in Chronic Hemodialysis Using Continuous Glucose Monitoring

et al. 2017

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Background: Glycated hemoglobin A1c (HbA1c) among diabetic hemodialysis patients continues to be the standard of care, although its limitations are well recognized. This study evaluated glycated albumin (GA) and glycated serum protein (GSP) as alternatives to HbA1c in detecting glycemic control among diabetic hemodialysis patients using continuous-glucose-monitoring (CGM)-derived glucose as reference standard. Methods: A CGM system (iPRO) was applied for 7 days in 37 diabetic hemodialysis patients to determine glycemic control. The accuracy of GA and GSP versus HbA1c in detecting a 7-day average glucose ≥184 mg/dL was evaluated via receiver-operating-characteristic (ROC) analysis. Results: CGM-derived glucose exhibited strong correlation (r = 0.970, p < 0.001) and acceptable agreement with corresponding capillary glucose measurements obtained by the patients themselves in 1,169 time-points over the 7-day-long CGM. The area under ROC curve (AUC) for GA, GSP, and HbA1c to detect poor glycemic control was 0.976 (0.862–1.000), 0.682 (0.502–0.862), and 0.776 (0.629–0.923) respectively. GA levels >20.3% had 90.9% sensitivity and 96.1% specificity in detecting a 7-day average glucose ≥184 mg/dL. The AUC for GA was significantly higher than the AUC for GSP (difference between areas: 0.294, p < 0.001) and the AUC for HbA1c (difference between areas: 0.199, p < 0.01). Conclusion: Among diabetic hemodialysis patients, GA is a stronger indicator of poor glycemic control assessed with 7-day-long CGM when compared to GSP and HbA1c.

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“…Subsequently, other manufacturers have released similarly methodologies for GA analysis, but instead of a specific measurement of its levels, these assays employ math equations to obtain %GA levels (33,34). In addition, the biological variation of GA measured by Lucica GA-L ® is lower when compared to fructosamine and A1C (1.7%, 2.8% and, 2.4%, respectively) (35).…”

Section: Laboratory Measurement Of Gamentioning

confidence: 99%

Glycated albumin: a potential biomarker in diabetes

Freitas

Ehlert

Camargo

2017

Arch. Endocrinol. Metab.

136

103

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Diabetes mellitus (DM) is a chronic and metabolic disease that presents a high global incidence. Glycated hemoglobin (A1C) is the reference test for long-term glucose monitoring, and it exhibits an association with diabetic chronic complications. However, A1C is not recommended in clinical situations which may interfere with the metabolism of hemoglobin, such as in hemolytic, secondary or iron deficiency anemia, hemoglobinopathies, pregnancy, and uremia. The glycated albumin (GA) is a test that reflects short-term glycemia and is not influenced by situations that falsely alter A1C levels. GA is the higher glycated portion of fructosamine. It is measured by a standardized enzymatic methodology, easy and fast to perform. These laboratory characteristics have ensured the highlight of GA in studies from the last decade, as a marker of monitoring and screening for DM, as well as a predictor of long-term outcomes of the disease. The aim of this review was to discuss the physiological and biochemistry characteristics of the GA, as well as its clinical utility in DM. Arch Endocrinol Metab.2017;61(3):296-304.

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Evaluation of biological variation of glycated albumin (GA) and fructosamine in healthy subjects

Cited by 34 publications

References 36 publications

The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

Comparison of Glycemic Markers in Chronic Hemodialysis Using Continuous Glucose Monitoring

Glycated albumin: a potential biomarker in diabetes

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