Comparing Multiple Measures of Glycemia: How to Transition from Biomarker to Diagnostic Test?

Cohen, Robert M.; Sacks, David B.

doi:10.1373/clinchem.2012.196139

Cited by 25 publications

(21 citation statements)

References 17 publications

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“…Alterations in serum protein turnover will affect the values of these assays and it remains unclear whether fructosamine should be corrected for total serum protein concentration. Conditions that may affect the interpretation of fructosamine and glycated albumin values include liver disease, hyperuricemia, acute illness or infection, and thyroid dysfunction (36). …”

Section: Discussionmentioning

confidence: 99%

Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Selvin

Rawlings

Grams

et al. 2014

The Lancet Diabetes & Endocrinology

220

181

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Background Hemoglobin A1c (HbA1c) is the standard measure to monitor long-term glucose control in diabetes management and is now used for diagnosis. Fructosamine and glycated albumin are markers of short-term glycemic control that may add complementary information to HbA1c. However, the performance of fructosamine and glycated albumin to identify people at risk of complications is unclear. Methods We measured glycated albumin and fructosamine in 11348 adults without diabetes and 958 adults with diagnosed diabetes who attended the second examination of the Atherosclerosis Risk in Communities (ARIC) Study in 1990–1992 (baseline). We evaluated the associations of fructosamine and glycated albumin with retinopathy and risk of incident chronic kidney disease and incident diabetes during two decades of follow-up. We compared these associations to those for HbA1c. Findings Fructosamine and glycated albumin were strongly associated with retinopathy and these associations were very similar to that observed for HbA1c. Fructosamine and glycated albumin were also significantly associated with risk of incident chronic kidney disease and incident diabetes. Compared to persons with no diabetes and fructosamine or glycated albumin levels <75th percentile, the multivariable-adjusted hazard ratios (95%CIs) for chronic kidney disease for persons with fructosamine and glycated albumin levels >95th percentile were 1.50 (1.22, 1.85) and 1.48 (1.20, 1.83), respectively. The HRs for incident diabetes were 4.96 (4.36, 5.64) for fructosamine >95th percentile and 6.17 (5.45, 6.99) for glycated albumin >95th percentile. Associations were attenuated but persisted after adjustment for HbA1c. Prediction of incident chronic kidney disease by fructosamine (C-statistic, 0.717) and glycated albumin (C-statistic, 0.717) were nearly as strong as by HbA1c (C-statistic, 0.726) but HbA1c outperformed fructosamine and glycated albumin for prediction of incident diabetes with C-statistics of 0.760, 0.706, and 0.703, respectively. Interpretation Fructosamine and glycated albumin were strongly associated with diabetes and its microvascular complications and complemented the prognostic utility of HbA1c.

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Section: Discussionmentioning

confidence: 99%

Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Selvin

Rawlings

Grams

et al. 2014

The Lancet Diabetes & Endocrinology

220

181

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“…HbA1c is an accepted biomarker for providing a long-term record of glycemic control over a period of 2–3 months, as made possible by the life span of approximately 90–120 days for hemoglobin in red blood cells [38,39]. However, it has been suggested that HbA1c may not be suitable for evaluating patients with unstable blood glucose concentrations, and the accuracy of this marker can be affected by the presence of hemoglobin variants [40], recent blood transfusions or diseases such as hemolytic anemia and renal failure, which can affect the production and effective life span of red blood cells in the circulation [41,42]. …”

Section: Measurement Of Glycated Albuminmentioning

confidence: 99%

“…The term “fructosamine” (often abbreviated as “FA”) typically refers to all ketoamine linkages that result from the glycation of serum proteins. Because HSA is the most abundant of the serum proteins, fructosamine is predominantly a measure of glycated HSA, contributing ~90% to the total [41,42]. As a result, fructosamine assays tend to be used when glycemic control needs to be examined over a period of 1–3 weeks [37,38,42].…”

Section: Measurement Of Glycated Albuminmentioning

confidence: 99%

Review: Glycation of human serum albumin

Anguizola

Matsuda

Barnaby

et al. 2013

Clinica Chimica Acta

338

308

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Glycation involves the non-enzymatic addition of reducing sugars and/or their reactive degradation products to amine groups on proteins. This process is promoted by the presence of elevated blood glucose concentrations in diabetes and occurs with various proteins that include human serum albumin (HSA). This review examines work that has been conducted in the study and analysis of glycated HSA. The general structure and properties of HSA are discussed, along with the reactions that can lead to modification of this protein during glycation. The use of glycated HSA as a short-to-intermediate term marker for glycemic control in diabetes is examined, and approaches that have been utilized for measuring glycated HSA are summarized. Structural studies of glycated HSA are reviewed, as acquired for both in vivo and in vitro glycated HSA, along with data that have been obtained on the rate and thermodynamics of HSA glycation. In addition, this review considers various studies that have investigated the effects of glycation on the binding of HSA with drugs, fatty acids and other solutes and the potential clinical significance of these effects.

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“…Factors that influence albumin metabolism may alter glycated albumin independent of glycemia. These factors include the nephrotic syndrome, cirrhosis, thyroid disease, hyperuricemia, hypertriglyceridemia, and smoking (57). As with fructosamine, glycated albumin concentrations can be affected by altered protein levels that occur with liver, thyroid, and renal disease (58).…”

Section: Glycated Albuminmentioning

confidence: 99%

Role of Glycated Proteins in the Diagnosis and Management of Diabetes: Research Gaps and Future Directions

2016

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Comparing Multiple Measures of Glycemia: How to Transition from Biomarker to Diagnostic Test?

Cited by 25 publications

References 17 publications

Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Review: Glycation of human serum albumin

Role of Glycated Proteins in the Diagnosis and Management of Diabetes: Research Gaps and Future Directions

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