Inverse association of fat mass, but not lean mass, with glycated albumin in hemodialysis patients with or without diabetes mellitus

Abstract

Background: Glycated albumin (GA), which is independent of anemia and/or use of erythropoiesis-stimulating agents, might provide a more precise measure than glycated hemoglobin (HbA1c) in hemodialysis patients. The present study examines whether body composition is associated with GA besides glycemic control in hemodialysis patients.Methods: This study included 90 hemodialysis patients with diabetes mellitus (DM) and 86 hemodialysis patients without DM. We examined blood parameters after an overnight fast and body fat and lean mass using dual X-ray absorptiometry 21–24 h after completing the dialysis session.Results: The mean body mass index (BMI) was 22.0 kg/m2. BMI and truncal fat mass were significantly higher, and total fat mass tended to be higher in hemodialysis patients with DM than in those without DM. GA exhibited inverse correlations with BMI, total lean mass, total fat mass, and truncal fat mass in hemodialysis patients with and without DM; however, there was a lack of correlation with total lean mass in patients without DM. In multiple regression analysis including total fat mass and total lean mass simultaneously as independent variables, total fat mass (with DM: β = –0.322, p = .006) (without DM: β = –0.391, p < .001), but not total lean mass, in addition to log fasting plasma glucose, emerged as an independent factor associated with GA in hemodialysis patients with and without DM. When total fat mass was replaced with truncal fat mass (with DM: β = –0.311, p = .007) (without DM: β = –0.396, p < .001), the association remained significant and independent with GA in both patient groups.Conclusions: Higher total fat mass, particularly truncal fat mass, might be associated with lower GA levels, beside glycemic control, in hemodialysis patients with or without DM.

Differential Association of Glycation Products with Bone Mineral Density and Fat Mass in Healthy and Diabetes Type 2 Subjects from Mexican Southeastern: A Cross Sectional Study

“…Regarding ALB-g, the primary observations indicated a negative correlation with fat (DXA), both in grams (for the entire sample and DM2 group) and as a percentage in DM2 postmenopausal women. The inverse relationship between ALB-g and fat mass has been established in previous studies [ 37 , 38 ], and it has been recognized as a reliable measure for monitoring glycemic control in individuals with diabetes over a moderate period of time [ 39 ]. In the present study, we observed that postmenopausal women with diabetes exhibited elevated levels in circulation, as shown in Figure S1 Supplementary (only included for the discussion section).…”