Performance of glycated albumin for type 2 diabetes and prediabetes diagnosis in a South African population

Zemlin, Annalise E.; Barkhuizen, Marizna; Kengne, André Pascal; Erasmus, Rajiv T; Matsha, Tandi E.

doi:10.1016/j.cca.2018.11.005

Cited by 18 publications

(10 citation statements)

References 28 publications

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“…Another study evaluated the performance of GA in Caucasian subjects from Italy [17] using HbA 1c only as a reference test and reported that the optimal threshold value (GA >14.0%) had sensitivity of 72.2% and specificity of 71.8% for diagnosis of DM. Lately, a study which examined African subjects [18] using OGTT as reference test referred the optimal cut-off value for GA as 14.9%, similar to the optimal threshold of GA of 14.8% reported in this present study. However, it should be noticed that, in this African study the suggested point in the ROC curve is not the point with the best equilibrium between sensitivity and specificity, as sensitivity and specificity for this GA threshold were 64.8% and 93.5%, respectively.…”

Section: Discussionsupporting

confidence: 82%

“…Though GA data have been accumulating in Asian population [12–15], limited data are available in other regions. There are few studies with non-Asians that report on the validity of GA test in screening and diagnosis of DM [16–18]. One study [16] evaluated the performance of GA in obese youth mainly Hispanic North Americans and suggested GA ≥12% as the cut point when using 2hPG as a reference test and GA ≥14% when HbA 1c is a reference test.…”

Section: Discussionmentioning

confidence: 99%

“…Although data about GA performance in diagnosis and screening of DM have been available in Asian populations [12–15], limited data exists in other populations [16–18]. We hypothesized that GA may be used in the diagnosis of DM and in clinical conditions where the HbA 1c test does not accurately reflect blood glucose concentrations GA may be an alternative marker.…”

Section: Introductionmentioning

confidence: 99%

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Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?

et al. 2019

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IntroductionStudies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in diagnosis of type 2 diabetes mellitus (DM). Thus, the aim of this study was to assess the clinical utility of GA in diagnosis of DM.Materials and methodsThis diagnostic test accuracy study was performed in 242 Brazilian individuals referred for OGTT in a tertiary university hospital. ROC curves were used to access the performance of GA and HbA1c in the diagnosis of DM by oral glucose tolerance test (OGTT).ResultsOGTT, HbA1c and GA were performed in all 242 participants (40.5% male, age 54.4 ± 13.0 years [mean ± SD], body mass index 28.9 ± 6.3 kg/m2). DM by OGTT was detected in 31.8% of individuals. The equilibrium threshold value of GA ≥14.8% showed sensitivity of 64.9% and specificity of 65.5% for the diagnosis of DM. The AUC for GA [0.703 (95% CI 0.631–0.775)] was lower than for HbA1c [0.802 (95% CI 0.740–0.864)], p = 0.028. A GA value of 16.8% had similar accuracy for detecting DM as defined by HbA1c ≥6.5% (48 mmol/mol) with sensitivity of 31.2% and specificity of 93.3% for both tests. However, GA detects different subjects from those detected by HbA1c and OGTT.ConclusionsGA detected different individuals with DM from those detected by HbA1c, though it showed overall diagnostic accuracy similar to HbA1c in the diagnosis of DM. Therefore, GA should be used as an additional test rather than an alternative to HbA1c or OGTT and its use as the sole DM diagnostic test should be interpreted with caution.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?

et al. 2019

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“…Three studies directly compared the performance of different diagnostic tests, with varied results. Hird et al 2016 reported a similar prevalence irrespective whether FPG, 2-h glucose or HbA1c was used [ 41 ], while Erasmus et al 2012 found that FPG was approximately 36% more sensitive than 2-h glucose [ 12 ], and Zemlin et al 2019 demonstrated that 2-h glucose was 30% more sensitive than FPG [ 42 ]. Eight studies reported T2DM prevalence by gender.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis

Wyk

Turawa

Levitt

et al. 2021

IJERPH

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Synthesis of existing prevalence data using rigorous systematic review methods is considered an effective strategy to generate representative and robust prevalence figures to inform health planning and policy. The purpose of this systematic review was to identify, collate, and synthesise all studies reporting the prevalence of total and newly diagnosed type 2 diabetes (T2DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in South Africa. Four databases, PubMed, Scopus, Web of Science, and African Index Medicus were searched for articles published between January 1997 and June 2020. A total of 1886 articles were identified, of which 11 were included in the meta-analysis. The pooled prevalence in individuals 25 years and older was 15.25% (11.07–19.95%) for T2DM, 9.59% (5.82–14.17%) for IGT, 3.55% (0.38–9.61%) for IFG, and 8.29% (4.97–12.34%) for newly diagnosed T2DM. Although our pooled estimate may be imprecise due to significant heterogeneity across studies with regard to population group, age, gender, setting, diagnostic test, and study design, we provide evidence that the burden of glucose intolerance in South Africa is high. These factors contribute to the paucity of representative T2DM prevalence data. There is a need for well-designed epidemiological studies that use best-practice and standardised methods to assess prevalence.

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“…It is necessary to discern the various conditions related to diabetes and to assess the value of GA based on the presence of comorbidity [ 35 ]. For example, Koga et al reported that serum GA levels are significantly lower than HbA1c in diabetic patients with preserved insulin secretion [ 55 , 56 , 57 ].…”

Section: Ga and Cardio-metabolic Risk Factorsmentioning

confidence: 99%

Recent Updates and Advances in the Use of Glycated Albumin for the Diagnosis and Monitoring of Diabetes and Renal, Cerebro- and Cardio-Metabolic Diseases

Giglio

Sasso

Agnello

et al. 2020

JCM

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Diabetes mellitus is a heterogeneous and dysmetabolic chronic disease in which the laboratory plays a fundamental role, from diagnosis to monitoring therapy and studying complications. Early diagnosis and good glycemic control should start as early as possible to delay and prevent metabolic and cardio-vascular complications secondary to this disease. Glycated hemoglobin is currently used as the reference parameter. The accuracy of the glycated hemoglobin dosage may be compromised in subjects suffering from chronic renal failure and terminal nephropathy, affected by the reduction in the survival of erythrocytes, with consequent decrease in the time available for glucose to attach to the hemoglobin. In the presence of these renal comorbidities as well as hemoglobinopathies and pregnancy, glycated hemoglobin is not reliable. In such conditions, dosage of glycated albumin can help. Glycated albumin is not only useful for short-term diagnosis and monitoring but predicts the risk of diabetes, even in the presence of euglycemia. This protein is modified in subjects who do not yet have a glycemic alteration but, as a predictive factor, heralds the risk of diabetic disease. This review summarizes the importance of glycated albumin as a biomarker for predicting and stratifying the cardiovascular risk linked to multiorgan metabolic alterations.

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Performance of glycated albumin for type 2 diabetes and prediabetes diagnosis in a South African population

Cited by 18 publications

References 28 publications

Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?

Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?

Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis

Recent Updates and Advances in the Use of Glycated Albumin for the Diagnosis and Monitoring of Diabetes and Renal, Cerebro- and Cardio-Metabolic Diseases

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