Plasma Albumin Concentration Is a Predictor of HbA1c Among Type 2 Diabetic Patients, Independently of Fasting Plasma Glucose and Fructosamine

Rodrı́guez-Segade, Santiago; Rodríguez, Juan Enrique Arias; Mayan, Dolores; Camiña, Félix

doi:10.2337/diacare.28.2.437

Cited by 35 publications

(48 citation statements)

References 14 publications

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“…This was also quite evident in a previous study with 4158 participants, where it was shown that more than 50% of the patients with lower albumin had higher HbA1c (>8%), whereas HbA1c was lower among patients with high albumin levels. 20 Our study suggests that variation in albumin levels can also influence the differential glycation of HbA1c. It is possible that a similar blood glucose level may lead to different HbA1c depending upon the albumin content in the plasma.…”

Section: ■ Results and Discussionmentioning

confidence: 94%

Low Plasma Albumin Levels Are Associated with Increased Plasma Protein Glycation and HbA1c in Diabetes

et al. 2012

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Albumin is one of the most abundant plasma proteins and is heavily glycated in diabetes. In this study, we have addressed whether variation in the albumin levels influence glycation of plasma proteins and HbA1c. The study was performed in three systems: (1) streptozotocin (STZ)-induced diabetic mice plasma, (2) diabetic clinical plasma, and (3) in vitro glycated plasma. Diabetic mice and clinical plasma samples were categorized as diabetic high albumin plasma (DHAP) and diabetic low albumin plasma (DLAP) on the basis of their albumin levels. For the in vitro experiment, two albumin levels, high albumin plasma (HAP) and low albumin plasma (LAP), were created by differential depletion of plasma albumin. Protein glycation was studied by using a combination of two-dimensional electrophoresis (2DE), Western blotting, and LC-MS(E). In both mice and clinical experiments, an increased plasma protein glycation was observed in DLAP than in DHAP. Additionally, plasma albumin levels were negatively correlated with HbA1c. The in vitro experiment with differential depletion of albumin mechanistically showed that the low albumin levels are associated with increased plasma protein glycation and that albumin competes for glycation with other plasma proteins.

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Section: ■ Results and Discussionmentioning

confidence: 94%

Low Plasma Albumin Levels Are Associated with Increased Plasma Protein Glycation and HbA1c in Diabetes

et al. 2012

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“…In addition, Cheng PC et al . have demonstrated that serum albumin concentration, which is inversely associated with HbA 1c 293031, is inversely associated with the risk of ketosis in patients with T2DM29. However, few research studies have concentrated on the value of HbA 1c as a screening tool for ketosis in T2DM.…”

Section: Discussionmentioning

confidence: 99%

HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus

Zhu

Zhang

et al. 2016

Sci Rep

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Ketosis in patients with type 2 diabetes mellitus (T2DM) is overlooked due to atypical symptoms. The objective of this study is to evaluate the value of hemoglobin A1c (HbA1c) as a screening tool for ketosis in T2DM patients. This retrospective study consisted of 253 T2DM patients with ketosis at Shanghai 10th People’s Hospital during a period from January 1, 2011 to June 30, 2015. A control group consisted of 221 T2DM patients without ketosis randomly selected from inpatients during the same period. Receiver operating characteristic curve (ROC) analysis was used to examine the sensitivity and specificity of HbA1c as an indicator for ketosis. Higher HbA1c levels were correlated with ketosis. In patients with newly diagnosed T2DM, the area under the curve (AUC) was 0.832, with 95% confidence interval (CI) 0.754–0.911. The optimal threshold was 10.1% (87 mmol/mol). In patients with previously diagnosed T2DM, the AUC was 0.811 (95% CI: 0.767–0.856), with an optimal threshold of 8.6% (70 mmol/mol). HbA1c is a potential screening tool for ketosis in patients with T2DM. Ketosis is much more likely with HbA1c values at ≥10.1% in patients with newly diagnosed T2DM and HbA1c values at ≥8.6% in patients with previously diagnosed T2DM.

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“…Additionally, in type 1 diabetes patients, insulin withdrawal resulted in a decrease in the albumin synthetic rate, with these changes being reversed by insulin [26]. In diabetic patients, however, plasma albumin concentration has been reported to be inversely related with HbA1c levels, revealing a large proportion of poorly controlled diabetes in patients with lower plasma albumin concentrations [27]. This inverse relationship may also be explained by the fact that poorly controlled type 2 diabetes has been associated with a further decrease in insulin production and secretion by the pancreatic β-cell [28,29].…”

Section: Discussionmentioning

confidence: 99%

Association between Serum Albumin, Insulin Resistance, and Incident Diabetes in Nondiabetic Subjects

et al. 2013

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BackgroundSerum albumin has been suggested to be associated with insulin resistance. We evaluated the association between serum albumin concentration and insulin resistance. We also investigated whether serum albumin level has an independent effect on the development of diabetes.MethodsIn our study, 9,029 subjects without diabetes, who underwent comprehensive health check-ups annually for 5 years, were categorized into tertiles based on their serum albumin levels at baseline. The odds ratio (OR) for the prevalence of insulin resistance, defined as the top quartile of homeostasis model assessment of insulin resistance and the presence of impaired fasting glucose and nonalcoholic fatty liver disease, was evaluated cross-sectionally. Also, the hazard ratio (HR) for incident diabetes was estimated longitudinally, according to the baseline albumin tertiles using Cox proportional hazard analysis respectively.ResultsFrom the lowest to the highest tertile of albumin, the multivariable-adjusted ORs of insulin resistance increased significantly in both men and women. During the mean follow-up period of nearly 4 years, 556 (6.1%) subjects progressed to diabetes. The multivariable-adjusted HR (95% confidence interval [CI]) of diabetes in men were 1, 1.09 (95% CI, 0.86 to 1.40), and 1.10 (95% CI, 0.86 to 1.41), respectively, from the lowest to the highest tertiles of baseline albumin. Corresponding values for women were 1, 1.21 (95% CI, 0.66 to 2.21), and 1.06 (95% CI, 0.56 to 2.02), respectively.ConclusionOur study showed that increased serum albumin level was associated with insulin resistance. However, serum albumin did not have an independent effect on the development of diabetes.

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Plasma Albumin Concentration Is a Predictor of HbA1c Among Type 2 Diabetic Patients, Independently of Fasting Plasma Glucose and Fructosamine

Cited by 35 publications

References 14 publications

Low Plasma Albumin Levels Are Associated with Increased Plasma Protein Glycation and HbA1c in Diabetes

Low Plasma Albumin Levels Are Associated with Increased Plasma Protein Glycation and HbA1c in Diabetes

HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus

Association between Serum Albumin, Insulin Resistance, and Incident Diabetes in Nondiabetic Subjects

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