Serum Glycated Albumin Concentrations during Pregnancy

Abstract

Additional key phrases: diabetes mellitus; haemoglobin Ale; glycated protein; fructosamineMany studies have been shown that fetal malformation and abnormal growth are significantly increased in pregnancies with poorly-controlled diabetes mellitus and that intensive glycaemic control is required in diabetic pregnancy. 1 Various indices including haemoglobin Ale, glycated protein and fructosamine are reported to be useful for assessing glycaemic control during pregnancy.t-' Glycated protein and fructosamine reflect glycaemic control levels over a shorter period, and so presumably more rapidly, than HbA1c" Measurement of glycated albumin seems more suitable than that of glycated protein because metabolism of serum albumin is better understood than that of other serum proteins. There are many reports of the usefulness of glycated albumin for assessing glycaemic control levels in non-pregnant diabetic patients. However, as there seem to be no reports on its value during pregnancy, we examined the changes of glycated albumin during pregnancy in comparison with those of other measurements. SUBJECTS AND METHODThe subjects studied were 249 pregnant women with normal glucose tolerance before pregnancy. Their fasting plasma glucose, serum total protein (T'P), glycated albumin, fructosarnine, HbA le and urinary glucose concentrations were examined several times between week 10 and 37 of pregnancy. The women were classified into three groups: a normal group, 225 women showed neither glycoCorrespondence: Dr Kenji Shima.198 suria nor hyperglycaemia (fasting glucosẽ 6'1 mmollL) throughout pregnancy; glycosuria group, 13 women who showed glycosuria at least once but not hyperglycaemia; and a hyperglycaernia group, 11 women who showed a fasting glucose concentration of > 6· 1 mmollL at least once. Glycated albumin was measured by column affinity chromatography by the HPLC method described previously. 4 Fructosamine was measured by the nitroblue tetrazolium method with an assay kit from Hoffmann-La Roche Co. (Basle, Switzerland). HbA\c was measured by an HPLC method, and plasma glucose by the international standard method with glucose dehydrogenase. Serum total protein was measured by the biuret method. The coefficients of variation of these assays for glycated albumin, fructosamine, HbA le, plasma glucose and total protein were 3'6,1-7,2-6,2'3 and 0-6l1Jo, respectively. The mean glycated albumin in 153 non-pregnant women aged 18 to 30 (mean 20' 3, SD 2· 5 years) with normal glucose tolerance was 15'6, SD 0·6%.For analysis, data were grouped into three gestational periods (weeks 10-19, 20-29, and 30-37 of gestation) named early, middle and late pregnancy, respectively. Data are given as means (SD). Statistical significance was analysed by ttest for paired and unpaired data or by analysis of variance. RESULTSThe results are summarized in Table 1. In normal pregnant women, fasting plasma glucose and glycated albumin did not change significantly as pregnancy progressed, total protein and fructosamine concentrations were significant...

Comparison of Glycated Albumin (GA) and Glycosylated Hemoglobin (A1C) in monitoring glycemic excursions during pregnancy

“…In this study, GA levels strongly correlated with the A1C levels in both GDM and NGT women and these glycated proteins also correlated with FPG and PPG, similar to the observation of Yang et al and Abe et al [10,12]. Hashimoto K et al [14] documented that A1C but not GA was elevated because of iron deficiency anemia in late pregnancy in diabetic women.…”

“…To understand the glycemic excursions during pregnancy besides performing the point of care by capillary blood glucose measurement with glucometers, there is a need to have a test which could give an idea about the plasma glucose excursions in the previous weeks. GA as well as A1C are useful markers of glycemic control in the recent past [12]. GA reflects the retrospective glycemic excursions in the immediate past of approximately two weeks and A1C, glycemic excursions of more than eight weeks.…”

Determination of reference intervals of glycated albumin and hemoglobin A1c in healthy pregnant Japanese women and analysis of their time courses and influencing factors during pregnancy

“…Therefore, blood glucose levels need to be controlled more strictly during pregnancy than non-pregnancy. Because GA reflects the recent glycemic control status more sensitively than HbA1c [11], it could be a useful marker for management in diabetic pregnant women [12]. More recently, an enzymatic method for GA measurement [8] has been developed for use in clinical settings.…”

Changes in Clinical Pathology Parameters During Gestation in the New Zealand White Rabbit

“…Cholesterol levels are known to be inversely related to thyroid function (26), although in pregnant women, increased cholesterol levels and increased thyroid function have been reported to occur (7). Conflicting observations have been reported for serum glucose levels in women during pregnancy (1,35,45). Chiang et al (9) reported that glucose levels increased in the first trimester (organogenesis) from nonpregnant levels and decreased slightly throughout gestation thereafter.…”