The ratio of glycated albumin to hemoglobin A1c measured in IFCC units accurately represents the glycation gap

Estimation of glycaemic control in the past month using ratio of glycated albumin to HbA1c

“…The features of high or low haemoglobin glycation phenotypes would be useful for the determination of glycaemic targets, as reported in the ACCORD study [20], and additionally as a predictor of diabetic complications [9]. The reference ranges (mean AE sd) obtained from the present study in Japanese children and adolescents with Type 1 diabetes were 6.69AE0.59 and 2.95AE0.24 for the glycated albumin/IFCC HbA 1c ratio and glycated albumin/NGSP HbA 1c ratio, respectively, as published previously [15]. The glycated albumin/HbA 1c ratio Z-score could be used to make comparisons between different ethnic groups, such as comparing patients who have different types of diabetes.…”

“…Recent reports proposed the use of glycated albumin [11,12] and glycated albumin/HbA 1c ratio as indices of chronic diabetic complications independently of HbA 1c [13,14]. We observed that the individual mean value of the glycated albumin/HbA 1c ratio over time showed long-term consistency and a highly significant inverse correlation with the glycation gap when using simultaneous measurement of HbA 1c and glycated albumin instead of fructosamine [15].…”

“…These findings could contribute to daily medical practice with regard to estimation of glycaemic control in the recent past without increasing the frequency of hospital visits and blood tests. Additionally, the individual mean value of the glycated albumin/HbA 1c ratio used in method B could reflect a haemoglobin glycation index that indicates the biological variability of HbA 1c , which can be obtained by assessing deviations in HbA 1c with the same mean glucose levels using self‐monitoring of blood glucose and by determining the glycation gap .…”

“…Each individual mean value for the glycated albumin/HbA 1c ratio was determined using the glycated albumin and HbA 1c measurements taken simultaneously at least 10 times during the study period, and we found that the mean value of the glycated albumin/HbA 1c ratio showed long‐term individual consistency . The correlations of the glycated albumin/HbA 1c ratio Z‐score with ΔHbA 1c and those of %glycated albumin/HbA 1c with ΔHbA 1c were assessed using linear regression analysis, and concordance rates between the glycated albumin/HbA 1c ratio Z‐score and ΔHbA 1c and those between %glycated albumin/HbA 1c and ΔHbA 1c were also examined.…”

“…The accuracy of the HbA 1c values in the National Glycohemoglobin Standardization Program (NGSP) units (NGSP HbA 1c ) obtained was confirmed using the Japanese Diabetes Society (JDS) calibrator . We used the JDS calibrator to maintain standardization . The International Federation of Clinical Chemistry (IFCC) units (IFCC HbA 1c ) were obtained using the master equation as follows: NGSP HbA 1c (IFCC HbA 1c = 10.93 × NGSP HbA 1c − 23.50) .…”