Results of a Study Comparing Glycated Albumin to Other Glycemic Indices

Cyrus V Desouza, Richard G Holcomb, Julio Rosenstock, Juan P Frias, Stanley H Hsia, Eric J Klein, Rong Zhou, Takuji Kohzuma, Vivian A Fonseca, Cyrus V Desouza, Richard G Holcomb, Julio Rosenstock, Juan P Frias, Stanley H Hsia, Eric J Klein, Rong Zhou, Takuji Kohzuma, Vivian A Fonseca

Abstract

Context: Intermediate-term glycemic control metrics fulfill a need for measures beyond hemoglobin A1C.

Objective: Compare glycated albumin (GA), a 14-day blood glucose measure, with other glycemic indices.

Design: 24-week prospective study of assay performance.

Setting: 8 US clinics.

Participants: Subjects with type 1 (n = 73) and type 2 diabetes (n = 77) undergoing changes to improve glycemic control (n = 98) or with stable diabetes therapy (n = 52).

Interventions: GA, fructosamine, and A1C measured at prespecified intervals. Mean blood glucose (MBG) calculated using weekly self-monitored blood glucose profiles.

Main outcome measures: Primary: Pearson correlation between GA and fructosamine. Secondary: magnitude (Spearman correlation) and direction (Kendall correlation) of change of glycemic indices in the first 3 months after a change in diabetes management.

Results: GA was more concordant (60.8%) with changes in MBG than fructosamine (55.5%) or A1C (45.5%). Across all subjects and visits, the GA Pearson correlation with fructosamine was 0.920. Pearson correlations with A1C were 0.655 for GA and 0.515 for fructosamine (P < .001) and with MBG were 0.590 and 0.454, respectively (P < .001). At the individual subject level, Pearson correlations with both A1C and MBG were higher for GA than for fructosamine in 56% of subjects; only 4% of subjects had higher fructosamine correlations with A1C and MBG. GA had a higher Pearson correlation with A1C and MBG in 82% and 70% of subjects, respectively.

Conclusions: Compared with fructosamine, GA correlates significantly better with both short-term MBG and long-term A1C and may be more useful than fructosamine in clinical situations requiring monitoring of intermediate-term glycemic control (NCT02489773).

© Endocrine Society 2019.

Figures

Figure 1.
Figure 1.
Study subjects with lowest within-in subject Pearson correlations (overall, r = 0.973). FRA = fructosamine. GA = glycated albumin. The line represents the fit for the total population.
Figure 2.
Figure 2.
Single subject data for all indices over time. (A) Example of a subject with good agreement between percent changes in all indices. (B) Example of a subject with unexpected changes in fructosamine results. FRA, fructosamine; GA, glycated albumin; MBG, mean blood glucose.
Figure 3.
Figure 3.
Median percent change in glycated albumin (GA), fructosamine (FRA), mean blood glucose (MBG), and A1C. Percent changes are used so that all indices can be shown on the same scale. (A) Group 1 with uncorrected fructosamine. (B) Group 2 with uncorrected fructosamine. (C) Group 1 with fructosamine corrected for albumin (FRA/ALB). (D) Group 2 with fructosamine corrected for albumin.

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Source: PubMed

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