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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #215331
Title: Direct Low Density Lipoprotein Cholesterol and Glycated Albumin Levels in Type 2 Diabetes Mellitus

Author
item AI, MASUMI - TUFTS UNIVERSITY
item OTOKOZAWA, SEIKO - TUFTS UNIVERSITY
item Schaefer, Ernst
item ASZTALOS, BELA - TUFTS UNIVERSITY
item NAKAJIMA, KATSUYUKI - HARVARD UNIVERSITY
item SHRADER, PETER - HARVARD UNIVERSITY
item KATHIRESAN, SEKAR - HARVARD UNIVERSITY
item MEGIS, JAMES - HARVARD UNIVERSITY
item WILLIAMS, GORDON - HARVARD UNIVERSITY
item NATHAN, DAVID - HARVARD UNIVERSITY

Submitted to: Clinica Chimica Acta
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/22/2009
Publication Date: 8/1/2009
Citation: Ai, M., Otokozawa, S., Schaefer, E., Asztalos, B., Nakajima, K., Shrader, P., Kathiresan, S., Megis, J.B., Williams, G., Nathan, D.M. 2009. Direct Low Density Lipoprotein Cholesterol and Glycated Albumin Levels in Type 2 Diabetes Mellitus. Clinica Chimica Acta. 406(1-2):71-74.

Interpretive Summary: Increased blood sugar or glucose levels over 125 mg/dl after an overnight fast is classified as diabetes. Another measure of glucose control is the amount of glucose attached to the red blood cells - known as glycosylated hemoglobin. This test allows one to assess long term glucose control over 2-3 months. The problem is that the test is expensive and cumbersome and requires the use of whole blood. We have evaluated a new and promising method of assessing glucose control by measuring the amount of glucose attached to albumin in plasma. The advantage of this test is that it is rapid, inexpensive, and can be run on an automated analyzer. Moreover we document that this test correlates well with glycosylated hemoglobin and seperates control subjects from diabetic subjects very well. In this study we also document that a new direct method of measuring low density lipoprotein or LDL cholesterol correlates very well with the calculated value. Therefore most diabetic subjects do not require the direct method. This information will help health professional take better care of diabetic subjects and help them prevent their heart disease and other diabetic complications like blindness, nerve problems, and kidney failure.

Technical Abstract: Diabetes mellitus is a major risk factor for coronary heart disease (CHD), renal failure, retinopathy, and neuropathy. Lowering glycosylated hemoglobin (HbA1c) as well as low-density lipoprotein-cholesterol (LDL-C) have been associated with a decreased risk of these complications. The aim in this study was to evaluate the utility of direct LDL-C and glycated albumin (GA), two novel assays, as compared to calculated LDL-C and HbA1c, in evaluating lipid and diabetes control in a heterogeneous population and in specific subgroups of patients with type 2 diabetes mellitus. We obtained fasting blood samples and measured HbA1c, GA, and direct LDL-C, as well as other parameters, in a multi-ethnic population of 616 male and female patients with type 2 diabetes and 895 non-diabetic controls. Calculated and direct LDL-C values correlated very highly (r=0.96, p<0.001). HbA1c and GA levels, which measure different periods of glycemia, had a correlation of r=0.70 (p<0.001), and mean values in patients were 38.7% and 43.4% higher, respectively, than controls in men, and 41.1% and 40.1% higher, respectively, than controls, in women (both p<0.001). The correlations between calculated and direct LDL-C, and between HbA1c and GA were similar for subgroups defined by gender, race, age, and other factors.Calculated LDL-C provides an accurate assessment of fasting LDL-C compared with a direct measurement in most subjects, except for those with hypertriglyceridemia, and GA correlates with HbA1c in diabetic and non-diabetic subjects and may serve as a reasonable marker of short term diabetic control.