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United States Department of Agriculture

Agricultural Research Service

Research Project: LIPOPROTEINS AND NUTRITION

Location: Human Nutrition Research Center on Aging

Title: Glycated albumin and direct low density lipoprotein cholesterol levels in type 2 diabetes mellitus

Authors
item Ai, Masumi -
item Otokozawa, Seiko -
item Schaefer, Ernst -
item Asztalos, Bela -
item Nakajima, Katsuyuki -
item Shrader, Peter -
item Kathiresan, Sekar -
item Meigs, James -
item Williams, Gordon -
item Nathan, David -

Submitted to: Clinica Chimica Acta
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 15, 2009
Publication Date: August 11, 2009
Citation: Ai, M., Otokozawa, S., Schaefer, E.J., Asztalos, B.F., Nakajima, K., Shrader, P., Kathiresan, S., Meigs, J.B., Williams, G., Nathan, D.M. 2009. Glycated albumin and direct low density lipoprotein cholesterol levels in type 2 diabetes mellitus. Clinica Chimica Acta. 406:71-74.

Interpretive Summary: Diabetes mellitus is a major risk factor for heart disease, kidney failure, blindness, and nerve problems. Lowering levels of blood glucose and the amount of glucose attached to the hemoglobin in red blood cells known as glucosylated hemoglobin or HbA1c, as well as lowering total cholesterol and low-density lipoprotein-cholesterol (LDL-C) has been associated with a decreased risk of these complications. We evaluated the utility of a new assay of long term glucose control which measures the amount of glucose attached to albumin, known as glycated albumin or GA, as well as a direct measure of LDL-C, instead of the usual calculated value. We measured these parameters in a multi-ethnic population of 616 male and female patients with type 2 diabetes and 895 non-diabetic controls. Our data showed that HbA1c and GA levels were highly correlated (r=0.70, p<0.001), and mean values in patients were about 40% higher than in controls for both measures. Calculated and direct LDL-C values were also highly correlated (r=0.96, p<0.001), with no differences based on age, gender, or ethnic subgroups. The data indicate that calculated LDL-C provides an accurate assessment of fasting LDL-C compared with a direct measurement in most subjects, except for those with high triglyceride levels, and that glycated albumin correlates with well with HbA1c in diabetic and non-diabetic subjects, and may serve as a reasonable marker of short term diabetic control.

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) has been associated with a decreased risk of these complications. We evaluated the utility of glycated albumin (GA) and direct LDL-C, 2 novel assay, as compared to HbA1c and calculated LDL-C, in evaluating diabetes control and lipid 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. 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). Calculated and direct LDL-C values correlated very highly (r = 0.96, p < 0.001). The correlations between HbA1c and GA, and between calculated and direct LDL-C 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.

Last Modified: 4/20/2014