|Schaefer, Ernst J.|
Submitted to: Diabetologia
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/24/2011
Publication Date: 12/1/2011
Citation: Furusyo, N., Koga, T., Ai, M., Otokozawa, S., Kohzuma, T., Ikezaki, H., Schaefer, E., Hayashi, J. 2011. Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study: results from the Kyushu and Okinawa Populaiton Study (KOPS). Diabetologia. 54(12):3028-3036. Interpretive Summary: Blood sugar or glucose can attach itself to any protein in the bloodstream. The percent of hemoglobin in the red blood cell that has glucose attached to it is about 5%, while for blood albumin this value is about 13%. In patients who are diabetic these values generally exceed 6.5% and 16.5%, respectively. The advantage of measuring glycated albumin is that one can use serum or plasma and does have to isolate the red blood cells. We measured glycated albumin with a standardized automated high throughput assay that had excellent ‘within’ and ‘between run’ coefficients of variation. The studies were done on samples obtained from 1,575 Japanese men and women who were participating in a population based survey. The data obtained indicated that glycated albumin is a useful marker of diabetes and that values greater than 16.5% indicate the presence of diabetes, while values over 15.5% are very strong predictors of future diabetic risk. Our research is of interest to people who are interested in the prevention, diagnosis, and treatment of diabetes.
Technical Abstract: Glycated albumin is a measure of the mean plasma glucose concentration over approximately 2-3 weeks. We determined reference values for glycated albumin, and assessed its utility for the diagnosis of type 2 diabetes mellitus in the general population. We studied 1,575 men and women (mean age, 49.9 years; range, 26-78 years) who participated in a periodic health examination in a suburban Japanese town. HbA(1c) and fasting plasma concentrations of glucose (FPG) and glycated albumin were measured. Participants with FPG greater than or equal to 7.0 mmol/l or HbA(1c) greater than or equal to 6.5% (48 mmol/mol) were diagnosed as having diabetes. In our laboratory, the glycated albumin assay had intra-assay and inter-assay CVs of 1.1% and 1.6%, respectively. Glycated albumin levels were significantly correlated with HbA(1c) levels (r = 0.766, p less than 0.001) and FPG (r = 0.706, p less than 0.001). The presence of diabetes was significantly higher in participants with glycated albumin levels between 15.0% and 15.9% (five of 276, 1.81%) than in those with glycated albumin less than 14% (three of 672, 0.45%) (p = 0.037), and was markedly increased in those with a glycated albumin level greater than 16% (58 of 207, 28.0%). Receiver operating characteristic curve analysis indicated that a glycated albumin level of greater than or equal to 15.5% was optimal for predicting diabetes, with a sensitivity of 83.3% and a specificity of 83.3%. In conclusion our data indicate that glycated albumin can to be used as an alternative measure of dysglycaemia for future research and clinical practice.