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Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection.
J Am Soc Nephrol. 2007 Mar; 18(3):896-903.JA

Abstract

The significance of glycated albumin (GA), compared with casual plasma glucose (PG) and glycated hemoglobin (HbA(1c)), was evaluated as an indicator of the glycemic control state in hemodialysis (HD) patients with diabetes. The mean PG, GA, and HbA(1c) levels were 164.5 +/- 55.7 mg/dl, 22.5 +/- 7.5%, and 5.85 +/- 1.26%, respectively, in HD patients with diabetes (n = 538), which were increased by 51.5, 31.6, and 17.7%, respectively, compared with HD patients without diabetes (n = 828). HbA(1c) levels were significantly lower than simultaneous PG and GA values in those patients in comparison with the relationship among the three parameters in patients who had diabetes without renal dysfunction (n = 365), as reflected by the significantly more shallow slope of regression line between HbA(1c) and PG or GA. A significant negative correlation was found between GA and serum albumin (r = -0.131, P = 0.002) in HD patients with diabetes, whereas HbA(1c) correlated positively and negatively with hemoglobin (r = 0.090, P = 0.036) and weekly dose of erythropoietin injection (r = -0.159, P < 0.001), respectively. Although PG and GA did not differ significantly between HD patients with diabetes and with and without erythropoietin injection, HbA(1c) levels were significantly higher in patients without erythropoietin. Categorization of glycemic control into arbitrary quartile by HbA(1c) level led to better glycemic control in a significantly higher proportions of HD patients with diabetes than those assessed by GA. Multiple regression analysis demonstrated that the weekly dose of erythropoietin, in addition to PG, emerged as an independent factor associated with HbA(1c) in HD patients with diabetes, although PG but not albumin was an independent factor associated with GA. In summary, it is suggested that GA provides a significantly better measure to estimate glycemic control in HD patients with diabetes and that the assessment of glycemic control by HbA(1c) in these patients might lead to underestimation likely as a result of the increasing proportion of young erythrocyte by the use of erythropoietin.

Authors+Show Affiliations

Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. inaba-m@med.osaka-cu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17267743

Citation

Inaba, Masaaki, et al. "Glycated Albumin Is a Better Glycemic Indicator Than Glycated Hemoglobin Values in Hemodialysis Patients With Diabetes: Effect of Anemia and Erythropoietin Injection." Journal of the American Society of Nephrology : JASN, vol. 18, no. 3, 2007, pp. 896-903.
Inaba M, Okuno S, Kumeda Y, et al. Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol. 2007;18(3):896-903.
Inaba, M., Okuno, S., Kumeda, Y., Yamada, S., Imanishi, Y., Tabata, T., Okamura, M., Okada, S., Yamakawa, T., Ishimura, E., & Nishizawa, Y. (2007). Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. Journal of the American Society of Nephrology : JASN, 18(3), 896-903.
Inaba M, et al. Glycated Albumin Is a Better Glycemic Indicator Than Glycated Hemoglobin Values in Hemodialysis Patients With Diabetes: Effect of Anemia and Erythropoietin Injection. J Am Soc Nephrol. 2007;18(3):896-903. PubMed PMID: 17267743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. AU - Inaba,Masaaki, AU - Okuno,Senji, AU - Kumeda,Yasuro, AU - Yamada,Shinsuke, AU - Imanishi,Yasuo, AU - Tabata,Tsutomu, AU - Okamura,Mikio, AU - Okada,Shigeki, AU - Yamakawa,Tomoyuki, AU - Ishimura,Eiji, AU - Nishizawa,Yoshiki, AU - ,, Y1 - 2007/01/31/ PY - 2007/2/3/pubmed PY - 2007/7/25/medline PY - 2007/2/3/entrez SP - 896 EP - 903 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 18 IS - 3 N2 - The significance of glycated albumin (GA), compared with casual plasma glucose (PG) and glycated hemoglobin (HbA(1c)), was evaluated as an indicator of the glycemic control state in hemodialysis (HD) patients with diabetes. The mean PG, GA, and HbA(1c) levels were 164.5 +/- 55.7 mg/dl, 22.5 +/- 7.5%, and 5.85 +/- 1.26%, respectively, in HD patients with diabetes (n = 538), which were increased by 51.5, 31.6, and 17.7%, respectively, compared with HD patients without diabetes (n = 828). HbA(1c) levels were significantly lower than simultaneous PG and GA values in those patients in comparison with the relationship among the three parameters in patients who had diabetes without renal dysfunction (n = 365), as reflected by the significantly more shallow slope of regression line between HbA(1c) and PG or GA. A significant negative correlation was found between GA and serum albumin (r = -0.131, P = 0.002) in HD patients with diabetes, whereas HbA(1c) correlated positively and negatively with hemoglobin (r = 0.090, P = 0.036) and weekly dose of erythropoietin injection (r = -0.159, P < 0.001), respectively. Although PG and GA did not differ significantly between HD patients with diabetes and with and without erythropoietin injection, HbA(1c) levels were significantly higher in patients without erythropoietin. Categorization of glycemic control into arbitrary quartile by HbA(1c) level led to better glycemic control in a significantly higher proportions of HD patients with diabetes than those assessed by GA. Multiple regression analysis demonstrated that the weekly dose of erythropoietin, in addition to PG, emerged as an independent factor associated with HbA(1c) in HD patients with diabetes, although PG but not albumin was an independent factor associated with GA. In summary, it is suggested that GA provides a significantly better measure to estimate glycemic control in HD patients with diabetes and that the assessment of glycemic control by HbA(1c) in these patients might lead to underestimation likely as a result of the increasing proportion of young erythrocyte by the use of erythropoietin. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/17267743/Glycated_albumin_is_a_better_glycemic_indicator_than_glycated_hemoglobin_values_in_hemodialysis_patients_with_diabetes:_effect_of_anemia_and_erythropoietin_injection_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=17267743 DB - PRIME DP - Unbound Medicine ER -