scholarly journals Recent Updates and Advances in the Use of Glycated Albumin for the Diagnosis and Monitoring of Diabetes and Renal, Cerebro- and Cardio-Metabolic Diseases

2020 ◽  
Vol 9 (11) ◽  
pp. 3634
Author(s):  
Rosaria Vincenza Giglio ◽  
Bruna Lo Sasso ◽  
Luisa Agnello ◽  
Giulia Bivona ◽  
Rosanna Maniscalco ◽  
...  
Keyword(s):  
Metabolic Diseases ◽  
Glycated Hemoglobin ◽  
Glycated Albumin ◽  
Vascular Complications ◽  
Short Term ◽  
Good Glycemic Control ◽  
Metabolic Alterations ◽  
Monitoring Therapy ◽  
Reference Parameter ◽  
Cardio Vascular

Diabetes mellitus is a heterogeneous and dysmetabolic chronic disease in which the laboratory plays a fundamental role, from diagnosis to monitoring therapy and studying complications. Early diagnosis and good glycemic control should start as early as possible to delay and prevent metabolic and cardio-vascular complications secondary to this disease. Glycated hemoglobin is currently used as the reference parameter. The accuracy of the glycated hemoglobin dosage may be compromised in subjects suffering from chronic renal failure and terminal nephropathy, affected by the reduction in the survival of erythrocytes, with consequent decrease in the time available for glucose to attach to the hemoglobin. In the presence of these renal comorbidities as well as hemoglobinopathies and pregnancy, glycated hemoglobin is not reliable. In such conditions, dosage of glycated albumin can help. Glycated albumin is not only useful for short-term diagnosis and monitoring but predicts the risk of diabetes, even in the presence of euglycemia. This protein is modified in subjects who do not yet have a glycemic alteration but, as a predictive factor, heralds the risk of diabetic disease. This review summarizes the importance of glycated albumin as a biomarker for predicting and stratifying the cardiovascular risk linked to multiorgan metabolic alterations.

scholarly journals Factors associated with glycated albumin in adults without diabetes

2020 ◽  
Author(s):  
Priscila Aparecida Corrêa Freitas ◽  
Mayana Kieling Hernandez ◽  
Joiza Lins Camargo
Keyword(s):  
Glycated Hemoglobin ◽  
Glycated Albumin ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Short Term ◽  
Cross Sectional ◽  
Factors Associated ◽  
Gender And Age ◽  
Term Monitoring

Background and aims. Glycated albumin is a glycemic marker useful in short-term monitoring and in situations when a glycated hemoglobin test is not reliable. This study aims to evaluate glycated albumin levels and its associated factors in normoglycemic adults from Southern Brazil. Method. 136 individuals, without diabetes or pre-diabetes, were included in this cross-sectional study. Levels of glycated albumin, glycated hemoglobin, and other biochemical markers were measured. Results. Glycated albumin levels ranged from 11.1% to 17.5% (2.5th and 97.5th percentiles). Glycated albumin/glycated hemoglobin ratio was 2.8 ± 0.2. Glycated albumin did not differ according to gender and age groups. However, in overweight individuals, levels of glycated albumin and glycated albumin/glycated hemoglobin ratio were lower and weakly and negatively correlated with body mass index. Conclusions. Glycated albumin levels in Brazilians were similar to those previously described in other populations. Glycated albumin seems to be irrespective of gender or age, but weakly correlated with weight. These aspects should be taken into account in the interpretation of glycated albumin results.

scholarly journals Biomarkers of Glyco-Metabolic Control in Hemodialysis Patients: Glycated Hemoglobin vs. Glycated Albumin

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 712
Author(s):  
Francesca Gabriela Martino ◽  
Marina Vitillo ◽  
Massimo Pieri ◽  
Giulia Marrone ◽  
Fabio Gangeri ◽  
...  
Keyword(s):  
Glycated Hemoglobin ◽  
Glycated Albumin ◽  
Normocytic Anemia ◽  
Lazio Region ◽  
Metabolic Alterations ◽  
Metabolic Monitoring ◽  
Previous Diagnosis ◽  
Study Population ◽  
Analysis Laboratory ◽  
Hypoglycemic Therapy

Background and Objectives: Glycated hemoglobin (HbA1c) dosage is considered the gold standard in glycol-metabolic monitoring, but it presents limits, which can underestimate the glycemia trend. In this regard, it was introduced the glycated albumin (GA). The aim of the study is to verify the predictivity of the GA compared to HbA1c in identifying glyco-metabolic alterations in non-diabetic and diabetic hemodialysis (HD) patients. Materials and Methods: For this purpose, we conducted a multicenter study involving one analysis laboratory and six dialysis centers in the Lazio region (Rome, Italy). Both diabetic and non-diabetic HD patients represent the study population, and the protocol included five time points. Results: The analyzed data highlighted the ability of GA to predict changes in glycemic metabolism in HD patients, and GA values are not significantly influenced, like HbA1c, by dialysis therapy itself and by comorbidities of the uremic state, such as normochromic and normocytic anemia. Thus, GA seems to reflect early glyco-metabolic alterations, both in patients with a previous diagnosis of diabetes and in subjects without diabetes mellitus. As part of this study, we analyzed two HD patients (one diabetic and one non-diabetic) in which GA was more predictive of glycol-metabolic alterations compared to HbA1c. Our study confirms the need to compare classical biomarkers used for the monitoring of glyco-metabolic alterations with new ones, likely more reliable and effective in specific subgroups of patients in which the classic biomarkers can be influenced by the preexisting pathological conditions. Conclusions: In conclusion, our evidence highlights that in uremic patients, GA shows a better ability to predict glyco-metabolic alterations allowing both an earlier diagnosis of DM and a prompt modulation of the hypoglycemic therapy, thus improving the clinical management of these patients.

scholarly journals Usefulness of Estimation of Glycated Albumin and Glycosylated Haemoglobin in Indian Diabetic Chronic Kidney Disease Patients

2014 ◽  
Vol 2 (3) ◽  
pp. 444-447
Author(s):  
Kumaresan Ramanathan ◽  
Giri Padmanabhan
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Glycated Hemoglobin ◽  
Glycated Albumin ◽  
Fasting State ◽  
Short Term ◽  
Estimated Gfr ◽  
Group I ◽  
The Mean

BACKGROUND: It is unclear whether the glycated hemoglobin (HbA1c) assay accurately reflects glycemic control in patients with chronic kidney disease (CKD).AIM: To evaluate the usefulness of glycated albumin (GA) in diabetic CKD population with reference to glycemic control in comparison to HbA1c.MATERIALS AND METHODS: Totally 194 Diabetic CKD (Male: 126, Female: 68) patients who attended a private nephrology clinic, were taken for the study. The age ranged between 18 to 87 years. Blood samples were collected in fasting state in all the patients and all biochemical estimations were done using fully automated analyzer. RESULTS: The mean estimated GFR levels were 82.47, 44.32, 24.13 and 10 ml/min/1.73 m2 in Group I, II, III & IV respectively. The GA levels were significantly increased when the eGFR levels have been decreased. Also the GA: HbA1c ratio differed significantly when compared between the groups I & II, I & III and group I & IV of CKD patients.CONCLUSION: GA estimation is a useful marker in assessment of short term glycemic control in stage III & IV (< 30 ml/min/1.73m2) diabetic CKD patients. GA: HbA1c ratio if routinely done may also become a useful marker in Diabetic CKD population in future.

scholarly journals Glycated Albumin, a Novel Biomarker for Short-Term Functional Outcomes in Acute Ischemic Stroke

2021 ◽  
Vol 11 (3) ◽  
pp. 337
Author(s):  
Yerim Kim ◽  
Sang-Hwa Lee ◽  
Min Kyoung Kang ◽  
Tae Jung Kim ◽  
Han-Yeong Jeong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Glycated Hemoglobin ◽  
Prognostic Biomarker ◽  
Glycated Albumin ◽  
Short Term ◽  
Multiple Covariates ◽  
New Biomarkers ◽  
The Impact

Background: There is growing interest in the use of new biomarkers such as glycated albumin (GA), but data are limited in acute ischemic stroke. We explored the impact of GA on short-term functional outcomes as measured using the modified Rankin Scale (mRS) at 3 months compared to glycated hemoglobin (HbA1c). Methods: A total of 1163 AIS patients from two hospitals between 2016 and 2019 were included. Patients were divided into two groups according to GA levels (GA < 16% versus GA ≥ 16%). Results: A total of 518 patients (44.5%) were included in the GA ≥ 16% group. After adjusting for multiple covariates, the higher GA group (GA ≥ 16%) had a 1.4-fold risk of having unfavorable mRS (95% CI 1.02–1.847). However, HbA1c was not significantly associated with 3-month mRS. In addition, GA ≥ 16% was independently associated with unfavorable short-term outcomes only in patients without diabetes. Conclusions: In light of these results, GA level might be a novel prognostic biomarker compared to HbA1c for short-term stroke outcome. Although the impact of GA is undervalued in the current stroke guidelines, GA monitoring should be considered in addition to HbA1c monitoring.

Mechanisms underlying heart failure in type 2 diabetes mellitus

2019 ◽  
pp. 37-39
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Experimental Studies ◽  
Vascular Complications ◽  
Molecular Alterations ◽  
Increased Risk ◽  
Cardioprotective Effects ◽  
Underlying Mechanisms ◽  
Cardio Vascular

The prevalence of heart failure is markedly increased in individuals with diabetes mellitus. Numerous observational studies suggest that this increased risk for heart failure can be attributed to exacerbated vascular complications and the presence of increased risk factors in diabetic subjects. In addition, experimental studies revealed the presence of a number of distinct molecular alterations in the myocardium that occur independently of vascular disease and hypertension. Many of these molecular alterations are similarly observed in failing hearts of nondiabetic patients and have thus been proposed to contribute to the increased risk for heart failure in diabetes. The interest in understanding the underlying mechanisms of impaired cardio- vascular outcomes in diabetic individuals has much increased since the demonstration of cardioprotective effects of SGLT-2 inhibitors and GLP-1 receptor agonists in recent clinical trials. The current review therefore summarizes the distinct mechanisms that have been proposed to increase the risk for heart failure in diabetes mellitus.

scholarly journals The effects of assisted reproduction technologies on metabolic health and disease

2020 ◽  
Author(s):  
Maria Florencia Heber ◽  
Grażyna Ewa Ptak
Keyword(s):  
Metabolic Syndrome ◽  
Health Outcomes ◽  
Metabolic Diseases ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Postnatal Life ◽  
Metabolic Alterations ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
The Individual

Abstract Background The increasing prevalence of metabolic diseases places a substantial burden on human health throughout the world. It is believed that predisposition to metabolic disease starts early in life, a period of great susceptibility to epigenetic reprogramming due to environmental insults. Assisted reproductive technologies (ART), i.e., treatments for infertility, may affect embryo development, resulting in multiple adverse health outcomes in postnatal life. The most frequently observed alteration in ART pregnancies is impaired placental nutrient transfer. Moreover, consequent intrauterine growth restriction and low birth weight followed by catch-up growth can all predict future obesity, insulin resistance, and chronic metabolic diseases. Scope of the review In this review, we have focused on evidence of adverse metabolic alterations associated with ART, which can contribute to the development of chronic adult-onset diseases, such as metabolic syndrome, type 2 diabetes, and cardiovascular disease. Due to high phenotypic plasticity, ART pregnancies can produce both offspring with adverse health outcomes, as well as healthy individuals. We further discuss the sex-specific and age-dependent metabolic alterations reflected in ART offspring, and how the degree of interference of a given ART procedure (from mild to more severe manipulation of the egg) affects the occurrence and degree of offspring alterations. Major conclusions Over the last few years, studies have reported signs of cardiometabolic alterations in ART offspring that are detectable at a young age but that do not appear to constitute a high risk of disease and morbidity per se. These abnormal phenotypes could be early indicators of the development of chronic diseases, including metabolic syndrome, in adulthood. The early detection of metabolic alterations could contribute to preventing the onset of disease in adulthood. Such early interventions may counteract the risk factors and improve the long-term health of the individual.

Abstract TP208: 1,5-anhydro-d-glucitol as a Predictor of Cerebral Infarction in Patients With Glycated Hemoglobin A1c-based Good Diabetes Control

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Yuji Shiga ◽  
Yuhei Kanaya ◽  
Shinichi Takeshima ◽  
Yasunori Fujikawa ◽  
Kazuhiro Takamatsu ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cerebral Infarction ◽  
Hba1c Level ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Glycemic Variability ◽  
Diabetes Control ◽  
Short Term ◽  
High Group ◽  
Glycated Hemoglobin A1c

Introduction: Current guidelines set the goal of diabetes control to a glycated hemoglobin A1c (HbA1c) level of <7% in order to prevent macrovascular events. However, we often experience diabetes patients with cerebral infarction (CI), even though their HbA1c level is well-controlled. A reason for this disparity between the diabetes control status and CI onset may be the limitation of HbA1c as a diabetes control indicator. HbA1c reflects the mean blood glucose level over the past 2-3 months. Therefore, with HbA1c, we cannot evaluate short-term blood glucose control and glycemic variability, which are reported as risk factors for CI. Measurement of 1,5-anhydro-D-glucitol (1,5AG) allows the evaluation of these factors. Hypothesis: 1,5AG can be used to evaluate the risk of CI in patients with well-controlled diabetes. Methods: We retrospectively reviewed the medical records of 1169 patients with diabetes who received treatment for CI at our hospital between 2009 and 2014. These patients were divided into the following two groups according to their HbA1c-based diabetes control status: a CI-low group (HbA1c <7%, n=549) and a CI-high group (HbA1c ≧7%, n=620). We also included a non-CI group of 394 diabetes patients without CI (control group), and these patients were further divided into the following two groups in the same manner: a nonCI-low group (n=199) and a nonCI-high group (n=195). The 1,5AG levels were compared between the CI-low and nonCI-low groups, and the CI-high and nonCI-high groups. Results: There was no difference in the 1,5AG level between the CI-high and nonCI-high groups (8.8±7.3% vs. 8.9±7.1%, p=0.83). However, the 1,5AG level was significantly lower in the CI-low group than in the nonCI-low group (12.5±8.1% vs. 15.2±8.8%, p<0.001). This difference remained significant after adjusting for age and sex. Conclusion: The results of this study show that short-term glycemic control and glycemic variability have a significant relationship with existing CI especially in patients with good diabetes control. The 1,5AG level may be a surrogate measure of the risk of CI in patients with HbA1c levels that indicate good diabetes control.

scholarly journals Trends in cardiovascular risk factors and treatment goals in patients with diabetes in Singapore-analysis of the SingHealth Diabetes Registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259157
Author(s):  
Liang Feng ◽  
Amanda Lam ◽  
David Carmody ◽  
Ching Wee Lim ◽  
Gilbert Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Glycated Hemoglobin ◽  
Temporal Trends ◽  
Vascular Complications ◽  
Housing Type ◽  
Risk Factor Control ◽  
Mixed Effect ◽  
Diabetes Registry ◽  
Adjusted Risk

Background Asian populations are at high risk of diabetes and related vascular complications. We examined risk factor control, preventive care, and disparities in these trends among adults with diabetes in Singapore. Methods The sample included 209,930 adults with diabetes aged≥18 years from a multi-institutional SingHealth Diabetes Registry between 2013 and 2019 in Singapore. We performed logistic generalized estimating equations (GEEs) regression analysis and used linear mixed effect modeling to evaluate the temporal trends. Results Between 2013 and 2019, the unadjusted control rates of glycated hemoglobin (4.8%, 95%CI (4.4 to 5.1) and low-density lipoprotein cholesterol (LDL-C) (11.5%, 95%CI (11.1 to 11.8)) improved, but blood pressure (BP) control worsened (systolic BP (SBP)/diastolic BP (DBP) <140/90 mmHg: -6.6%, 95%CI (-7.0 to -6.2)). These trends persisted after accounting for the demographics including age, gender, ethnicity, and housing type. The 10-year adjusted risk for coronary heart disease (CHD) (3.4%, 95% (3.3 to 3.5)) and stroke (10.4%, 95% CI (10.3 to 10.5)) increased. In 2019, the control rates of glycated hemoglobin, BP (SBP/DBP<140/90 mmHg), LDL-C, each, and all three risk factors together, accounted for 51.5%, 67.7%, 72.2%, and 24.4%, respectively. Conclusions Trends in risk factor control improved for glycated hemoglobin and LDL-C, but worsened for BP among diabetic adults in Singapore from 2013 to 2019. Control rates for all risk factors remain inadequate.

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