Results of a Study Comparing Glycated Albumin to Other Glycemic Indices

Cyrus V. Desouza, Richard G. Holcomb, Julio Rosenstock, Juan P. Frias, Stanley H. Hsia, Eric J. Klein, Rong Zhou, Takuji Kohzuma, Vivian A. Fonseca

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Abstract

Context: Intermediate-term glycemic control metrics fulfill a need for measures beyond hemoglobin A1C. Objective: Compare glycated albumin (GA), a 14-day blood glucose measure, with other glycemic indices. Design: 24-week prospective study of assay performance. Setting: 8 US clinics. Participants: Subjects with type 1 (n = 73) and type 2 diabetes (n = 77) undergoing changes to improve glycemic control (n = 98) or with stable diabetes therapy (n = 52). Interventions: GA, fructosamine, and A1C measured at prespecified intervals. Mean blood glucose (MBG) calculated using weekly self-monitored blood glucose profiles. Main Outcome Measures: Primary: Pearson correlation between GA and fructosamine. Secondary: magnitude (Spearman correlation) and direction (Kendall correlation) of change of glycemic indices in the first 3 months after a change in diabetes management. Results: GA was more concordant (60.8%) with changes in MBG than fructosamine (55.5%) or A1C (45.5%). Across all subjects and visits, the GA Pearson correlation with fructosamine was 0.920. Pearson correlations with A1C were 0.655 for GA and 0.515 for fructosamine (P <. 001) and with MBG were 0.590 and 0.454, respectively (P <. 001). At the individual subject level, Pearson correlations with both A1C and MBG were higher for GA than for fructosamine in 56% of subjects; only 4% of subjects had higher fructosamine correlations with A1C and MBG. GA had a higher Pearson correlation with A1C and MBG in 82% and 70% of subjects, respectively. Conclusions: Compared with fructosamine, GA correlates significantly better with both short-term MBG and long-term A1C and may be more useful than fructosamine in clinical situations requiring monitoring of intermediate-term glycemic control (NCT02489773).

Original languageEnglish (US)
Article numberdgz087
JournalJournal of Clinical Endocrinology and Metabolism
Volume105
Issue number3
DOIs
StatePublished - Jan 8 2020

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Desouza, C. V., Holcomb, R. G., Rosenstock, J., Frias, J. P., Hsia, S. H., Klein, E. J., Zhou, R., Kohzuma, T., & Fonseca, V. A. (2020). Results of a Study Comparing Glycated Albumin to Other Glycemic Indices. Journal of Clinical Endocrinology and Metabolism, 105(3), [dgz087]. https://doi.org/10.1210/clinem/dgz087