Glycated albumin as a marker of glycemia in diabetes and its vascular complications

COMMENTARY ON THE LAW

Glycated albumin as a marker of glycemia in diabetes and its vascular complications

Maria Warwas 1 , Ewa Żurawska-Płaksej 1 , Dagmara Ciężka 1 , Agnieszka Piwowar 1

1. Katedra i Zakład Biochemii Farmaceutycznej, Wydział Farmaceutyczny z Oddziałem Analityki Medycznej, Uniwersytet Medyczny im. Piastów Śląskich we Wrocławiu

Published: 2015-05-17
GICID: 01.3001.0009.6538
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2015; 69 : 638-648

 

Abstract

Effective glycemic control is very important to prevent the onset and the progression of chronic complications in diabetic patients. It is known that glycation of various proteins is increased in diabetic patients compared with non-diabetics. Among these glycated proteins, glycated hemoglobin (HbA1c) is commonly used as a gold standard index of glycemic control in the clinical setting. However, it can be unreliable in conditions affecting the lifespan of erythrocytes (120 days) as well as in the clinical state in which glycemic control alleviates or deteriorates in a short period. By overcoming the shortcomings of HbA1c, glycated albumin (GA) has gained interest as a useful index for an intermediate glycation period (2 weeks) and pathogenic protein.After giving a brief overview of the key role of HbA1c as a long-term glycemic marker, this review focuses on (a) glycation of human albumin and its main properties, (b) methods of GA determination, (c) the recent clinical status of GA as a glycemic index in diabetic patients and its association with vascular complications. Finally, conditions with a possible inaccurate GA level are also mentioned.

References

  • 1. Abidin D., Liu L., Dou C., Datta A., Yuan C.: An improved enzymaticassay for glycated serum protein. Anal. Methods, 2013; 5: 2461-2469
    Google Scholar
  • 2. Anguizola J., Matsuda R., Barnaby O.S., Hoy K.S., Wa C., DeBoltE., Koke M., Hage D.S.: Review: Glycation of human serum albumin.Clin. Chim. Acta, 2013; 425: 64-76
    Google Scholar
  • 3. Ansari N.A., Dash D.: Amadori glycated proteins: role in productionof autoantibodies in diabetes mellitus and effect of inhibitorson non-enzymatic glycation. Aging Dis., 2013; 4: 50-56
    Google Scholar
  • 4. Arasteh A., Farahi S., Habibi-Rezaei M., Moosavi-Movahedi A.A.:Glycated albumin: an overview of the in vitro models of an in vivopotential disease marker. J. Diabetes Metab. Disord., 2014; 13: 49
    Google Scholar
  • 5. Baraka-Vidot J., Guerin-Dubourg A., Dubois F., Payet B., BourdonE., Rondeau P.: New insights into deleterious impacts of in vivo glycationon albumin antioxidant activities. Biochim. Biophys. Acta,2013; 1830: 3532-3541
    Google Scholar
  • 6. Cohen M.P.: Clinical, pathophysiological and structure/functionconsequences of modification of albumin by Amadori-glucose adducts.Biochim. Biophys. Acta, 2013; 1830: 5480-5485
    Google Scholar
  • 7. Czekalski S.: Nefropatia cukrzycowa czy cukrzycowa chorobanerek? Forum Nefrol., 2008; 1: 53-56
    Google Scholar
  • 8. Ding F.H., Lu L., Zhang R.Y., Zhu T.Q., Pu L.J., Zhang Q., Chen Q.J.,Hu J., Yang Z.K., Shen W.F.: Impact of elevated serum glycated albuminlevels on contrast-induced acute kidney injury in diabeticpatients with moderate to severe renal insufficiency undergoingcoronary angiography. Int. J. Cardiol., 2013; 167: 369-373
    Google Scholar
  • 9. Dingari N.C., Horowitz G.L., Kang J.W., Dasari R.R., Barman I.:Raman spectroscopy provides a powerful diagnostic tool for accuratedetermination of albumin glycation. PLoS One, 2012; 7: e32406
    Google Scholar
  • 10. Enomoto H., Aizawa N., Nakamura H., Sakai Y., Iwata Y., TanakaH., Ikeda N., Aoki T., Yuri Y., Yoh K., Hashimoto K., Ishii A., TakashimaT., Iwata K., Saito M. i wsp.: An increased ratio of glycated albuminto HbA1c is associated with the degree of liver fibrosis in hepatitis Bvirus-positive patients. Gastroenterol. Res. Pract., 2014, 2014: 351396
    Google Scholar
  • 11. Freedman B.I.: A critical evaluation of glycated protein parametersin advanced nephropathy: a matter of life or death. Time todispense with the hemoglobin A1C in end-stage kidney diseases.Diabetes Care, 2012; 35: 1621-1624
    Google Scholar
  • 12. Furusyo N., Hayashi J.: Glycated albumin and diabetes mellitus.Biochim. Biophys. Acta, 2013; 1830: 5509-5514
    Google Scholar
  • 13. Furusyo N., Koga T., Ai M., Otokozawa S., Kohzuma T., Ikezaki H.,Shaefer E.J., Hayashi J.: Plasma glycated albumin level and atherosclerosis:results from the Kyushu and Okinawa Population Study(KOPS). Int. J. Cardiol., 2013; 167: 2066-2072
    Google Scholar
  • 14. Guariguata L., Whiting D.R., Hambleton I., Beagley J., LinnenkampU., Shaw J.E.: Global estimates of diabetes prevalence for 2013and projections for 2035. Diabetes Res. Clin. Pract., 2014; 103: 137-149
    Google Scholar
  • 15. Hashimoto K., Osugi T., Noguchi S., Morimoto Y., Wasada K., ImaiS., Waguri M., Toyoda R., Fujita T., Kasayama S., Koga M.: A1C butnot serum glycated albumin is elevated because of iron deficiency inlate pregnancy in diabetic women. Diabetes Care, 2010; 33: 509-511
    Google Scholar
  • 16. He B.B., Wei L., Gu Y.J., Han J.F., Li M., Liu Y.X., Bao Y.Q., Jia W.P.: Factors associated with diabetic retinopathy in Chinese patientswith type 2 diabetes mellitus. Int. J. Endocrinol., 2012; 2012: 157940
    Google Scholar
  • 17. Hiramatsu Y., Shimizu I., Omori Y., Nakabayashi M., JGA (JapanGlycated Albumin) Study Group: Determination of reference intervalsof glycated albumin and hemoglobin A1c in healthy pregnantJapanese women and analysis of their time courses and influencingfactors during pregnancy. Endocr. J., 2012; 59: 145-151
    Google Scholar
  • 18. Isshiki K., Nishio T., Isono M., Makiishi T., Shikano T., Tomita K.,Nishio T., Kanasaki M., Maegawa H., Uzu T.: Glycated albumin predictsthe risk of mortality in type 2 diabetic patients on hemodialysis:evaluation of a target level for improving survival. Ther. Apher.Dial., 2014; 18: 434-442
    Google Scholar
  • 19. Kalantar-Zadeh K.: A critical evaluation of glycated protein parametersin advanced nephropathy: a matter of life or death. A1Cremains the gold standard outcome predictor in diabetic dialysispatients. Diabetes Care, 2012; 35: 1625-1628
    Google Scholar
  • 20. Kim D., Kim K.J., Huh J.H., Lee B.W., Kang E.S., Cha B.S., Lee H.C.:The ratio of glycated albumin to glycated haemoglobin correlateswith insulin secretory function. Clin. Endocrinol., 2012; 77: 679-683
    Google Scholar
  • 21. Kim K.J., Lee B.W.: The roles of glycated albumin as intermediateglycation index and pathogenic protein. Diabetes Metab. J.,2012; 36: 98-107
    Google Scholar
  • 22. Knapik-Kordecka M., Piwowar A., Żurawska-Płaksej E., WarwasM.: Albumina modyfikowana niedokrwieniem – specyficzny markerw diagnostyce kardiologicznej? Wiad. Lek., 2008; 61: 263-268
    Google Scholar
  • 23. Koga M.: Glycated albumin; clinical usefulness. Clin. Chim. Acta,2014; 433: 96-104
    Google Scholar
  • 24. Koga M., Kasayama S.: Clinical impact of glycated albumin asanother glycemic control marker. Endocr. J., 2010; 57: 751-762
    Google Scholar
  • 25. Koga M., Murai J., Saito H., Kasayama S., Imagawa A., HanafusaT., Kobayashi T., Japan Diabetes Society’s Committee on Research onType 1 Diabetes: Serum glycated albumin to haemoglobin A1C ratiocan distinguish fulminant type 1 diabetes mellitus from type 2 diabetesmellitus. Ann. Clin. Biochem., 2010, 47, 313-317
    Google Scholar
  • 26. Koga M., Shimizu I., Murai J., Saito H., Kasayama S., Kobayashi T.,Imagawa A., Hanafusa T., Members of the Japan Diabetes Society,s Committeeof Research on Type 1 Diabetes Mellitus: The glycated albuminto HbA1c ratio is elevated in patients with fulminant type 1 diabetesmellitus with onset during pregnancy. J. Med. Invest., 2013; 60; 41-45
    Google Scholar
  • 27. Kohzuma T., Yamamoto T., Uematsu Y., Shihabi Z.K., FreedmanB.I.: Basic performance of an enzymatic method for glycated albuminand reference range determination. J. Diabetes Sci. Technol.,2011; 5: 1455-1462
    Google Scholar
  • 28. Kondaveeti S.B., D K., Mishra S., Kumar R.A., Shaker I.A.: Evaluationof glycated albumin and microalbuminuria as early risk markersof nephropathy in type 2 diabetes mellitus. J. Clin. Diagn. Res.,2013; 7: 1280-1283
    Google Scholar
  • 29. Konya J., Ng J.M., Cox H., Cooke M., Lewis N., Bhandari S., AtkinS.L., Kilpatrick E.S.: Use of complementary markers in assessing glycaemiccontrol in people with diabetic kidney disease undergoingiron or erythropoietin treatment. Diabet. Med., 2013; 30: 1250-1254
    Google Scholar
  • 30. Kouzuma T., Usami T., Yamakoshi M., Takahashi M., ImamuraS.: An enzymatic method for the measurement of glycated albuminin biological samples. Clin. Chim. Acta, 2002; 324: 61-71
    Google Scholar
  • 31. Matsumoto H., Murase-Mishiba Y., Yamamoto N., Sugitatsu-NakatsukasaS., Shibasaki S., Sano H., Terasaki J., Imagawa A., HanafusaT.: Glycated albumin to glycated hemoglobin ratio is a sensitive indicatorof blood glucose variability in patients with fulminant type 1 diabetes. Intern. Med., 2012; 51: 1315-1321
    Google Scholar
  • 32. Montagnana M., Paleari R., Danese E., Salvagno G.L., Lippi G.,Guidi G.C., Mosca A.: Evaluation of biological variation of glycatedalbumin (GA) and fructosamine in healthy subjects. Clin. Chim. Acta,2013; 423: 1-4
    Google Scholar
  • 33. Mosca A., Lapolla A., Gillery P.: Glycemic control in the clinicalmanagement of diabetic patients. Clin. Chem. Lab. Med., 2013;51: 753-766
    Google Scholar
  • 34. Murai J., Soga S., Saito H., Koga M.: Usefulness of glycated albuminfor early detection of deterioration of glycemic control stateafter discharge from educational admission. Endocr. J., 2013; 60:409-413
    Google Scholar
  • 35. Murea M., Moran T., Russell G.B., Shihabi Z.K., Byers J.R., AndriesL., Bleyer A.J., Freedman B.I.: Glycated albumin, not hemoglobin A1c,predicts cardiovascular hospitalization and length of stay in diabeticpatients on dialysis. Am. J. Nephrol., 2012; 36: 488-496
    Google Scholar
  • 36. Nathan D.M., McGee P., Steffes M.W., Lachin J.M., and the DCCT/EDIC Research Group: Relationship of glycated albumin to blood glucoseand HbA1c values and to retinopathy, nephropathy, and cardiovascularoutcomes in the DCCT/EDIC study. Diabetes, 2014; 63: 282-290
    Google Scholar
  • 37. Nathan D.M., Steffes M.W., Sun W., Rynders G.P., Lachin J.M.: Determiningstability of stored samples retrospectively: the validationof glycated albumin. Clin. Chem., 2011; 57: 286-290
    Google Scholar
  • 38. Nayak A.U., Nevill A.M., Bassett P., Singh B.M.: Association ofglycation gap with mortality and vascular complications in diabetes.Diabetes Care, 2013; 36: 3247-3253
    Google Scholar
  • 39. Ogawa A., Hayashi A., Kishihara E., Yoshino S., Takeuchi A.,Shichiri M.: New indices for predicting glycaemic variability. PLoSOne, 2012; 7: e46517
    Google Scholar
  • 40. Otagiri M., Chuang V.T.: Pharmaceutically important pre- andposttranslational modifications on human serum albumin. Biol.Pharm. Bull., 2009; 32: 527-534
    Google Scholar
  • 41. Pan J., Zhang F., Zhang L., Bao Y., Tao M., Jia W.: Influence of insulinsensitivity and secretion on glycated albumin and hemoglobinA1c in pregnant women with gestational diabetes mellitus. Int. J.Gynaecol. Obstet., 2013; 121: 252-256
    Google Scholar
  • 42. Piwowar A.: Aspekty biochemiczne i kliniczne zaawansowanychproduktów utlenienia białek w chorobach nerek i zaburzeniach metabolicznych.Postępy Hig. Med. Dośw., 2014; 68: 179-190
    Google Scholar
  • 43. Płaczkowska S., Kokot I, Siemsia J., Płosa J., Pawlik-Sobecka L,Piwowar A.: Kliniczna użyteczność oznaczeń hemoglobiny glikowanej.Family Med. Prim. Care Rev., 2014; 16: 57-62
    Google Scholar
  • 44. Pu L.J., Lu L., Xu X.W., Zhang R.Y., Zhang Q., Zhang J.S., Hu J.,Yang Z.K., Ding F.H., Chen Q.J., Lou S., Shen J., Fang D.H., Shen W.F.:Value of serum glycated albumin and high-sensitivity C-reactive proteinlevels in the prediction of presence of coronary artery diseasein patients with type 2 diabetes. Cardiovasc. Diabetol., 2006; 5: 27
    Google Scholar
  • 45. Rondeau P., Bourdon E.: The glycation of albumin: structuraland functional impacts. Biochimie, 2011; 93: 645-658
    Google Scholar
  • 46. Roohk H.V., Zaidi A.R.: A review of glycated albumin as an intermediateglycation index for controlling diabetes. J. Diabetes Sci.Technol., 2008; 2: 1114-1121
    Google Scholar
  • 47. Saisho Y., Tanaka K., Abe T., Kawai T., Itoh H.: Lower beta cellfunction relates to sustained higher glycated albumin to glycatedhemoglobin ratio in Japanese patients with type 2 diabetes. Endocr.J., 2014; 61: 149-157
    Google Scholar
  • 48. Sany D., Elshahawy Y., Anwar W.: Glycated albumin versus glycatedhemoglobin as glycemic indicator in hemodialysis patientswith diabetes mellitus: variables that influence. Saudi J. Kidney Dis.Transpl., 2013; 24: 260-273
    Google Scholar
  • 49. Sato Y., Nagao M., Asai A., Nakajima Y., Takaya M., Takeichi N.,Takemitsu S., Sudo M., Kano-Wakakuri T., Ishizaki A., Harada T.,Tanimura-Inagaki K., Okajima F., Tamura H., Sugihara H., Oikawa S.:Association of glycated albumin with the presence of carotid plaquein patients with type 2 diabetes. J. Diabetes Investig., 2013; 4: 634-639
    Google Scholar
  • 50. Schalkwijk C.G., Miyata T.: Early- and advanced non-enzymaticglycation in diabetic vascular complications: search for therapeutics.Amino Acids, 2012; 42: 1193-1204
    Google Scholar
  • 51. Selvin E., Francis L.M., Ballantyne C.M., Hoogeveen R.C., CoreshJ., Brancati F.L., Steffes M.W.: Nontraditional markers of glycemia.Associations with microvascular conditions. Diabetes Care, 2011:34; 960-967
    Google Scholar
  • 52. Selvin E., Rawlings A.M., Grams M., Klein R., Sharrett A.R., SteffesM., Coresh J.: Fructosamine and glycated albumin for risk stratificationand prediction of incident diabetes and microvascular complications:a prospective cohort analysis of the Atherosclerosis Risk in Communities(ARIC) study. Lancet Diabetes Endocrinol., 2014; 2: 279-288
    Google Scholar
  • 53. Shen Y., Lu L., Ding F.H., Sun Z., Zhang R.Y., Zhang Q., Yang Z.K.,Hu J., Chen Q.J., Shen W.F.: Association of increased serum glycatedalbumin level with low coronary collateralization in type 2 diabeticpatients with stable angina and chronic total occlusion. Cardiovasc.Diabetol., 2013; 12: 165
    Google Scholar
  • 54. Shen Y., Pu L.J., Lu L., Zhang Q., Zhang R.Y., Shen W.F.: Glycatedalbumin is superior to hemoglobin A1c for evaluating the presenceand severity of coronary artery disease in type 2 diabetic patients.Cardiology, 2012; 123: 84-90
    Google Scholar
  • 55. Song S.O., Kim K.J., Lee B.W., Kang E.S., Cha B.S., Lee H.C.: Serumglycated albumin predicts the progression of carotid arterialatherosclerosis. Atherosclerosis, 2012; 225: 450-455
    Google Scholar
  • 56. Speeckaert M., Van Biesen W., Delanghe J., Slingerland R., WiecekA., Heaf J., Drechsler C., Lacatus R., Vanholder R., Nistor I., and forthe European Renal Best Practice Guideline Development Group onDiabetes and Advanced CKD: Are there better alternatives than haemoglobinA1c to estimate glycaemic control in the chronic kidneydisease population? Nephrol. Dial. Transplant., 2014; 29: 2167-2177
    Google Scholar
  • 57. Suzuki S., Koga M.: Glycemic control indicators in patients withneonatal diabetes mellitus. World J. Diabetes, 2014; 5: 198-208
    Google Scholar
  • 58. Sztefko K.: Hemoglobina glikowana – problemy analityczne.Diagn. Lab., 2012; 48: 303-311
    Google Scholar
  • 59. True M.W.: Circulating biomarkers of glycemia in diabetes managementand implications for personalized medicine. J. Diabetes Sci.Technol., 2009; 3: 743-747
    Google Scholar
  • 60. Vos F.E., Schollum J.B., Coulter C.V., Manning P.J., Duffull S.B.,Walker R.J.: Assessment of markers of glycaemic control in diabeticpatients with chronic kidney disease using continuous glucose monitoring.Nephrology, 2012; 17: 182-188
    Google Scholar
  • 61. Wang F., Ma X., Hao Y., Yang R., Ni J., Xiao Y., Tang J., Bao Y., JiaW.: Serum glycated albumin is inversely influenced by fat mass andvisceral adipose tissue in Chinese with normal glucose tolerance.PLoS One, 2012; 7: e 51098
    Google Scholar
  • 62. Watano T., Sasaki K., Omoto K., Kawano M.: Stability of storedsamples for assays of glycated albumin. Diabetes Res. Clin. Pract.,2013; 101: e1-e2
    Google Scholar
  • 63. Weigl B.H., Drake J.K.: Developing an adaptable set of pointof-carediabetes screening technologies for low-resource settings.Point of Care, 2013; 12: 33-40
    Google Scholar
  • 64. Westgard QC. www.westgard.com/biodatabase1.htm (21.04.2015)
    Google Scholar
  • 65. Whaley-Connell A., Sowers J.R.: Implications for glucose measuresin the Diabetes Control and Complications Trial/Epidemiologyof Diabetes Intervention and Complications Study. Diabetes,2014; 63; 45-47
    Google Scholar
  • 66. Yang C., Li H., Wang Z., Zhang W., Zhou K., Meng J., Zhao Y., PanJ., Lv X., Liang H., Jiang X.: Glycated albumin is a potential diagnostictool for diabetes mellitus. Clin. Med., 2012; 12: 568-571
    Google Scholar
  • 67. Zalecenia kliniczne dotyczące postępowania u chorych na cukrzycę, 2013 Diabetol. Klin., 2013; 2 (Supl. A): A3-A52
    Google Scholar
  • 68. Zhang T., He H., Yang H.L., Huang H.J., Zhang M.F., An Z.M., LiS.Q.: Study of glycated albumin cut-off point in diabetes mellitusand impaired glucose regulation. Sichuan Da Xue Xue Bao Yi XueBan, 2014; 45: 274-277
    Google Scholar

Full text

Skip to content