Yonsei Med J.  2012 May;53(3):578-586. 10.3349/ymj.2012.53.3.578.

Estimating Average Glucose Levels from Glycated Albumin in Patients with End-Stage Renal Disease

• Kim JK
• Park JT
• Oh HJ
• Yoo DE
• Kim SJ
• Han SH
• Kang SW
• Choi KH
• Yoo TH

• KMID: 1776994
• DOI: http://doi.org/10.3349/ymj.2012.53.3.578

Abstract

PURPOSE
In patients with diabetic end stage renal disease (ESRD), glycated albumin (GA) reflects recent glycemic control more accurately than glycated hemoglobin (HbA1c). We evaluated the relationship between GA and average blood glucose (AG) level and developed an estimating equation for translating GA values into easier-to-understand AG levels.
MATERIALS AND METHODS
A total of 185 ESRD patients, including 154 diabetic and 31 non-diabetic participants, were enrolled (108 hemodialysis, 77 peritoneal dialysis). Patients were asked to perform four-point daily self-monitoring of capillary blood glucose (SMBG) at least three consecutive days each week for four weeks. Serum levels of GA, HbA1c and other biochemical parameters were checked at baseline, as well as at 4 and 8 weeks.
RESULTS
Approximately 74.3+/-7.0 SMBG readings were obtained from each participant and mean AG was 169.1+/-48.2 mg/dL. The correlation coefficient between serum GA and AG levels (r=0.70, p<0.001) was higher than that of HbA1c and AG (r=0.54, p<0.001). Linear regression analysis yielded the following equation: estimated AG (eAG) (mg/dL)=4.71xGA%+73.35, and with this formula, serum GA levels could be easily translated to eAG levels. Multivariate analysis revealed significant contributions of postprandial hyperglycemia (beta=0.25, p=0.03) and serum albumin (beta=0.17, p=0.04) in determining serum GA level, independent to other clinical parameters.
CONCLUSION
Compared to HbA1c, serum GA levels were better correlated with AG levels. Using the estimating equation, an average blood glucose level of 155-160 mg/dL could be matched to a GA value of 18-19% in patients with ESRD.

Keyword

Average blood glucose; end-stage renal disease; glycated albumin; self-monitoring blood glucose

MeSH Terms

Adolescent
Adult
Aged
Blood Glucose/*metabolism
Female
Humans
Kidney Failure, Chronic/*blood/metabolism
Male
Middle Aged
Prospective Studies
Serum Albumin/*metabolism
Young Adult

Figure

• 

  Fig. 1 Correlation between AG and serum GA or HbA1c levels. The strength of correlation between serum GA and AG levels (r=0.70, p<0.001, left) was higher than that of HbA1c and AG (r=0.54, p<0.001, right). GA, glycated albumin; AG, average blood glucose.

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