Diabetes Metab J.  2014 Dec;38(6):456-463. 10.4093/dmj.2014.38.6.456.

The Glycated Albumin to Glycated Hemoglobin Ratio Might Not Be Associated with Carotid Atherosclerosis in Patients with Type 1 Diabetes

• Kim W
• Kim KJ
• Lee BW
• Kang ES
• Cha BS
• Lee HC

• KMID: 2174083
• DOI: http://doi.org/10.4093/dmj.2014.38.6.456

Abstract

BACKGROUND
The ratio of glycated albumin to glycated hemoglobin (GA/A1c) is known to be elevated in subjects with type 2 diabetes mellitus (T2DM) who had decreased insulin secretion. Additionally, the carotid intima media thickness (IMT) is greater in T2DM patients with higher GA/A1c ratios. We investigated whether increased GA/A1c ratio and IMT are also associated in type 1 diabetes mellitus (T1DM), which is characterized by lack of insulin secretory capacity.
METHODS
In this cross-sectional study, we recruited 81 T1DM patients (33 men, 48 women; mean age 44.1+/-13.0 years) who underwent carotid IMT, GA, and HbA1c measurements.
RESULTS
The mean GA/A1c ratio was 2.90. Based on these results, we classified the subjects into two groups: group I (GA/A1c ratio <2.90, n=36) and group II (GA/A1c ratio > or =2.90, n=45). Compared with group I, the body mass indexes (BMIs), waist circumferences, and IMTs were lower in group II. GA/A1c ratio was negatively correlated with BMI, urine albumin to creatinine ratio (P<0.001 for both), and both the mean and maximal IMT (P=0.001, both). However, after adjusting the confounding factors, we observed that IMT was no longer associated with GA/A1c ratio.
CONCLUSION
In contrast to T2DM, IMT was not significantly related to GA/A1c ratio in the subjects with T1DM. This suggests that the correlations between GA/A1c ratio and the parameters known to be associated with atherosclerosis in T2DM could be manifested differently in T1DM. Further studies are needed to investigate these relationships in T1DM.

Keyword

Diabetes mellitus, type 1; Carotid intima-media thickness; Glycated albumin to glycated hemoglobin ratio; Glycosylated serum albumin

MeSH Terms

Atherosclerosis
Body Mass Index
Carotid Artery Diseases*
Carotid Intima-Media Thickness
Creatinine
Cross-Sectional Studies
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Female
Hemoglobin A, Glycosylated*
Humans
Insulin
Male
Waist Circumference
Creatinine
Insulin

Figure

• 

  Fig. 1 (A, B) Relationships of body mass index (BMI) with glycated albumin to glycated hemoglobin (GA/A1c) ratio and intima media thickness (IMT) in type 1 diabetes mellitus patients. (A) There was a positive association between BMI and IMT (r=0.331, P=0.005). (B) In contrast, BMI and GA/A1c were negatively related (r=-0.448, P<0.001).

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