Ann Pediatr Endocrinol Metab.  2013 Dec;18(4):208-213. 10.6065/apem.2013.18.4.208.

Serum glycated albumin as a new glycemic marker in pediatric diabetes

• Lee JW
• Kim HJ
• Kwon YS
• Jun YH
• Kim SK
• Choi JW
• Lee JE

• KMID: 2266357
• DOI: http://doi.org/10.6065/apem.2013.18.4.208

Abstract

PURPOSE
Serum glycated albumin (GA) has been recently used as another glycemic marker that reflects shorter term glycemic control than glycated hemoglobin (HbA1c). Insulin secretory function and glycemic fluctuation might be correlated with the ratio of GA to HbA1c (GA/HbA1c) in diabetic adult patients. This study investigated the association of GA and GA/HbA1c ratio with the levels of fasting C-peptide, fasting plasma glucose in type 1 and type 2 pediatric diabetes.
METHODS
Total 50 cases from 42 patients were included. The subjects were classified into type 1 diabetes mellitus (T1DM) (n=30) and type 2 diabetes mellitus (T2DM) (n=20) group. The associations among HbA1c, GA, and GA/HbA1c ratio were examined. The relationship between the three glycemic indices and fasting glucose, fasting C-peptide were analyzed.
RESULTS
Mean values of GA, the GA/HbA1c ratio were significantly higher in T1DM than T2DM. GA (r=0.532, P=0.001), HbA1c (r=0.519, P=0.002) and the GA/HbA1c ratio (r=0.409, P=0.016) were correlated with the fasting plasma glucose. Fasting C-peptide level arranged 4.22+/-3.22 ng/mL in T2DM, which was significantly above the values in T1DM (0.26+/-0.49 ng/mL). There were no significant correlation between HbA1c and fasting C-peptide level. However, GA and the GA/HbA1c ratio exhibited inverse correlations with fasting C-peptide level (r=-0.214, P=0.002; r=-0.516, P<0.001).
CONCLUSION
GA seems to more accurately reflects fasting plasma glucose level than HbA1c. GA, GA/HbA1c ratio appear to reflect insulin secretory function.

Keyword

Diabetes mellitus; Glycosylated serum albumin; Glycosylated hemoglobin A; Child

MeSH Terms

Adult
Blood Glucose
C-Peptide
Child
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Fasting
Glucose
Glycemic Index
Hemoglobin A, Glycosylated
Humans
Insulin
C-Peptide
Glucose
Hemoglobin A, Glycosylated
Insulin

Figure

• 

  Fig. 1 Glycated hemoglobin (HbA1c) and serum glycated albumin (GA) and the GA/HbA1c ratio in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM).

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  Fig. 2 Correlation between each glycemic markers. There were positive correlations between glycated hemoglobin (HbA1c) and glycated albumin (GA) (r=0.945, P<0.001), HbA1c and the GA/HbA1c ratio (r=0.625, P<0.001), and GA and the GA/HbA1c ratio (r=0.882, P<0.001).

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  Fig. 3 Correlation between fasting glucose and each glycemic markers. There was a positive correlation between fasting glucose and each of the glycemic markers.

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  Fig. 4 Correlation between fasting C-peptide and each glycemic markers. There was a negative correlation between fasting C-peptide and glycated albumin (GA) levels (r=-0.334, P=0.029), and C-peptide and GA/HbA1c ratio (r=-0.516, P<0.001) (Fig. 3). But glycated hemoglobin (HbA1c) was not correlated to fasting C-peptide (r=-0.214, P=0.169).

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