J Rheum Dis.  2018 Apr;25(2):131-139. 10.4078/jrd.2018.25.2.131.

Hemoglobin A1c, Not Glycated Albumin, Can Independently Reflect the Ankylosing Spondylitis Disease Activity Score

• Byun S
• Jung SM
• Song JJ
• Park YB
• Lee SW

• KMID: 2408931
• DOI: http://doi.org/10.4078/jrd.2018.25.2.131

Abstract

OBJECTIVE
This study examined whether glycated hemoglobin (HbA1c) and glycated albumin (GA) are well correlated with the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), and ASDAS-C-reactive protein (CRP) in AS patients without medical conditions affecting the glycated protein levels.
METHODS
The data of 76 patients with AS were analyzed. Univariate and multivariate analyses of the variables associated with ASDAS-ESR and ASDAS-CRP were performed using a linear regression test. The patients were divided into active and inactive AS groups based on an ASDAS-CRP of 2.1, and the variables between the two groups were compared.
RESULTS
ASDAS-ESR did not correlated with either HbA1c or GA. ASDAS-CRP was positively correlated with HbA1c (r=0.315, p=0.006) and the white blood cell (r=0.288, p=0.012), and inversely correlated with hemoglobin (r=−0.241, p=0.036) and serum albumin (r=−0.262, p=0.022), but not GA. Multivariate analysis revealed HbA1c and white blood cell to be significantly correlated with ASDAS-CRP (β=0.234, p=0.033 and β=0.265, p=0.017). The mean HbA1c, not GA, of the active group was significantly higher than that of the inactive group (p=0.020). In addition, the optimal cut-off value of HbA1c was set to 5.6, and the patients with HbA1c ≥5.6 were found to have a 3.3 times higher risk of active AS than those without.
CONCLUSION
HbA1c was significantly correlated with ASDAS-CRP, and could be a useful marker to reflect ASDAS-CRP in AS patients without medical conditions affecting the glycated protein levels.

Keyword

Ankylosing spondylitis; Glycated hemoglobin A; Glycosylated serum albumin

MeSH Terms

Hemoglobin A, Glycosylated
Humans
Leukocytes
Linear Models
Multivariate Analysis
Serum Albumin
Spondylitis, Ankylosing*
Serum Albumin

Figure

• 

  Figure 1. Optimal cutoff values of HbA1c to reflect active ankylosing spondylitis. Active ankylosing spondylitis in patients having HbA1c ≥5.6 was identified more often than in those having HbA1c ＜5.6 (62.9% vs. 34.1%, p=0.012). Patients having HbA1c more than 5.6 showed significantly enhanced risk of active AS than those having not (RR=3.264). ASDAS: ankylosing spondylitis disease activity score, CRP: C-reactive protein, RR: relative risk, HbA1c: hemoglobin A1c, AS: ankylosing spondylitis.

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