Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
Autoři:
Fernando Chimela Chume aff001; Mayana Hernandez Kieling aff001; Priscila Aparecida Correa Freitas aff001; Gabriela Cavagnolli aff004; Joíza Lins Camargo aff001
Působiště autorů:
Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul Porto Alegre, Porto Alegre–RS, Brazil
aff001; Universidade Zambeze, Beira, Mozambique
aff002; Laboratory Diagnosis Division, Clinical Biochemistry Unit, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre–RS, Brazil
aff003; Centro Universitário FSG, Caxias do Sul—RS, Brazil
aff004; Endocrinology Division and Experimental Research Centre, Hospital de Clinicas de Porto Alegre, Porto Alegre–RS, Brazil
aff005
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0227065
Souhrn
Introduction
Studies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in diagnosis of type 2 diabetes mellitus (DM). Thus, the aim of this study was to assess the clinical utility of GA in diagnosis of DM.
Materials and methods
This diagnostic test accuracy study was performed in 242 Brazilian individuals referred for OGTT in a tertiary university hospital. ROC curves were used to access the performance of GA and HbA1c in the diagnosis of DM by oral glucose tolerance test (OGTT).
Results
OGTT, HbA1c and GA were performed in all 242 participants (40.5% male, age 54.4 ± 13.0 years [mean ± SD], body mass index 28.9 ± 6.3 kg/m2). DM by OGTT was detected in 31.8% of individuals. The equilibrium threshold value of GA ≥14.8% showed sensitivity of 64.9% and specificity of 65.5% for the diagnosis of DM. The AUC for GA [0.703 (95% CI 0.631–0.775)] was lower than for HbA1c [0.802 (95% CI 0.740–0.864)], p = 0.028. A GA value of 16.8% had similar accuracy for detecting DM as defined by HbA1c ≥6.5% (48 mmol/mol) with sensitivity of 31.2% and specificity of 93.3% for both tests. However, GA detects different subjects from those detected by HbA1c and OGTT.
Conclusions
GA detected different individuals with DM from those detected by HbA1c, though it showed overall diagnostic accuracy similar to HbA1c in the diagnosis of DM. Therefore, GA should be used as an additional test rather than an alternative to HbA1c or OGTT and its use as the sole DM diagnostic test should be interpreted with caution.
Klíčová slova:
Albumins – Blood plasma – Diabetes diagnosis and management – Glucose tolerance tests – Cholesterol – Oral glucose suppression test
Zdroje
1. International Diabetes Federation. IDF Diabetes Atlas. Eighth edition. Brussels, Belgium: International Diabetes Federation. http://www.diabetesatlas.org. 2017. Accessed 17 Jan 2019
2. Herman WH, Ye W, Griffin SJ, Simmons RK, Davies MJ, Khunti K, et al. Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: a simulation of the results of the Anglo-DanishDutch study of intensive treatment in people with screen-detected diabetes in primary care (ADDITION-Europe). Diabetes Care. 2015; 38(8):1449–55. doi: 10.2337/dc14-2459 25986661
3. American Diabetes Association (ADA) Diagnosis and classification of diabetes mellitus. Diabetes Care 41(Supplement 1): S13–S27. http://care.diabetesjournals.org/content/41/Supplement_1/S13. (2018).
4. National Glycohemoglobin Standardization Program (NGSP) Factors that Interfere with HbA1c Test Results [Updated 10/5/2018]. Available from http://www.ngsp.org/factors.asp. Accessed 12 Dez 2018.
5. Cavagnolli G, Pimentel AL, Freitas PA, Gross JL, Camargo JL. Factors affecting A1c in non-diabetic individuals: review and meta-analysis. Clin Chim Acta. 2015; 445:107–14. doi: 10.1016/j.cca.2015.03.024 25818244
6. Rohlfing C, Hanson S, Weykamp C, Siebelder C, Higgins T, Molinaro R, et al. Effects of Hemoglobin C, D, E and S traits on Measurements of Hemoglobin A1c by Twelve Methods. Clin Chim Acta. 2016; 455:80–3. doi: 10.1016/j.cca.2016.01.031 26828530
7. Freitas PAC, Ehlert LR, Camargo JL. Glycated albumin: a potential biomarker in diabetes. Arch Endocrinol Metab 2017; 61(3):296–304. doi: 10.1590/2359-3997000000272 28699985
8. Furusyo N, Hayashi J. Glycated albumin and diabetes mellitus. Biochim Biophys Acta. 2013; 1830(12):5509–14. doi: 10.1016/j.bbagen.2013.05.010 23673238
9. Selvin E, Rawlings AM, Grams M, Klein R, Sharrett AR, Steffes M, et al. Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2014; 2(4):279–88. doi: 10.1016/S2213-8587(13)70199-2 24703046
10. Selvin E, Rawlings AM, Lutsey P, Maruthur N, Pankow JS, Steffes M, et al. Fructosamine and Glycated Albumin and the Risk of Cardiovascular Outcomes and Death. Circulation. 2015; 132(4):269–77. doi: 10.1161/CIRCULATIONAHA.115.015415 26022911
11. Nathan DM, McGee P, Steffes MW, Lachin JM DCCT/EDIC Research Group. Relationship of glycated albumin to blood glucose and HbA1c values and to retinopathy, nephropathy, and cardiovascular outcomes in the DCCT/EDIC study. Diabetes. 2014; 63(1):282–90. doi: 10.2337/db13-0782 23990364
12. Wu WC, Ma WY, Wei JN, Yu TY, Lin MS, Shih SR, et al. Serum Glycated Albumin to Guide the Diagnosis of Diabetes Mellitus. PLoS One. 2016; 11(1):e0146780. doi: 10.1371/journal.pone.0146780 26765575
13. Furusyo N, Koga T, Ai M, Otokozawa S, Kohzuma T, Ikezaki H, Schaefer EJ, et al. Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study: results from the Kyushu and Okinawa Population Study (KOPS). Diabetologia. 2011; 54(12):3028–36. doi: 10.1007/s00125-011-2310-6 21947435
14. Hsu P, Ai M, Kanda E, Yu NC, Chen HL, Chen HW, et al. A comparison of glycated albumin and glycosylated hemoglobin for the screening of diabetes mellitus in Taiwan. Atherosclerosis. 2015; 242(1):327–33. doi: 10.1016/j.atherosclerosis.2015.07.037 26247684
15. Ma XJ, Pan JM, Bao YQ, Zhou J, Tang JL, Li Q, et al. Combined assessment of glycated albumin and fasting plasma glucose improves the detection of diabetes in Chinese subjects. Clin Exp Pharmacol Physiol. 2010; 37(10):974–9. doi: 10.1111/j.1440-1681.2010.05417.x 20557319
16. Chan CL, Pyle L, Kelsey M, Newnes L, Zeitler PS, Nadeau KJ. Screening for type 2 diabetes and prediabetes in obese youth: evaluating alternate markers of glycemia—1,5-anhydroglucitol, fructosamine, and glycated albumin. Pediatr Diabetes. 2016; 17(3):206–11. doi: 10.1111/pedi.12258 25652226
17. Bellia C, Zaninotto M, Cosma C, Agnello L, Bivona G, Marinova M, et al. Clinical usefulness of Glycated Albumin in the diagnosis of diabetes: Results from an Italian study. Clin Biochem. 2018; 54:68–72. doi: 10.1016/j.clinbiochem.2018.02.017 29486186
18. Zemlin AE, Barkhuizen M, Kengne AP, Erasmus RT, Matsha TE. Performance of glycated albumin for type 2 diabetes and prediabetes diagnosis in a South African population. Clin Chim Acta. 2019; 488:122–128. doi: 10.1016/j.cca.2018.11.005 30395867
19. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD Group. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. Clin Chem. 2015; 61(12):1446–52. doi: 10.1373/clinchem.2015.246280 26510957
20. Nathan DM, Steffes MW, Sun W, Rynders GP, Lachin JM. Determining stability of stored samples retrospectively: the validation of glycated albumin. Clin Chem. 2011; 57(2):286–90. doi: 10.1373/clinchem.2010.150250 21030684
21. Little RR, Rohlfing C, Sacks DB. The National Glycohemoglobin Standardization Program: Over 20 Years of Improving Hemoglobin A1c Measurement. Clin Chem. 2018; 296962. doi: 10.1373/clinchem.2018.296962 30518660
22. Freitas PAC, Ehlert LR, Camargo JL. Comparison between two enzymatic methods for glycated albumin. Anal Methods 2016; 8:8173–8.
23. Rodriguez-Capote K, Tovell K, Holmes D, Dayton J, Higgins TN. Analytical evaluation of the Diazyme glycated serum protein assay on the siemens ADVIA 1800: comparison of results against HbA1c for diagnosis and management of diabetes. J Diabetes Sci Technol 2015; 9(2):192–9. doi: 10.1177/1932296814567894 25591854
24. Akobeng AK. Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta Paediatr. 2007; 96(4):487–91. doi: 10.1111/j.1651-2227.2006.00179.x 17306009
25. Kallner A. Bayes' theorem, the ROC diagram and reference values: Definition and use in clinical diagnosis. Biochemia medica, 2017; 28(1):010101. doi: 10.11613/BM.2018.010101 29209139
26. Selvin E1, Steffes MW, Ballantyne CM, Hoogeveen RC, Coresh J, Brancati FL. Racial differences in glycemic markers: a cross-sectional analysis of community-based data. Ann Intern Med. 2011; 154(5):303–9. doi: 10.7326/0003-4819-154-5-201103010-00004 21357907
27. Cavagnolli G, Comerlato J, Comerlato C, Renz PB, Gross JL, Camargo JL., et al. HbA1c measurement for the diagnosis of diabetes: is it enough?. Diabetic Medicine 2011; 28: 31–35. doi: 10.1111/j.1464-5491.2010.03159.x 21210540
28. Koga M. Glycated albumin; clinical usefulness. Clin Chim Acta. 2014; 433:96–104. doi: 10.1016/j.cca.2014.03.001 24631132
29. Wang F, Ma X, Hao Y, Yang R, Ni J, Xiao Y, et al. Serum Glycated Albumin Is Inversely Influenced by Fat Mass and Visceral Adipose Tissue in Chinese with Normal Glucose Tolerance. PLoS One. 2012; 7(11):e51098. doi: 10.1371/journal.pone.0051098 23209844
30. Sumner AE, Duong MT, Bingham BA. Glycated Albumin Identifies Prediabetes Not Detected by Hemoglobin A1c: The Africans in America Study. Clin Chem. 2016; 62 (11) 1524–1532. doi: 10.1373/clinchem.2016.261255 27624138
31. Cohen MP. Clinical, pathophysiological and structure/function consequences of modification of albumin by Amadori-glucose adducts. Biochim Biophys Acta. 2013; 1830(12):5480–5. doi: 10.1016/j.bbagen.2013.04.024 23624335
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