Markers Other Than HbA1c Useful for Monitoring Diabetes
(HealthDay News) – Fructosamine and glycated albumin are markers of glycemic control that may complement hemoglobin A1c (HbA1c) in identifying risk of diabetes and its complications, according to research published online Jan. 15 in The Lancet Diabetes & Endocrinology.
Elizabeth Selvin, PhD, MPH, of the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues measured levels of fructosamine and glycated albumin in 11,348 adults without diabetes and 958 with diagnosed diabetes. The authors sought to assess their value in predicting risk of incident diabetes and its complications during two decades of follow-up.
The researchers found that, similar to HbA1c, fructosamine and glycated albumin were strongly associated with retinopathy. Compared with individuals with no diabetes and marker levels less than the 75th percentile, patients with fructosamine and glycated albumin levels greater than the 95th percentile had significantly higher risk for chronic kidney disease (multivariable-adjusted hazard ratios (HRs), 1.5 and 1.48, respectively) and incident diabetes (HRs, 4.96 and 6.17, respectively). Prediction of incident diabetes was strongest for HbA1c (C-statistic, 0.76) compared with fructosamine (C-statistic, 0.706) and glycated albumin (C-statistic, 0.703). Prediction of incident chronic kidney disease was almost as strong for fructosamine and glycated albumin (C-statistic for both, 0.717) as for HbA1c (C-statistic, 0.726).
"Fructosamine and glycated albumin were strongly associated with diabetes and its microvascular complications and complemented the prognostic utility of HbA1c," the authors write.