Serum Glycated Albumin to Guide the Diagnosis of Diabetes Mellitus

doi:10.1371/journal.pone.0146780

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Title:	Serum Glycated Albumin to Guide the Diagnosis of Diabetes Mellitus
Authors:	Wu, Wan-Chen Ma, Wen-Ya Wei, Jung-Nan Yu, Tse-Ya Lin, Mao-Shin Shih, Shyang-Rong Hua, Cyue-Huei Liao, Ying-Jhu Chuang, Lee-Ming Li, Hung-Yuan
Contributors:	Natl Taiwan Univ Hosp, Dept Internal Med, Div Endocrinol Cardinal Tien Hosp, Dept Internal Med, Div Endocrinol Chia Nan Univ Pharm & Sci Far Eastern Mem Hosp, Dept Hlth Management Ctr Natl Taiwan Univ Hosp, Dept Internal Med, Div Cardiol Natl Taiwan Univ Hosp, Yun Lin Branch, Div Clin Pathol
Keywords:	chronic kidney-disease iron-deficiency hemodialysis-patients late pregnancy hemoglobin glucose values a1c predicts index
Date:	2016-01
Issue Date:	2018-01-18 11:41:25 (UTC+8)
Publisher:	Public Library Science
Abstract:	In the diagnosis of diabetes mellitus, hemoglobin A1c (HbA1c) is sometimes measured to determine the need of an oral glucose tolerance test (OGTT). However, HbA1c does not accurately reflect glycemic status in certain conditions. This study was performed to test the possibility that measurement of serum glycated albumin (GA) better assesses the need for OGTT. From 2006 to 2012, 1559 subjects not known to have diabetes or to use anti-diabetic medications were enrolled. Serum GA was measured, and a 75-g OGTT was then performed to diagnose diabetes. Serum GA correlated significantly to age (r = 0.27, p<0.001), serum albumin (r = -0.1179, age-adjusted p = 0.001), body mass index (r = -0.24, age-adjusted p<0.001), waist circumference (r = -0.16, age-adjusted p<0.001), and plasma GA (r = 0.999, p<0.001), but was unaffected by diet (p = 0.8). Using serum GA at 15% for diagnosis of diabetes, the sensitivity, specificity, and area under the receiver-operating characteristic curve were 74%, 85%, and 0.86, respectively. Applying a fasting plasma glucose (FPG) value of < 100 mg/dL to exclude diabetes and of >= 126 mg/dL to diagnose diabetes, 14.4% of the study population require an OGTT (OGTT%) with a sensitivity of 78.8% and a specificity of 100%. When serum GA value of 14% and 17% were used to exclude and diagnose diabetes, respectively, the sensitivity improved to 83.3%, with a slightly decrease in specificity (98.2%), but a significant increase in OGTT%(35%). Using combined FPG and serum GA cutoff values (FPG < 100 mg/dL plus serum GA < 15% to exclude diabetes and FPG >= 126 mg/dL or serum GA >= 17% to diagnose diabetes), the OGTT% was reduced to 22.5% and the sensitivity increased to 85.6% with no change in specificity (98.2%). In the diagnosis of diabetes, serum GA measurements can be used to determine the need of an OGTT.
Relation:	Plos One, v.11 n.1, e0146780
Appears in Collections:	[Dept. of Occupational Safety] Periodical Articles

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