The Clinical Value Of Glycated Albumin Measurement By Enzymatic Method For Diagnosis And Treatment Of Diabetes Mellitus

Objective: Glycated hemogloin(Hb A1c) is widely used as the gold standard parameter of long-term glycemic control in diabetic patients. Hb A1 c reflects glycemic status during a relatively long period(past 1 to 3 months). Mean Hb A1 c level is associated with the development and progression of diabetic complications. However, Hb A1 c does not accurately reflect the actual status of glycemic control in some conditions with rapid changes in glycemic control and in patients with anemia(hemolytic anemia, iron deficiency anemia, etc.). In comparison, glycated albumin(GA) more accurately reflects changes in plasma glucose during the short term(past 2 to 3 weeks)and postprandial plasma glucose.GA also reflects glycemic control in patients with hematologic disorders.This study evaluated the clinical value of glycated albumin(GA) measurement by enzymatic method as a glycemic marker and investigated the association of GA with the levels of Hb A1 c, fasting plasma glucose(FPG) and 2-hours postprandial glucose(2-h PG)in type 2 diabetes patients.Method: 150 patients with type 2 diabetes(T2DM) patients were recruited to be as diabetes mellitus(DM) group from the Department of Endocrinology. The group consisted of 78 cases males and 72 females with a mean age of(54.25±11.25) years old. They were all diagnosed by the 1999 WHO criteria for the diagnosis and classification of diabetes. As Han people in Hebei, they were unrelated to each other. Exclusion criteria included anemia, pregnancy, chronic liver disease, chronic kidney disease, hypoalbuminemia, thyroid disease and administration of glucocorticoid. The levels of GA, Hb A1 c, FPG and 2-h PG were detected at baseline and afetr 2 weeks treatment.At the same time 144 healthy subjects was recruited for normal control(NC)group from the population for regular physical examination and workers in our hospital, including 70 males and 74 females with a mean age of(52.58±9.26) years old. As Han people without diabetes, hypertension, cardiovascular and kidney disease history in Hebei, they were unrelated to each other. To detect the levels of GA and Hb A1 c.1 The clinical dataThe data included gender, age, height, weight and body mass index(BMI).2 The blood biochemistry dataA venous blood sample was obtained after a night(about 8-12 hours) fast. Fasting blood glucose(FBG)and 2-hours postprandial glucose(2-h PG)were tested with a glucose-oxidase method by using an automatic biochemical analyzer.GA was determined by an enzymatic method using a liquied chemistry system(GA assay, Asahi kasei core,Tokyo, Japan) in a clinical autoanalyzer. Hb Alc was measured by high-performance liquid chromatography(HPLC).3 Statistical analysisThe statistical analysis was performed using SPSS 17.0 statistical software. After testing for normality, all normally distributed data were expressed as mean±SD values. Correlation coefficients were calculated by simple regression analysis, and the differences in means between the two groups were analyzed by t test.The level of significance was 0.05.Results:1 There was no significant difference in age,sex and height between DM group and NC group. There was significant difference in weight and body mass index(BMI) between DM group and NC group,DM group higher than NC group.2 The levels of GA and Hb A1 c in DM group were significantly higher than NC group(P<0.05).3 Comparison of GA, Hb A1 c,FPG and 2-h PG at baseline and end of 2 weeks after the start of therapy in DM group,GA decreased more rapidly than Hb Alc(P<0.05).The Hb Alc didn’t decreased significantly at end of 2 weeks(P>0.05).4 In DM group, simple regression analysis showed that serum GA level was positively correlated with Hb Alc,FPG and 2-h PG.Conclusions:1 Enzymatic measuring GA was highly correlated with Hb Alc,FPG and 2-h PG,and changing concomitantly with the decrease of Hb Alc,FPG and 2-h PG during the 2 weeks treatment.GA can be a short- term indicater for blood glucose control in type 2 diabetes mellitus.2 GA was more sensitive than Hb Alc for short- term and mild changes of glycemic control during treatment in type 2 diabetes mellitus.