Development of an HbA1c-based conversion equation for estimating glycated albumin in a Korean population with a wide range of glucose intolerance

Chang Hee Jung, You Cheol Hwang, Kwang Joon Kim, Bong Soo Cha, Cheol Young Park, Won Seon Jeon, Jae Hyeon Kim, Sang Man Jin, Sang Youl Rhee, Jeong Taek Woo, Byung Wan Lee

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Abstract

Background: Compared to the golden standard glycation index of HbA1c, glycated albumin (GA) has potentials for assessing insulin secretory dysfunction and glycemic fluctuation as well as predicting diabetic vascular complications. However, the reference ranges of GA and a conversion equation need to be clearly defined. We designed this study to determine the reference ranges in patients with normal glucose tolerance (NGT) based on conventional measures of glycemic status and to devise a conversion equation for calculating HbA1c and GA in a Korean population. Methodology/Principal Findings: In this multicenter, retrospective, cross-sectional study, we recruited antidiabetic drug-naïve patients with available glycemic variables including HbA1c, GA, and fasting plasma glucose regardless of glucose status. For the reference interval of serum GA, 5th to 95th percentile value of GA in subjects with NGT was adopted. The conversion equation between HbA1c and GA was devised using an estimating regression model with unknown breakpoints method. The reference range for GA was 9.0-14.0% in 2043 subjects. The 95th percentile responding values for FPG, and HbA1c were approximately 5.49 mmol/l, and 5.6%, respectively. The significant glycemic turning points were 5.868% HbA1c and 12.2% GA. The proposed conversion equation for below and above the turning point were GA (%) = 6.960+0.8963 x HbA1c (%) and GA (%) = -9.609+3.720 x HbA1c (%), respectively. Conclusions/Significance: These results should be helpful in future studies on the clinical implications of high GA relative to HbA1c and the clinical implementation of diabetes management.

Original languageEnglish
Article numbere95729
JournalPloS one
Volume9
Issue number4
DOIs
Publication statusPublished - 2014 Apr 22

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Jung, C. H., Hwang, Y. C., Kim, K. J., Cha, B. S., Park, C. Y., Jeon, W. S., Kim, J. H., Jin, S. M., Rhee, S. Y., Woo, J. T., & Lee, B. W. (2014). Development of an HbA1c-based conversion equation for estimating glycated albumin in a Korean population with a wide range of glucose intolerance. PloS one, 9(4), [e95729]. https://doi.org/10.1371/journal.pone.0095729