Glycated albumin is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with early diabetic kidney disease

Ji Hye Huh, Minyoung Lee, So Young Park, Jae Hyeon Kim, byungwan lee

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3 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-Dglucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR). Methods: We classified 1,061 participants with T2DM into two groups according to uNAG level-normal vs. high ( > 5.8 U/g creatinine)- and measured their biochemical parameters. Results: Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=-0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%). Conclusion: GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

Original languageEnglish
Pages (from-to)215-223
Number of pages9
JournalDiabetes and Metabolism Journal
Volume42
Issue number3
DOIs
Publication statusPublished - 2018 Jun 1

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Diabetic Nephropathies
Area Under Curve
Kidney
Confidence Intervals
Type 2 Diabetes Mellitus
Glucose
Glycosylated Hemoglobin A
Glomerular Filtration Rate
Fasting
ROC Curve
Linear Models
Creatinine
Homeostasis
Regression Analysis
glycosylated serum albumin
Sensitivity and Specificity
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{fbd248e900884c648e09a87a28a3f361,
title = "Glycated albumin is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with early diabetic kidney disease",
abstract = "Background: The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-Dglucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR). Methods: We classified 1,061 participants with T2DM into two groups according to uNAG level-normal vs. high ( > 5.8 U/g creatinine)- and measured their biochemical parameters. Results: Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=-0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95{\%} confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95{\%} CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95{\%} CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95{\%} CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55{\%} (sensitivity 59{\%}, specificity 62{\%}). Conclusion: GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.",
author = "Huh, {Ji Hye} and Minyoung Lee and Park, {So Young} and Kim, {Jae Hyeon} and byungwan lee",
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Glycated albumin is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with early diabetic kidney disease. / Huh, Ji Hye; Lee, Minyoung; Park, So Young; Kim, Jae Hyeon; lee, byungwan.

In: Diabetes and Metabolism Journal, Vol. 42, No. 3, 01.06.2018, p. 215-223.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Glycated albumin is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with early diabetic kidney disease

AU - Huh, Ji Hye

AU - Lee, Minyoung

AU - Park, So Young

AU - Kim, Jae Hyeon

AU - lee, byungwan

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-Dglucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR). Methods: We classified 1,061 participants with T2DM into two groups according to uNAG level-normal vs. high ( > 5.8 U/g creatinine)- and measured their biochemical parameters. Results: Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=-0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%). Conclusion: GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

AB - Background: The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-Dglucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR). Methods: We classified 1,061 participants with T2DM into two groups according to uNAG level-normal vs. high ( > 5.8 U/g creatinine)- and measured their biochemical parameters. Results: Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=-0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%). Conclusion: GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

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U2 - 10.4093/dmj.2017.0091

DO - 10.4093/dmj.2017.0091

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