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, Byung Wan
N1 - Publisher Copyright:
© 2018 Korean Diabetes Association.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
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
M3 - Article
AN - SCOPUS:85048926640
VL - 42
SP - 215
EP - 223
JO - Diabetes and Metabolism Journal
JF - Diabetes and Metabolism Journal
SN - 2233-6079
IS - 3
ER -