The relationship between BMI and glycated albumin to glycated hemoglobin (GA/A1c) ratio according to glucose tolerance status

Ji Hye Huh, Kwang Joon Kim, byungwan lee, Dong Wook Kim, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Glycated albumin to glycated hemoglobin (GA/A1c) ratio is known to be inversely related with body mass index (BMI) and insulin secretory capacity. However, the reasons for this association remain unknown. We aimed to investigate whether BMI directly or indirectly influences GA/A1c by exerting effects on insulin secretion or resistance and to confirm whether these associations differ according to glucose tolerance status. We analyzed a total of 807 subjects [242 drug-naïve type 2 diabetes (T2D), 378 prediabetes, and 187 normal glucose tolerance (NGT)]. To assess the direct and indirect effects of BMI on GA/A1c ratio, structural equation modeling (SEM) was performed. GA/A1c ratio was set as a dependent variable, BMI was used as the independent variable, and homeostasis model assessment-pancreatic beta-cell function (HOMA-b), homeostasis model assessment-insulin resistance (HOMA-IR), glucose level were used as mediator variables. The estimates of a direct effect of BMI on GA/A1c to be the strongest in NGT and weakest in T2D (20.375 in NGT, 20.244 in prediabetes, and 20.189 in T2D). Conversely, the indirect effect of BMI on GA/A1c exerted through HOMA-b and HOMA-IR was not statistically significant in NGT group, but significant in prediabetes and T2D groups (0.089 in prediabetes, 20.003 in T2D). It was found that HOMA-b or HOMA-IR indirectly influences GA/A1c in T2D and prediabetes group through affecting fasting and postprandial glucose level. The relationship between GA/A1c and BMI is due to the direct effect of BMI on GA/A1c in NGT group, while in T2D and prediabetes groups, this association is mostly a result of BMI influencing blood glucose through insulin resistance or secretion.

Original languageEnglish
Article numbere89478
JournalPLoS One
Volume9
Issue number2
DOIs
Publication statusPublished - 2014 Feb 28

Fingerprint

glycohemoglobin
Glycosylated Hemoglobin A
glucose tolerance
Medical problems
albumins
body mass index
Prediabetic State
Body Mass Index
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
Glucose
homeostasis
insulin resistance
Homeostasis
Insulin
Insulin Resistance
islets of Langerhans
Insulin-Secreting Cells
insulin secretion
glycosylated serum albumin

All Science Journal Classification (ASJC) codes

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

Cite this

Huh, Ji Hye ; Kim, Kwang Joon ; lee, byungwan ; Kim, Dong Wook ; Kang, Eun Seok ; Cha, Bong Soo ; Lee, Hyun Chul. / The relationship between BMI and glycated albumin to glycated hemoglobin (GA/A1c) ratio according to glucose tolerance status. In: PLoS One. 2014 ; Vol. 9, No. 2.
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abstract = "Glycated albumin to glycated hemoglobin (GA/A1c) ratio is known to be inversely related with body mass index (BMI) and insulin secretory capacity. However, the reasons for this association remain unknown. We aimed to investigate whether BMI directly or indirectly influences GA/A1c by exerting effects on insulin secretion or resistance and to confirm whether these associations differ according to glucose tolerance status. We analyzed a total of 807 subjects [242 drug-na{\"i}ve type 2 diabetes (T2D), 378 prediabetes, and 187 normal glucose tolerance (NGT)]. To assess the direct and indirect effects of BMI on GA/A1c ratio, structural equation modeling (SEM) was performed. GA/A1c ratio was set as a dependent variable, BMI was used as the independent variable, and homeostasis model assessment-pancreatic beta-cell function (HOMA-b), homeostasis model assessment-insulin resistance (HOMA-IR), glucose level were used as mediator variables. The estimates of a direct effect of BMI on GA/A1c to be the strongest in NGT and weakest in T2D (20.375 in NGT, 20.244 in prediabetes, and 20.189 in T2D). Conversely, the indirect effect of BMI on GA/A1c exerted through HOMA-b and HOMA-IR was not statistically significant in NGT group, but significant in prediabetes and T2D groups (0.089 in prediabetes, 20.003 in T2D). It was found that HOMA-b or HOMA-IR indirectly influences GA/A1c in T2D and prediabetes group through affecting fasting and postprandial glucose level. The relationship between GA/A1c and BMI is due to the direct effect of BMI on GA/A1c in NGT group, while in T2D and prediabetes groups, this association is mostly a result of BMI influencing blood glucose through insulin resistance or secretion.",
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The relationship between BMI and glycated albumin to glycated hemoglobin (GA/A1c) ratio according to glucose tolerance status. / Huh, Ji Hye; Kim, Kwang Joon; lee, byungwan; Kim, Dong Wook; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul.

In: PLoS One, Vol. 9, No. 2, e89478, 28.02.2014.

Research output: Contribution to journalArticle

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AU - Huh, Ji Hye

AU - Kim, Kwang Joon

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AU - Cha, Bong Soo

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