Bellia Chiara, Zaninotto Martina, Cosma Chiara, Agnello Luisa, Bivona Giulia, Marinova Mariela, Lo Sasso Bruna, Plebani Mario, Ciaccio Marcello
Department of Biopathology and Medical Biotechnologies, Section of Clinical Biochemistry and Clinical Molecular Medicine, University of Palermo, Italy.
Department of Laboratory Medicine, University-Hospital, Padova, Italy.
Clin Biochem. 2018 Apr;54:68-72. doi: 10.1016/j.clinbiochem.2018.02.017. Epub 2018 Feb 24.
Glycated Albumin (GA) has been proposed as a screening marker for diabetes in Asian countries in the last years. Nevertheless, few studies have been conducted in Caucasian population. The aim of this study is to evaluate the clinical usefulness of GA in diabetes diagnosis in Caucasian asymptomatic subjects considered at risk of diabetes based on medical history and Fasting Plasma Glucose (FPG).
Three hundred and thirty-four Caucasian subjects having one or more risk factor for diabetes, and/or FPG ranging from 5.6 mmol/L to 6.9 mmol/L with no symptoms for diabetes were enrolled in this study. Plasma GA was measured by an enzymatic method (quantILab Glycated Albumin) on ILab Taurus instrument (Instrumentation Laboratory - A Werfen Company).
GA median levels were 13.2% (IQR:12.2-14.4). Eighteen subjects (5.4%) were classified as diabetics based on their HbA1c. According to the ROC curve analysis, GA identified subjects with diabetes with a sensitivity of 72.2% (95% CI: 46.5-90.3) and a specificity of 71.8% (95% CI: 66.5-76.7) (AUC: 0.80; 95% CI: 0.75-0.84; P < 0.0001) at the cut-off of 14%. The cut-off of 13.5% was associated to a higher sensitivity 88.9% (95%CI: 65.3-98.6) and a specificity of 60.4% (95%CI, 54.8-65.9).
This study confirms the clinical usefulness of GA for the diagnosis of diabetes in Caucasian subjects at risk for diabetes. More studies are required to clarify the role of GA in relation to the other diagnostic criteria for diabetes.
近年来,糖化白蛋白(GA)已被提议作为亚洲国家糖尿病的筛查标志物。然而,针对白种人群的相关研究较少。本研究旨在评估GA在基于病史和空腹血糖(FPG)被视为有糖尿病风险的无症状白种人受试者糖尿病诊断中的临床应用价值。
本研究纳入了334名有一个或多个糖尿病风险因素和/或FPG在5.6 mmol/L至6.9 mmol/L之间且无糖尿病症状的白种人受试者。采用酶法(quantILab糖化白蛋白)在ILab Taurus仪器(仪器实验室 - 沃芬公司)上测定血浆GA。
GA中位数水平为13.2%(四分位间距:12.2 - 14.4)。根据糖化血红蛋白,18名受试者(5.4%)被归类为糖尿病患者。根据ROC曲线分析,GA识别糖尿病患者的敏感性为72.2%(95%置信区间:46.5 - 90.3),特异性为71.8%(95%置信区间:66.5 - 76.7)(曲线下面积:0.80;95%置信区间:0.75 - 0.84;P < 0.0001),截断值为14%。截断值为13.5%时,敏感性更高,为88.9%(95%置信区间:65.3 - 98.6),特异性为60.4%(95%置信区间,54.8 - 65.9)。
本研究证实了GA在有糖尿病风险的白种人受试者糖尿病诊断中的临床应用价值。需要更多研究来阐明GA相对于糖尿病其他诊断标准的作用。