Bai Yuanyuan, Fang Yujie, Ming Jie, Wei Huigang, Zhang Pinghua, Yan Juan, Du Yongfeng, Li Qiaoyue, Yu Xinwen, Guo Minglan, Liang Shengru, Hu Ruofan, Ji Qiuhe
Department of Endocrinology and Metabolism of the First Affiliated Hospital to Air Force Medical University, Xian, China.
Diabetes Metab Res Rev. 2022 Jan;38(1):e3477. doi: 10.1002/dmrr.3477. Epub 2021 Jun 15.
Glycated albumin (GA) is a biomarker for short-term (2-3 weeks) glycaemic control. However, the predictive utility of GA for diabetes and prediabetes is largely uncharacterised. We aimed to investigate the relationships of baseline serum GA levels with incident diabetes and prediabetes.
This was a longitudinal cohort study involving 516 subjects without diabetes or prediabetes at baseline. Blood glucose levels were observed during follow-up. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using COX proportional hazard models. Receiver operating characteristic curves and areas under the curves (AUCs) were used to evaluate the discriminating abilities of glycaemic biomarkers and prediction models.
During a 9-year follow-up, 51 individuals (9.88%) developed diabetes and 92 (17.83%) prediabetes. Unadjusted HRs (95% CI) for both diabetes and prediabetes increased proportionally with increasing GA levels in a dose-response manner. Multivariable-adjusted HRs (95% CI) for diabetes were significantly elevated from 1.0 (reference) to 5.58 (1.86-16.74). However, the trend was no longer significant for prediabetes after multivariable adjustment. AUCs for GA, fasting blood glucose (FBG) and 2-h postprandial blood glucose (2h-PBG) for predicting diabetes were 0.698, 0.655 and 0.725, respectively. The AUCs for GA had no significant differences compared with those for FBG (p = 0.376) and 2h-PBG (p = 0.552). Replacing FBG or 2h-PBG or both with GA in diabetes prediction models made no significant changes to the AUCs of the models.
GA is of good prognostic utility in predicting diabetes. However, GA may not be a useful biomarker for predicting prediabetes.
糖化白蛋白（GA）是短期（2 - 3周）血糖控制的生物标志物。然而，GA对糖尿病和糖尿病前期的预测效用在很大程度上尚未明确。我们旨在研究基线血清GA水平与新发糖尿病和糖尿病前期的关系。
这是一项纵向队列研究，纳入了516名基线时无糖尿病或糖尿病前期的受试者。随访期间观察血糖水平。使用COX比例风险模型计算95%置信区间（CI）的风险比（HR）。采用受试者工作特征曲线及曲线下面积（AUC）评估血糖生物标志物和预测模型的判别能力。
在9年的随访中，51人（9.88%）患糖尿病，92人（17.83%）患糖尿病前期。糖尿病和糖尿病前期的未调整HR（95%CI）均随GA水平升高呈剂量反应关系而相应增加。糖尿病的多变量调整HR（95%CI）从1.0（参照）显著升高至5.58（1.86 - 16.74）。然而，多变量调整后糖尿病前期的这一趋势不再显著。GA、空腹血糖（FBG）和餐后2小时血糖（2h - PBG）预测糖尿病的AUC分别为0.698、0.655和0.725。GA的AUC与FBG（p = 0.376）和2h - PBG（p = 0.552）相比无显著差异。在糖尿病预测模型中用GA替代FBG或2h - PBG或两者，模型的AUC无显著变化。
GA在预测糖尿病方面具有良好的预后效用。然而，GA可能不是预测糖尿病前期的有用生物标志物。
