Akihiko Nakamura1, Ryo Kodera1,2, Noriko Sakamoto3, Haruyo Ujike4,5, Jun Wada5, Kenichi Shikata2, Hirofumi Makino6. 1. Osafune Clinic, 332-1 Haji, Osafune, Setouchi, Okayama 701-4264 Japan. 2. 2Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata, Kita-ku, Okayama, Japan. 3. Diabetes, Metabolism, and Endocrinology, Shin Kashiwa Clinic, 1-7, Shinkashiwa, Kashiwa, Chiba Japan. 4. 4Departments of Nephrology, Kagawa Prefectural Central Hospital, 1-2-1, Asahi, Takamatsu, Kagawa Japan. 5. 5Dentistry and Pharmaceutical Sciences, Medicine and Clinical Science, Okayama University Graduate School of Medicine, 2-5-1 Shikata, Kita-ku, Okayama, Japan. 6. 6Okayama University Hospital, 2-5-1 Shikata, Kita-ku, Okayama, Japan.
Abstract
AIM: We developed a novel estimation method for hemoglobin A1c (HbA1c) in type 2 diabetes (T2D) patients with end-stage renal disease (ESRD). This method is based on the glycated albumin (GA) level. METHODS: Of the 788 Japanese patients with T2D included in this study, 545 had normal renal function (NRF group) and 243 had ESRD. Oral glucose tolerance tests (OGTTs) were performed in 80 subjects. The variables GA, body mass index (BMI), hemoglobin (Hb), and estimated glomerular filtration rate (eGFR) were significantly associated with the GA-to-HbA1c ratio and were used to determine the estimated HbA1c (eHbA1c). One method of estimating HbA1c involved dividing GA by the GA-to-HbA1c ratio predicted from the estimated regression equation; the estimated HbA1c obtained in this manner was denoted eHbA1c-1. RESULTS: eHbA1c-1 (%) = GA × [4.688 - 18.833 × GA-1 - 0.015 × BMI - 0.037 × Hb (- 0.002 × eGFR for patients without ESRD)]-1; adjusted R 2 = 0.676 for actual HbA1c. The sensitivity of eHbA1c-1 was better than that of GA for diabetes diagnosis using the 75-g OGTT. There were no differences in the slope of eHbA1c-1 versus GA and the variance of eHbA1c-1 between the ESRD and NRF groups. eHbA1c-1 was not associated with Hb, erythropoiesis-stimulating agent use, or ESRD concomitance. CONCLUSIONS: eHbA1c-1 may be a useful parameter for estimating HbA1c in T2D patients with ESRD.
AIM: We developed a novel estimation method for hemoglobin A1c (HbA1c) in type 2 diabetes (T2D) patients with end-stage renal disease (ESRD). This method is based on the glycated albumin (GA) level. METHODS: Of the 788 Japanese patients with T2D included in this study, 545 had normal renal function (NRF group) and 243 had ESRD. Oral glucose tolerance tests (OGTTs) were performed in 80 subjects. The variables GA, body mass index (BMI), hemoglobin (Hb), and estimated glomerular filtration rate (eGFR) were significantly associated with the GA-to-HbA1c ratio and were used to determine the estimated HbA1c (eHbA1c). One method of estimating HbA1c involved dividing GA by the GA-to-HbA1c ratio predicted from the estimated regression equation; the estimated HbA1c obtained in this manner was denoted eHbA1c-1. RESULTS: eHbA1c-1 (%) = GA × [4.688 - 18.833 × GA-1 - 0.015 × BMI - 0.037 × Hb (- 0.002 × eGFR for patients without ESRD)]-1; adjusted R 2 = 0.676 for actual HbA1c. The sensitivity of eHbA1c-1 was better than that of GA for diabetes diagnosis using the 75-g OGTT. There were no differences in the slope of eHbA1c-1 versus GA and the variance of eHbA1c-1 between the ESRD and NRF groups. eHbA1c-1 was not associated with Hb, erythropoiesis-stimulating agent use, or ESRD concomitance. CONCLUSIONS: eHbA1c-1 may be a useful parameter for estimating HbA1c in T2D patients with ESRD.
Authors: T P Peacock; Z K Shihabi; A J Bleyer; E L Dolbare; J R Byers; M A Knovich; J Calles-Escandon; G B Russell; B I Freedman Journal: Kidney Int Date: 2008-02-20 Impact factor: 10.612
Authors: Sara Kazempour-Ardebili; Varunika L Lecamwasam; Thushara Dassanyake; Andrew H Frankel; Frederick W K Tam; Anne Dornhorst; Gary Frost; Jeremy J O Turner Journal: Diabetes Care Date: 2009-02-05 Impact factor: 17.152