The ratio of glycated albumin to hemoglobin A1c measured in IFCC units accurately represents the glycation gap.

Abstract:

:The glycation gap (G-gap: difference between measured hemoglobin A1c [A1C] and the value predicted by its regression on the fructosamine level) is stable and associated with diabetic complications. Measuring A1C level in International Federation of Clinical Chemistry (IFCC) units (A1C-SI; mmol/mol) and National Glycohemoglobin Standardization Program units (A1C-NGSP; %) and using glycated albumin (GA) level instead of fructosamine level for calculating the G-gap, we investigated whether the G-gap is better represented by GA/A1C ratio if expressed in SI units (GA/A1C-SI ratio) rather than in NGSP units (GA/A1C-% ratio). We examined 749 Japanese children with type 1 diabetes using simultaneous GA and A1C measurements. Of these, 369 patients were examined more than five times to assess the consistency of the G-gap and the GA/A1C ratio within individuals. The relationship of GA/A1C-% ratio to the corresponding A1C-NGSP was stronger than that of GA/A1C-SI ratio to A1C-IFCC. At enrollment, the inverse relationship between the GA/A1C-SI ratio and G-gap was highly significant (R(2) = 0.95) compared with that between the GA/A1C-% ratio and G-gap (R(2) = 0.69). A highly significant inverse relationship was also observed between the mean GA/A1C-SI ratio and the mean G-gaps obtained individually over time (R(2) = 0.95) compared with that using the corresponding A1C-NGSP (R(2) = 0.67). We conclude that the G-gap is better represented by the GA/A1C-SI ratio. We propose the use of mean GA/A1C-SI ratios easily obtained individually over time as reference values in Japanese children with type 1 diabetes (6.75 ± 0.60 [means ± SD]).

journal_name

Endocr J

journal_title

Endocrine journal

authors

Akatsuka J,Mochizuki M,Musha I,Ohtake A,Kobayashi K,Kikuchi T,Kikuchi N,Kawamura T,Urakami T,Sugihara S,Hoshino T,Amemiya S,Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes.

doi

10.1507/endocrj.EJ14-0066

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

161-72

issue

2

eissn

0918-8959

issn

1348-4540

pii

DN/JST.JSTAGE/endocrj/EJ14-0066

journal_volume

62

pub_type

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