PMID- 23776693
OWN - NLM
STAT- MEDLINE
DCOM- 20140123
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 6
DP  - 2013
TI  - Variables involved in the discordance between HbA1c and fructosamine: the 
      glycation gap revisited.
PG  - e66696
LID - 10.1371/journal.pone.0066696 [doi]
LID - e66696
AB  - AIMS: Glycation gap (GG) is defined as the difference between the measured level 
      of HbA1c and the level that would be predicted from its regression on the 
      fructosamine level. The aims of the study were: 1) To determine the 
      reproducibility and consistency of GC; 2) To discover factors related to GG 
      value. Given that metformin might increase glucose transport through the 
      erythrocyte membrane, this treatment was also considered in the analyses of the 
      results. METHODS: GG was calculated in two blood samples separated 30.6 (SD 7.3) 
      weeks, obtained in 508 type 2 diabetic patients. The following variables were 
      considered: HbA1c, fructosamine, glucose, creatinine, hematological parameters 
      and treatment with metformin. Multivariate and logistic regression analyses were 
      performed to explore the variables independently related to CG. RESULTS: GG was 
      reproducible and consistent over time. Creatinine, mean corpuscular hemoglobin 
      concentration (MCHC), and glycemia (inverse relationship); and HbA1c and 
      treatment with metformin (direct relationship) were independently related to GG. 
      Patients treated with metformin showed higher HbA1c values, despite similar 
      fructosamine concentrations, than patients not treated with the drug. 
      CONCLUSIONS: GG is independently related to serum levels of creatinine, MCHC and 
      treatment with metformin. The spurious effect of metformin on Hb glycation could 
      have serious clinical implications and should be considered when interpreting the 
      results of clinical trials.
FAU - Zafon, Carles
AU  - Zafon C
AD  - Diabetes and Metabolism Research Unit (VHIR) and Department of Endocrinology, 
      Hospital Vall d'Hebron and Universitat Autonoma de Barcelona, Barcelona, Spain. 
      26276czl@comb.cat
FAU - Ciudin, Andreea
AU  - Ciudin A
FAU - Valladares, Silvia
AU  - Valladares S
FAU - Mesa, Jordi
AU  - Mesa J
FAU - Simo, Rafael
AU  - Simo R
LA  - eng
PT  - Journal Article
DEP - 20130612
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 4429-04-3 (Fructosamine)
RN  - 9100L32L2N (Metformin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Analysis of Variance
MH  - Creatinine/blood
MH  - Diabetes Mellitus, Type 2/*blood
MH  - Fructosamine/*blood
MH  - Glycated Hemoglobin/*metabolism
MH  - Glycosylation/drug effects
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology
MH  - Logistic Models
MH  - Metformin/pharmacology
MH  - Spain
PMC - PMC3680426
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/06/19 06:00
MHDA- 2014/01/24 06:00
PMCR- 2013/06/12
CRDT- 2013/06/19 06:00
PHST- 2013/03/20 00:00 [received]
PHST- 2013/05/13 00:00 [accepted]
PHST- 2013/06/19 06:00 [entrez]
PHST- 2013/06/19 06:00 [pubmed]
PHST- 2014/01/24 06:00 [medline]
PHST- 2013/06/12 00:00 [pmc-release]
AID - PONE-D-13-13224 [pii]
AID - 10.1371/journal.pone.0066696 [doi]
PST - epublish
SO  - PLoS One. 2013 Jun 12;8(6):e66696. doi: 10.1371/journal.pone.0066696. Print 2013.