PMID- 30112873
OWN - NLM
STAT- Publisher
LR  - 20240228
IS  - 2233-6079 (Print)
IS  - 2233-6079 (Linking)
DP  - 2018 May 2
TI  - Glycated Albumin Is a More Useful Glycation Index than HbA1c for Reflecting Renal 
      Tubulopathy in Subjects with Early Diabetic Kidney Disease.
AB  - BACKGROUND: The aim of this study was to investigate which glycemic parameters 
      better reflect urinary N-acetyl-beta-D-glucosaminidase (uNAG) abnormality, a marker 
      for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects 
      with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR). 
      METHODS: We classified 1,061 participants with T2DM into two groups according to 
      uNAG level-normal vs. high (>5.8 U/g creatinine)-and measured their biochemical 
      parameters. RESULTS: Subjects with high uNAG level had significantly higher 
      levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated 
      hemoglobin (HbA1c) and lower levels of homeostasis model assessment of beta-cell 
      compared with subjects with normal uNAG level. Multiple linear regression 
      analyses showed that uNAG was significantly associated with GA (standardized beta 
      coefficient [beta]=0.213, P=0.016), but not with HbA1c (beta=-0.137, P=0.096) or 
      stimulated glucose (beta=0.095, P=0.140) after adjusting confounding factors. In 
      receiver operating characteristic analysis, the value of the area under the curve 
      (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% 
      confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% 
      CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or 
      fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point 
      for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%). 
      CONCLUSION: GA is a more useful glycation index than HbA1c for reflecting renal 
      tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.
CI  - Copyright (c) 2018 Korean Diabetes Association.
FAU - Huh, Ji Hye
AU  - Huh JH
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei 
      University Wonju College of Medicine, Wonju, Korea.
FAU - Lee, Minyoung
AU  - Lee M
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei 
      University College of Medicine, Seoul, Korea.
FAU - Park, So Young
AU  - Park SY
AD  - Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical 
      Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Kim, Jae Hyeon
AU  - Kim JH
AUID- ORCID: 0000-0001-5001-963X
AD  - Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical 
      Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 
      jaehyeon@skku.edu.
FAU - Lee, Byung Wan
AU  - Lee BW
AUID- ORCID: 0000-0002-9899-4992
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei 
      University College of Medicine, Seoul, Korea. bwanlee@yuhs.ac.
LA  - eng
PT  - Journal Article
DEP - 20180502
PL  - Korea (South)
TA  - Diabetes Metab J
JT  - Diabetes & metabolism journal
JID - 101556588
OTO - NOTNLM
OT  - Diabetes mellitus, type 2
OT  - Glycated hemoglobin A
OT  - Glycosylated serum albumin
OT  - Kidney tubules
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2018/08/17 06:00
MHDA- 2018/08/17 06:00
CRDT- 2018/08/17 06:00
PHST- 2017/12/05 00:00 [received]
PHST- 2018/02/05 00:00 [accepted]
PHST- 2018/08/17 06:00 [entrez]
PHST- 2018/08/17 06:00 [pubmed]
PHST- 2018/08/17 06:00 [medline]
AID - 42.e11 [pii]
PST - aheadofprint
SO  - Diabetes Metab J. 2018 May 2.