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Relationship between GA and diabetes complications

Diabetes afflicts an increasing number of people worldwide each year. Proper blood glucose control is essential in preventing complications associated with diabetes, such as neuropathy, nephropathy, retinopathy, and macroangiopathy. The relationship between GA and diabetic complication risks has been reported around the world.

DCCT/EDIC Study 1-2)
In case-cohort analyses (n=497), HbA1c and GA had similar associations with
Retinopathy and nephropathy. These associations were strengthened when both
Measures were considered together.2)

ARIC Study 3-4)
Over the course of two decade of following up on 11,104 participants, there were 1,096 new cases of coronary heart disease, 605 cases of ischemic stroke, 1,432 cases of heart failure, and 2,860 deaths. GA was associated with vascular outcomes and mortality.4)

A five-year retrospective longitudinal study in Shanghai 5)
In this five-year retrospective longitudinal study (n=359), the presence of diabetic retinopathy (DR) at baseline, poor glycemic control, GA, and impaired renal function provided signs of DR progression in patients with type 2 diabetes mellitus.

 

References
1) Nathan DM, et l., Determining stability of stored samples retrospectively: the validation of glycated albumin, Clin Chem. 2011 Feb;57(2):286-90.
2) Nathan DM, et al., Relationship of glycated albumin to blood glucose and HbA1c values and to retinopathy, nephropathy,and cardiovascular outcomes in the DCCT/EDIC Study, Diabetes, 63(1): 282-290, 2014
3) Selvin E, et al., Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study, Lancet Diabetes Endocrinol. 2014 Apr;2(4):279-88.
4) Selvin E, et al., Fructosamine and glycated albumin and the risk of cardiovascular outcomes and death, circulation, 132(4): 269-277, 2015
5) Pan J, et al., Serum glycated albumin predicts the progression of diabetic retinopathy-a five year retrospective longitudinal study, J Diabetes
Complic, 28(6): 772-778, 2014

 

Hisayama Study (Japan)

The Hisayama study epidemiological study on lifestyle diseases in Japan, indicated that higher GA and HbA1c were associated with increases in the prevalence of diabetic retinopathy. For the predictability of the onset of diabetic retinopathy, both GA and HbA1c had the AUC higher than 0.9.

Prevalence of diabetic retinopathy by deciles of the distribution of fasting plasma glucose, two-hour postload glucose, hemoglobin A1c, and glycated albumin

Prevalence of retinopathy

[Subjects] A total of 2681 individuals aged 40-79 years underwent 75 g oral glucose tolerance tests (OGTT)
[Method] The prevalence of diabetic retinopathy was calculated by deciles of the distribution of fasting plasma glucose (FPG), two-hour post-load glucose, (two-hour PG), HbA1c, and GA, and the diabetic retinopathy incidence of each glycemic marker was subjected to ROC analysis.

 

Comparison of the discriminative ability of fasting plasma glucose, 2-hour postload glucose, hemoglobin A1c, glycated albumin, and 1,5-anhydroglucitol for detecting the presence of diabetic retinopathy.

Prevalence of diabetic retinopathy by deciles of the distribution of fasting plasma glucose, two-hour postload glucose, hemoglobin A1c, and glycated albumin

Mukai N, et al. Thresholds of various glycemic measures for diagnosing diabetes based on
prevalence of retinopathy in community-dwelling Japanese subjects: the Hisayama Study.
http://www.cardiab.com/content/13/1/45
©2014 Mukai N, et al. ; licensee BioMed Central Ltd Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0/)

 

 

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