Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?


Autoři: Fernando Chimela Chume aff001;  Mayana Hernandez Kieling aff001;  Priscila Aparecida Correa Freitas aff001;  Gabriela Cavagnolli aff004;  Joíza Lins Camargo aff001
Působiště autorů: Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul Porto Alegre, Porto Alegre–RS, Brazil aff001;  Universidade Zambeze, Beira, Mozambique aff002;  Laboratory Diagnosis Division, Clinical Biochemistry Unit, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre–RS, Brazil aff003;  Centro Universitário FSG, Caxias do Sul—RS, Brazil aff004;  Endocrinology Division and Experimental Research Centre, Hospital de Clinicas de Porto Alegre, Porto Alegre–RS, Brazil aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227065

Souhrn

Introduction

Studies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in diagnosis of type 2 diabetes mellitus (DM). Thus, the aim of this study was to assess the clinical utility of GA in diagnosis of DM.

Materials and methods

This diagnostic test accuracy study was performed in 242 Brazilian individuals referred for OGTT in a tertiary university hospital. ROC curves were used to access the performance of GA and HbA1c in the diagnosis of DM by oral glucose tolerance test (OGTT).

Results

OGTT, HbA1c and GA were performed in all 242 participants (40.5% male, age 54.4 ± 13.0 years [mean ± SD], body mass index 28.9 ± 6.3 kg/m2). DM by OGTT was detected in 31.8% of individuals. The equilibrium threshold value of GA ≥14.8% showed sensitivity of 64.9% and specificity of 65.5% for the diagnosis of DM. The AUC for GA [0.703 (95% CI 0.631–0.775)] was lower than for HbA1c [0.802 (95% CI 0.740–0.864)], p = 0.028. A GA value of 16.8% had similar accuracy for detecting DM as defined by HbA1c ≥6.5% (48 mmol/mol) with sensitivity of 31.2% and specificity of 93.3% for both tests. However, GA detects different subjects from those detected by HbA1c and OGTT.

Conclusions

GA detected different individuals with DM from those detected by HbA1c, though it showed overall diagnostic accuracy similar to HbA1c in the diagnosis of DM. Therefore, GA should be used as an additional test rather than an alternative to HbA1c or OGTT and its use as the sole DM diagnostic test should be interpreted with caution.

Klíčová slova:

Albumins – Blood plasma – Diabetes diagnosis and management – Glucose tolerance tests – Cholesterol – Oral glucose suppression test


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2019 Číslo 12