In gastrectomized subjects, oral glucose tolerance test often shows marked hyperglycaemia (oxyhyperglycaemia) after glucose loading. Because serum glycated albumin (GA) has been shown to better reflect postprandial and maximum plasma glucose levels, we investigated whether or not the clinical significance of serum GA and glycated haemoglobin (HbA(1C)) in non-diabetic gastrectomized subjects differs.
During health examinations, 62 non-diabetic subjects with a history of gastrectomy and 87 non-diabetic control subjects were selected in the present study. Body mass index (BMI) in the gastrectomy group was significantly lower than in the control group.
Fasting plasma glucose levels were significantly lower in the gastrectomized subjects than in the control subjects. Although both HbA(1C) and serum GA were significantly higher in the gastrectomized subjects, there was a significant difference in GA/HbA(1C) ratio between the gastrectomized subjects and the control subjects. BMI-adjusted serum GA, based on our previous finding of inverse influence of BMI on serum GA, was also significantly higher in the gastrectomized subjects than in the controls.
Serum GA is higher relative to HbA(1C) in gastrectomized subjects. This suggests that serum GA may be a better marker than HbA(1C) for glycaemic excursion in these subjects.
"Therefore, that GA/A1c ratio increased along with higher A1c may be attributable to more marked increases in GA levels than A1c levels in subjects with poorly controlled diabetes. Even among similar A1c levels, GA better reflected postprandial hyperglycemia [6,33,45], which is mainly caused by inadequate or dysfunctional endogenous insulin secretion. Koga et al.  measured GA and A1c in type 1 and 2 diabetes and found that the GA/A1c ratio was significantly higher in type 1 diabetic patients, in which glucose levels fluctuate over wider ranges, than in type 2 diabetic patients. "
[Show abstract][Hide abstract] ABSTRACT: The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein.
[Show abstract][Hide abstract] ABSTRACT: L’albumina è una proteina di notevole importanza nella fisiologia dell’organismo e alterazioni nella sua struttura e funzione possono avere rilevanti ripercussioni fisiopatologiche. è quanto accade in seguito a processi di glicossidazione che portano alla formazione dell’albumina glicata in concentrazioni elevate in caso di iperglicemia cronica o di picchi iperglicemici rilevanti. L’albumina glicata si presenta quindi non solo come un indice di controllo della malattia diabetica, ma anche come un vero e proprio fattore patogenetico. E in non poche e non poco importanti condizioni il suo utilizzo può risultare più vantaggioso della stessa emoglobina glicata. Tuttavia, a causa dei limiti iniziali di specificità delle tecniche impiegate per misurare genericamente le fruttosamine (l’insieme delle proteine glicate circolanti), e a causa del persistere di una certa confusione tra fruttosamina e albumina glicata, la determinazione di quest’ultima non ha goduto dello stesso successo dell’emoglobina glicata. In verità, con le metodiche più recenti la misurazione dell’albumina glicata nel plasma umano è divenuta sufficientemente precisa e accurata, nonchè semplice ed economica da eseguire. I risultati che stanno emergendo negli ultimi anni in merito ai progressi analitici e alle applicazioni cliniche dell’albumina glicata porteranno probabilmente nel prossimo futuro a una richiesta sempre maggiore, nell’ottica della crescente attenzione all’appropriatezza in laboratorio.
Rivista Italiana della Medicina di Laboratorio 06/2012; 8(2). DOI:10.1007/s13631-012-0045-0
[Show abstract][Hide abstract] ABSTRACT: It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Currently, among these glycated proteins, glycated hemoglobin (HbA(1C)) is used as the gold standard index of glycemic control in clinical practice for diabetes treatment. However, HbA(1C) does not accurately reflect the actual status of glycemic control in some conditions where plasma glucose changes during short term, and in patients who have diseases such as anemia and variant hemoglobin. In comparison, another index of glycemic control, glycated albumin (GA), more accurately reflects changes in plasma glucose during short term and also postprandial plasma glucose. Although GA is not influenced by disorders of hemoglobin metabolism, it is affected by disorders of albumin metabolism. This review summarizes diseases and pathological conditions where GA measurement is useful. These include the status of glycemic control changes during short term, diseases which cause postprandial hyperglycemia, iron deficiency anemia, pregnancy, chronic liver disease (liver cirrhosis), chronic renal failure (diabetic nephropathy), and variant hemoglobin.
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