Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2021; 12(2): 149-157
Published online Feb 15, 2021. doi: 10.4239/wjd.v12.i2.149
Use of glycated albumin for the identification of diabetes in subjects from northeast China
Guo-Yan Li, Hao-Yu Li, Qiang Li
Guo-Yan Li, Qiang Li, Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin 150080, Heilongjiang Province, China
Hao-Yu Li, Faculty of Population Health Sciences, University College London, London WC1E 6BT, United Kingdom
Author contributions: Li GY designed the study, collected the routine blood samples, contributed to the study design, and wrote the manuscript; Li HY analyzed the data; Li Q made critical revisions to the article for important intellectual content; All authors discussed the results and approved the final version of the manuscript.
Supported by Youth Fund Project of the Second Affiliated Hospital of Harbin Medical University, No. QN2010-20.
Institutional review board statement: The study was reviewed and approved by the Second Affiliated Hospital of Harbin Medical University Institutional Review Board (Approval No. KY2019-020).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at qiangli1964@126.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Li, PhD, Professor, Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin 150080, Heilongjiang Province, China. qiangli1964@126.com
Received: November 19, 2020
Peer-review started: November 19, 2020
First decision: November 30, 2020
Revised: December 10, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: February 15, 2021
Abstract
BACKGROUND

Metabolic memory is important for the diagnosis and treatment of diabetes in the early stage, and in maintaining blood glucose concentrations within the normal range. The clinical diagnosis of diabetes mellitus is currently made using fasting plasma glucose, 2 h-plasma glucose (2h-PG) during a 75 g oral glucose tolerance test, and hemoglobin A1c (HbA1c) level. However, the fasting plasma glucose test requires fasting, which is a barrier to screening, and reproducibility of the 2h-PG level is poor. HbA1c is affected by a shortened red blood cell lifespan. In patients with anemia and hemoglobinopathies, the measured HbA1c levels may be inaccurate. Compared with HbA1c, glycated albumin (GA) is characterized by more rapid and greater changes, and can be used to diagnose new-onset diabetes especially if urgent early treatment is required, for example in gestational diabetes. In this study, we provided cutoff values for GA and evaluated its utility as a screening and diagnostic tool for diabetes in a large high-risk group study.

AIM

To evaluate the utility of GA in identifying subjects with diabetes in northeast China, and to assess the diagnostic accuracy of the proposed GA cutoff in the diagnosis of diabetes mellitus.

METHODS

This cross-sectional study included 1935 subjects, with suspected diabetes or in high-risk groups, from 2014 to 2015 in the Second Affiliated Hospital of Harbin Medical University (Harbin, China). The use of GA to identify diabetes was investigated using the area under the receiver operating characteristic curve (AUC). The GA cutoffs were derived from different 2h-PG values with hemoglobin A1c cutoffs used as a calibration curve.

RESULTS

The GA cutoff for the diagnosis of diabetes mellitus was 15.15% from the receiver operating characteristic (ROC) curve. ROC analysis demonstrated that GA was an efficient marker for detecting diabetes, with an AUC of 90.3%.

CONCLUSION

Our study supports the use of GA as a biomarker for the diagnosis of diabetes.

Keywords: Glycated albumin, Receiver operating characteristic, Cut-off, Hemoglobin A1c, Diagnosis, Diabetes mellitus

Core Tip: Our study supports the use of glycated albumin (GA) as a biomarker for the diagnosis of diabetes. The GA cutoff for the diagnosis of diabetes mellitus was 15.15% from the receiver operating characteristic (ROC) curve. ROC analysis demonstrated that GA was an efficient marker for detecting diabetes, with an area under the ROC curve of 90.3%.