Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;10(4):276-285.
doi: 10.1111/1753-0407.12618. Epub 2017 Dec 21.

Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: Results from the Atherosclerosis Risk in Communities Study

Molly Jung  1 , Bethany Warren  1 , Morgan Grams  1   2 , Yuenting D Kwong  3 , Tariq Shafi  1   2 , Josef Coresh  1 , Casey M Rebholz  1 , Elizabeth Selvin  1   2
Affiliations

Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: Results from the Atherosclerosis Risk in Communities Study

Molly Jung et al. J Diabetes. 2018 Apr.

Abstract

Background: In people with chronic kidney disease (CKD), HbA1c may be a problematic measure of glycemic control. Glycated albumin and fructosamine have been proposed as better markers of hyperglycemia in CKD. In the present study we investigated associations of HbA1c, glycated albumin, and fructosamine with fasting glucose by CKD categories.

Methods: A cross-sectional analysis was performed of 1665 Atherosclerosis Risk in Communities Study participants with diagnosed diabetes aged ≥65 years. Spearman's rank correlations (r) were compared and Deming regression was used to obtain root mean square errors (RMSEs) for the associations across CKD categories defined using estimated glomerular filtration rate and urine albumin:creatinine ratio.

Results: Correlations of HbA1c, glycated albumin, and fructosamine with fasting glucose were lowest in people with severe CKD (HbA1c r = 0.52, RMSE = 0.91; glycated albumin r = 0.39, RMSE = 1.89; fructosamine r = 0.41, RMSE = 1.87) and very severe CKD (r = 0.48 and RMSE = 1.01 for HbA1c; r = 0.36 and RMSE = 2.14 for glycated albumin; r = 0.36 and RMSE = 2.22 for fructosamine). Associations of glycated albumin and fructosamine with HbA1c were relatively similar across CKD categories.

Conclusions: In older adults with severe or very severe CKD, HbA1c, glycated albumin, and fructosamine were not highly correlated with fasting glucose. The results suggest there may be no particular advantage of glycated albumin or fructosamine over HbA1c for monitoring glycemic control in CKD.

Keywords: biomarkers; chronic kidney disease; epidemiology; older adults; 慢性肾脏疾病; 流行病学; 生物标志物; 老年人.

PubMed Disclaimer

Conflict of interest statement

Disclosure. No potential conflicts of interest relevant for this article were reported.

Figures

Figure 1
Figure 1
Scatterplots of HbA1c, glycated albumin, and fructosamine with fasting glucose or HbA1c by CKD categories Solid black line is the Deming linear regression (Table 2); dashed line is the Lowess line. Note: Chronic kidney disease staging was done using the KDIGO 2012 guidelines with eGFR and albumin-to-creatinine ratio.
Figure 1
Figure 1
Scatterplots of HbA1c, glycated albumin, and fructosamine with fasting glucose or HbA1c by CKD categories Solid black line is the Deming linear regression (Table 2); dashed line is the Lowess line. Note: Chronic kidney disease staging was done using the KDIGO 2012 guidelines with eGFR and albumin-to-creatinine ratio.
Figure 1
Figure 1
Scatterplots of HbA1c, glycated albumin, and fructosamine with fasting glucose or HbA1c by CKD categories Solid black line is the Deming linear regression (Table 2); dashed line is the Lowess line. Note: Chronic kidney disease staging was done using the KDIGO 2012 guidelines with eGFR and albumin-to-creatinine ratio.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Chronic Kidney Disease Fact Sheet: General Information and National Estimates on Chronic Kidney Disease in the United States, 2010. 2010.
    1. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014;9(1):e84943. - PMC - PubMed
    1. Little RR, Tennil ALW, England JD, et al. Can glycohemoglobin (GHB) be used to accurately assess glycemic control in patients with chronic renal failure (CRF)? Diabetes. 1999;48(5):SA84–SA84.
    1. Inaba M, Okuno S, Kumeda Y, et al. Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol. 2007;18(3):896–903. - PubMed
    1. Vos FE, Schollum JB, Walker RJ. Glycated albumin is the preferred marker for assessing glycaemic control in advanced chronic kidney disease. NDT Plus. 2011;4(6):368–375. - PMC - PubMed

MeSH terms