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Takebayashi K, Yamauchi M, Hara K, Tsuchiya T, Hashimoto K. Association of the Ratio of Glycoalbumin to Hemoglobin A1c With Season Change and the COVID-19 Pandemic in Patients With Type 2 Diabetes Mellitus. Cureus 2024; 16:e64444. [PMID: 39007025 PMCID: PMC11245681 DOI: 10.7759/cureus.64444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 07/16/2024] Open
Abstract
AIM The main purpose of the current study was to investigate the effect of season change and the influence of the COVID-19 pandemic on the ratio of glycoalbumin to hemoglobin A1c (GA/HbA1c) in patients with type 2 diabetes. PATIENTS AND METHODS A total of 267 patients in whom both HbA1c and GA were measured at baseline were included in this retrospective study. GA/HbA1c was investigated for three years, 2018, 2019, and 2020 (COVID-19 pandemic period). RESULTS The mean values for GA/HbA1c per year in 2018, 2019, and 2020 were 2.64±0.35, 2.61±0.35, 2.64±0.39, respectively. There were no significant differences in GA/HbA1c during these years. There was a tendency toward seasonal variation in GA/HbA1c (i.e., higher in summer or autumn and lower in spring or winter). CONCLUSION In patients with type 2 diabetes, GA/HbA1c tended to show seasonal variation, which was not influenced by the COVID-19 pandemic.
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Affiliation(s)
- Kohzo Takebayashi
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN
| | - Mototaka Yamauchi
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN
| | - Kenji Hara
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN
| | - Takafumi Tsuchiya
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN
| | - Koshi Hashimoto
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN
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2
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Shiren Y, Jiangnan Y, Xinhua Y, Xinye N. Interpretable prediction model for assessing diabetes complication risks in Chinese sufferers. Diabetes Res Clin Pract 2024; 209:111560. [PMID: 38316188 DOI: 10.1016/j.diabres.2024.111560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/10/2024] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Abstract
AIMS With growing concerns over complications in diabetes sufferers, this study sought to develop an interpretable machine learning model to offer enhanced diagnostic and treatment recommendations. METHODS We assessed coronary heart disease, diabetic nephropathy, diabetic retinopathy, and fatty liver disease using logistic regression, decision tree, random forest, and CatBoost algorithms. The SHAP algorithm was employed to elucidate the model's predictions, offering a more in-depth understanding of influential features. RESULTS The CatBoost model notably outperformed other algorithms in AUC, achieving an average AUC of 90.47 % for the four complications. Through SHAP analysis and visualization, we provided clear and actionable insights into risk factors, enabling better complication risk assessment. CONCLUSIONS We introduced an innovative, interpretable complication risk model for people with diabetes. This not only offers a potent tool for healthcare professionals but also empowers sufferers with clearer self-assessment capabilities, encouraging earlier preventive actions. Further studies will underscore the model's clinical applicability.
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Affiliation(s)
- Ye Shiren
- School of Computer and Artificial Intelligence, Changzhou University, Changzhou, China.
| | - Ye Jiangnan
- School of Computer and Artificial Intelligence, Changzhou University, Changzhou, China
| | - Ye Xinhua
- Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, China
| | - Ni Xinye
- Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, China
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3
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Choi YJ, Lee NY, Ahn MB, Kim SH, Cho WK, Cho KS, Jung MH, Suh BK. Usefulness of glycated albumin level as a glycemic index complementing glycosylated hemoglobin in diabetic children and adolescents. Ann Pediatr Endocrinol Metab 2023; 28:289-295. [PMID: 38173383 PMCID: PMC10765020 DOI: 10.6065/apem.2244202.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Glycated albumin (GA) is a glycemic marker reflecting the average serum glucose of the previous 2 weeks. This study aimed to evaluate the usefulness of GA as a glycemic index to complement glycosylated hemoglobin (HbA1c) in children and adolescents. METHODS Fifty-four children and adolescents with diabetes mellitus (DM) and 97 children and adolescents without DM (NDM) were enrolled. The correlation between mean blood glucose (MG) and GA compared to HbA1c was investigated in the DM group. The correlation between fasting glucose (FG) and GA compared to HbA1c was investigated in the NDM group. Factors affecting GA, HbA1c, and GA/HbA1c were analyzed. RESULTS In the DM group, positive correlations were observed between MG and GA (P=0.003), between MG and HbA1c (P=0.001), and between GA and HbA1c (P<0.001). The correlation coefficient between MG and GA did not differ from that between MG and HbA1c in the DM group (P=0.811). Among patients with DM, those whose standardized body mass index standard deviation score (BMI SDS) was ≥2 had a lower GA/HbA1c compared with those whose BMI SDS was <2 (P=0.001). In the NDM group, there were no significant correlations between FG and GA, between FG and HbA1c, or between GA and HbA1c. The NDM subjects whose BMI SDS was ≥2 had a lower GA/HbA1c than did the NDM subjects whose BMI SDS was <2 (P=0.003). CONCLUSION GA is comparable with HbA1c in reflecting glycemic control in children and adolescents with DM. GA is affected by obesity in children and adolescents with or without DM.
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Affiliation(s)
- Young Ju Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Na Yeong Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shin Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Soon Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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4
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Wang Y, Pang X, Gu C, Li C, Li B, Zhou C, Chen H, Zheng Z. Different associations of anthropometric indices with diabetic retinopathy and diabetic kidney disease in chinese patients with type 2 diabetes mellitus. Acta Diabetol 2023; 60:1187-1198. [PMID: 37179497 DOI: 10.1007/s00592-023-02111-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
AIMS To investigate the associations of anthropometric indices, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist circumference (WC) and hip circumference (HC), with diabetic retinopathy (DR) and diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS This cross-sectional study evaluated 5226 Chinese participants with T2DM at three hospitals between 2005 and 2016. Logistic regression models and restricted cubic spline analysis were used to assess the associations of anthropometric indices with DR and DKD. RESULTS A BMI of around 25 kg/m2 was related to a low risk of DR (OR based on the third fifth: 0.752, 95%CI: 0.615-0.920). Besides, HC had an inverse association with DR in men independently of BMI (OR based on the highest fifth: 0.495, 95%CI: 0.350-0.697). In the restricted cubic spline models, BMI, WHtR, WC, and HC showed J-shaped associations with DKD, while WHR showed an S-shaped association with DKD. Compared to the lowest fifth, the odds ratios (OR) based on the highest fifth of BMI, WHR, WHtR, WC and HC for DKD were 1.927 (1.572-2.366), 1.566 (1.277-1.923), 1.910 (1.554-2.351), 1.624 (1.312-2.012) and 1.585 (1.300-1.937) respectively in multivariable models. CONCLUSIONS A median BMI and a large hip might be related to a low risk of DR, while lower levels of all the anthropometric indices were associated with a lower risk of DKD. Our findings suggested maintain a median BMI, a low WHR, a low WHtR and a large hip for prevention of DR and DKD.
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Affiliation(s)
- Yujie Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
| | - Xin Pang
- Department of Ophthalmology, Haiyan County People's Hospital, No.901 Yanhu West Road, Wuyuan Street, Haiyan County, Jiaxing, Zhejiang Province, China
| | - Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
| | - Chenxin Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
| | - Bo Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
| | - Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
| | - Haibing Chen
- Department of Endocrinology and Metabolism, Shanghai 10th People's Hospital, Tongji University, No.301 Yanan Zhong Road, Shanghai, China.
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.
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5
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Chaurasiya A, Jaiswal MR, Bayatigeri S, Kahar S, Tiwari S, Unnikrishnan AG, Kulkarni MJ. Elevated Level of Glycated KQTALVELVK Peptide of Albumin Is Associated with the Risk of Diabetic Nephropathy. ACS OMEGA 2023; 8:20654-20660. [PMID: 37332825 PMCID: PMC10268606 DOI: 10.1021/acsomega.3c01219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/31/2023] [Indexed: 06/20/2023]
Abstract
Diabetic nephropathy is a leading cause of end-stage renal disease. Hence, early detection of diabetic nephropathy is essential to mitigate the disease burden. Microalbuminuria, the currently used diagnostic marker of diabetic nephropathy, is not efficient in detecting it at an early stage. Therefore, we explored the utility of glycated human serum albumin (HSA) peptides for risk prediction of diabetic nephropathy. Three glycation-sensitive HSA peptides, namely, FKDLGEENFK, KQTALVELVK, and KVPQVSTPTLVEVSR, with deoxyfructosyllysine (DFL) modification were quantified by targeted mass spectrometry (MS) in a study population comprising healthy and type II diabetes subjects with and without nephropathy. Mass spectrometry, receiver operating characteristic (ROC) curve, and correlation analysis revealed that the DFL-modified KQTALVELVK peptide was better than other glycated HSA peptides and HbA1c for identifying diabetic nephropathy. DFL-modified KQTALVELVK could be a potential marker for risk prediction of diabetic nephropathy.
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Affiliation(s)
- Arvindkumar
H. Chaurasiya
- Biochemical
Sciences Division, CSIR-National Chemical
Laboratory, Pune 411008, India
- Academy
of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Meera R. Jaiswal
- Biochemical
Sciences Division, CSIR-National Chemical
Laboratory, Pune 411008, India
- Academy
of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Santhakumari Bayatigeri
- Academy
of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- Center
for Materials Characterization, CSIR-National
Chemical Laboratory, Pune 411008, India
| | - Shweta Kahar
- Department
of Diabetes and Endocrine Research, Chellaram
Diabetes Institute, Pune 411021, India
| | - Shalbha Tiwari
- Department
of Diabetes and Endocrine Research, Chellaram
Diabetes Institute, Pune 411021, India
| | - Ambika G. Unnikrishnan
- Department
of Diabetes and Endocrine Research, Chellaram
Diabetes Institute, Pune 411021, India
| | - Mahesh J. Kulkarni
- Biochemical
Sciences Division, CSIR-National Chemical
Laboratory, Pune 411008, India
- Academy
of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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6
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Shin A, Connolly S, Kabytaev K. Protein glycation in diabetes mellitus. Adv Clin Chem 2023; 113:101-156. [PMID: 36858645 DOI: 10.1016/bs.acc.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Diabetes mellitus is the ninth leading cause of mortality worldwide. It is a complex disease that manifests as chronic hyperglycemia. Glucose exposure causes biochemical changes at the proteome level as reflected in accumulation of glycated proteins. A prominent example is hemoglobin A1c (HbA1c), a glycated protein widely accepted as a diabetic indicator. Another emerging biomarker is glycated albumin which has demonstrated utility in situations where HbA1c cannot be used. Other proteins undergo glycation as well thus impacting cellular function, transport and immune response. Accordingly, these glycated counterparts may serve as predictors for diabetic complications and thus warrant further inquiry. Fortunately, modern proteomics has provided unique analytic capability to enable improved and more comprehensive exploration of glycating agents and glycated proteins. This review broadly covers topics from epidemiology of diabetes to modern analytical tools such as mass spectrometry to facilitate a better understanding of diabetes pathophysiology. This serves as an attempt to connect clinically relevant questions with findings of recent proteomic studies to suggest future avenues of diabetes research.
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Affiliation(s)
- Aleks Shin
- Department of Pathology & Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Shawn Connolly
- Department of Pathology & Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Kuanysh Kabytaev
- Department of Pathology & Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO, United States.
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7
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Wang S, Gu L, Zhu J, Shan T, Sun J, Jiang Q, Wang H, Zhao D, Wang Q, Wang L. Association of glycated albumin to hemoglobin A1c ratio with all-cause and cardiovascular mortality among US adults: A population-based cohort study. Diabetes Res Clin Pract 2022; 193:110116. [PMID: 36240956 DOI: 10.1016/j.diabres.2022.110116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022]
Abstract
AIMS To investigate the association of glycated albumin to hemoglobin A1c (GA/HbA1c) ratio, an indicator of blood glucose fluctuations, with all-cause and cardiovascular mortality among US adults. METHODS This cohort study used data from the National Health and Nutrition Examination Survey 1999-2004. Participants were linked to National Death Index mortality data through December 31, 2015. Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), and restricted cubic spline (RCS) regression was conducted. RESULTS A total of 11,508 US adults (weighted mean age, 43.9 years; 5748 males [weighted, 48.9 %]) were included. During a median follow‑up of 13.6 years, 1963 total deaths occurred, including 383 cardiovascular deaths. After multivariable adjustments, a higher GA/HbA1c ratio was associated with a higher risk of all-cause (tertiles: P for trend < 0.001; continuous: HR 1.49 [95 % CI 1.32-1.69]) and cardiovascular (tertiles: P for trend = 0.048; continuous: HR 1.65 [95 % CI 1.27-2.14]) mortality. RCS revealed a linear relationship of GA/HbA1c ratio to mortality. CONCLUSIONS In the nationally representative cohort of US adults, GA/HbA1c ratio was significantly associated with the risk of all-cause and cardiovascular mortality. These findings suggest that GA/HbA1c ratio may serve as an effective indicator for identifying high-risk individuals.
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Affiliation(s)
- Sibo Wang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Lingfeng Gu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Jun Zhu
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China; Department of Cardiology, Geriatrics Hospital of Jiangsu Province, Nanjing 210024, China
| | - Tiankai Shan
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Jiateng Sun
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Qiqi Jiang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Hao Wang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Di Zhao
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
| | - Qiming Wang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China.
| | - Liansheng Wang
- Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China.
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8
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Zhang L, Zhang Q. Glycated Plasma Proteins as More Sensitive Markers for Glycemic Control in Type 1 Diabetes. Proteomics Clin Appl 2020; 14:e1900104. [PMID: 31868294 DOI: 10.1002/prca.201900104] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/08/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Glycated hemoglobin (HbA1c) is used clinically for diagnosis and therapeutic management of diabetes. However, HbA1c reflects average blood glucose level over a long period. The aim of this study is to look for short period, more sensitive protein markers that correlate better with glycemic level. EXPERIMENTAL DESIGN The glycated proteome of human plasma from type 1 diabetic individuals with good and poor (n = 20 each) glycemic control are analyzed using an online two-dimensional proteomics approach. Selected glycated peptides are further validated for their potential as candidate biomarkers using parallel reaction monitoring. RESULTS 305 glycated peptides are quantified and 290 are significantly increased in samples with poor glycemic control. 76 of the 88 selected glycated peptides have receiver operating characteristic area under curve (AUC) values greater than 0.8. Six validated glycated peptides with high AUC show high correlation with HbA1c and have higher fold changes between poor and good glycemic control than HbA1c. The parent proteins have half-lives shorter than HbA1c. CONCLUSIONS AND CLINICAL RELEVANCE Using an advanced proteomics platform for protein glycation analysis, glycated peptides and proteins are identified that are promising as more sensitive, shorter term indicators of glycemic control in diabetic patients than the commonly used HbA1c.
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Affiliation(s)
- Lina Zhang
- Center for Translational Biomedical Research, University of North Carolina at Greensboro, North Carolina Research Campus, Kannapolis, NC, 28081, USA.,State Key Laboratory of Food Science & Technology, Jiangnan University, Wuxi, 214122, Jiangsu Province, China
| | - Qibin Zhang
- Center for Translational Biomedical Research, University of North Carolina at Greensboro, North Carolina Research Campus, Kannapolis, NC, 28081, USA.,Department of Chemistry & Biochemistry, University of North Carolina at Greensboro, Greensboro, NC, 27412, USA
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9
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Milutinovic M, Velickovic Radovanovic R, Savikin K, Radenkovic S, Arvandi M, Pesic M, Kostic M, Miladinovic B, Brankovic S, Kitic D. Chokeberry juice supplementation in type 2 diabetic patients - impact on health status. J Appl Biomed 2019; 17:218-224. [PMID: 34907720 DOI: 10.32725/jab.2019.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/04/2019] [Indexed: 12/12/2022] Open
Abstract
Recent literature evidence indicates the potential use of chokeberry preparations in the prevention and treatment of some chronic noncommunicable diseases. The aim of the present study was to evaluate the effects of the three months oral chokeberry juice supplementation in type 2 diabetic patients, as well as its influence on hematological parameters and certain parameters of the renal dysfunction. The study was designed as an open-label trial, which included 35 patients who have received the herbal supplement, polyphenol-rich chokeberry juice (150 ml/day, three times a day for 50 ml), in addition to their standard therapy. Chokeberry juice as a rich source of polyphenol compounds could be an effective preventive and therapeutic agent in diabetes mellitus type 2. Hematological and biochemical parameters were measured at baseline, after 3 months with the chokeberry juice supplementation and after the next 3 months without the chokeberry juice supplementation (follow-up period). Significant difference was noticed in the levels of LDL-cholesterol, glycated hemoglobin and serum creatinine (p < 0.05), as well as in the levels of some hematological parameters, such as white blood cell and lymphocyte count (p < 0.01), hematocrit, blood hemoglobin, mean corpuscular volume, hemoglobin and hemoglobin concentration and red blood cell count (p < 0.05). The daily consumption of the chokeberry juice could improve the health status in patients with type 2 diabetes mellitus, in combination with their standard therapy.
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Affiliation(s)
- Milica Milutinovic
- University of Nis, Faculty of Medicine, Department of Pharmacy, Nis, Serbia
| | - Radmila Velickovic Radovanovic
- University of Nis, Faculty of Medicine, Department of Pharmacology, Nis, Serbia.,Clinical Center Nis, Clinic of Nephrology, Nis, Serbia
| | - Katarina Savikin
- Institute for Medicinal Plants Research "Dr. Josif Pancic", Belgrade, Serbia
| | - Sasa Radenkovic
- University of Nis, Faculty of Medicine, Department of Internal Medicine, Nis, Serbia.,Clinical Center Nis, Clinic of Endocrinology, Diabetes and Metabolic Disorders, Nis, Serbia
| | - Marjan Arvandi
- Institute of Public Health, Medical Decision Making, and Health Technology Assessment, UMIT, Hall in Tirol, Austria
| | - Milica Pesic
- University of Nis, Faculty of Medicine, Department of Internal Medicine, Nis, Serbia.,Clinical Center Nis, Clinic of Endocrinology, Diabetes and Metabolic Disorders, Nis, Serbia
| | - Milica Kostic
- University of Nis, Faculty of Medicine, Department of Pharmacy, Nis, Serbia
| | - Bojana Miladinovic
- University of Nis, Faculty of Medicine, Department of Pharmacy, Nis, Serbia
| | - Suzana Brankovic
- University of Nis, Faculty of Medicine, Department of Physiology, Nis, Serbia
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10
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Lee MY, Hsu WH, Lai CW, Chen SC, Liang CC. The association between glycated albumin, glycohemoglobin, and glycated albumin to glycohemoglobin ratio in diabetic retinopathy of prediabetes. Kaohsiung J Med Sci 2019; 35:695-701. [PMID: 31483568 DOI: 10.1002/kjm2.12125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 07/31/2019] [Indexed: 01/14/2023] Open
Abstract
Prediabetes increased risk of diabetes and diabetes-related macrovascular and microvascular complication. Glycohemoglobin (HbA1c ) is clinically used as the gold standard for glycemic control of diabetes. Glycated albumin (GA) is an early Amadori-type glycation protein between glucose and serum albumin, which changes in a shorter period of time than HbA1c and is superior to HbA1c in reflecting fluctuations in blood glucose. In this study, we aim to assess the predictive value of GA and glycohemoglobin (HbA1c) on a progression of diabetic retinopathy (DR) in prediabetic patients in Taiwan. This study was conducted at the outpatient department of a regional hospital in Southern Taiwan, and recruited 291 patients with prediabetes from January 2016 to February 2017. Blood and urine samples were obtained from all patients after fasting for 12 hours within 1 month of enrollment. The mean age is 62.5 ± 13.0 years and there are 161 males and 130 females. A total of 24.1% of patients have DR. The average value of GA and HbA1c are 14.6% ± 2.8% and 6.0% ± 0.4%, respectively. Old age, male, high systolic blood pressure, high HbA1C , and low total cholesterol are significantly associated with DR in patients with pre-DM. Therefore, in the prediabetic populations, high HbA1C, but not GA nor GA/HbA1C ratio, is significantly associated with DR.
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Affiliation(s)
- Mei-Yueh Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Hao Hsu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chia-Wei Lai
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Ching-Chao Liang
- Department of Laboratory Technology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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11
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Xu Y, Ma X, Shen Y, Wang Y, Zhou J, Bao Y. Increasing waist circumference is associated with decreased levels of glycated albumin. Clin Chim Acta 2019; 495:118-122. [PMID: 30946814 DOI: 10.1016/j.cca.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/13/2019] [Accepted: 04/01/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Glycated albumin (GA) levels are affected by body fat and its distribution. We explored the association of waist circumference (WC) with GA and to assess the extent to which WC influences GA. METHODS We recruited 1799 subjects (age 26-82 y) from communities. GA was determined using the enzyme method, and glycated hemoglobin A1c (HbA1c) was detected using high-performance liquid chromatography. RESULTS Subjects with central obesity had lower GA and GA/HbA1c than those without (both P < .01). GA and GA/HbA1c were negatively correlated with central obesity (both P < .01), whereas HbA1c was not correlated (P = .833). In the euglycemic and hyperglycemic subpopulations, GA and GA/HbA1c showed decreasing trends as WC levels increased (both P for trends <0.01). WC was a significant negative determinant of GA (P < .05). In the hyperglycemic subpopulation, the GA value decreased by approximately 0.15% for each 5 cm increment in WC regardless of the presence of central obesity. CONCLUSIONS The GA value was reduced by approximately 0.15% for each 5 cm increment in WC, suggesting that more attention should be paid to actual blood glucose underestimated by GA in obese people.
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Affiliation(s)
- Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
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12
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Sueud T, Hadi NR, Abdulameer R, Jamil DA, Al-Aubaidy HA. Assessing urinary levels of IL-18, NGAL and albumin creatinine ratio in patients with diabetic nephropathy. Diabetes Metab Syndr 2019; 13:564-568. [PMID: 30641767 DOI: 10.1016/j.dsx.2018.11.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/02/2018] [Indexed: 01/05/2023]
Abstract
AIMS Diabetic nephropathy (DN) is a serious microvascular complication of a longstanding hyperglycemia. This study aims to evaluate whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary Interleukin-18 possess a better diagnostic value than albumin creatinine ratio in assessing the severity of nephropathy in patients with type 2 diabetes mellitus (T2DM). MATERIAL & METHODS Ninety participants diagnosed with T2DM were recruited and they were divided into three study groups according to their albumin/creatinine ratio (ACR): (Normoalbuminuria group, Microalbuminuria group, and Macroalbuminuria group). A matching of Ninety healthy subjects were included as controls. Blood and urine samples were collected to measure various markers of glycemic control and kidney function. RESULTS IL-18 levels were not changed significantly between all study groups (P > 0.05), despite a significant positive correlation between IL-18 and urinary albumin levels. NGAL levels were significantly increased in Microalbuminuria group and Macroalbuminuria group as compared to the control and Normoalbuminuria groups. NGAL was also positively correlated with urinary albumin and ACR, but negatively correlated with the age and body mass index. Receiver Operating Characteristic curves revealed that for early detection of DN, the best cutoff values to discriminate DN and diabetic without nephropathy groups were ˃ 21.4 ng/ml for NGAL (94.67 sensitivity, 26.67% specificity), ≤0.34 pg/mL for IL-18 (72% sensitivity, 53.33% specificity), and ˃29.8 mg/g for ACR (80% sensitivity, 100% specificity). CONCLUSION We conclude that the urinary ACR is a more accurate individual biomarker of DN when compared to both NGAL and IL-18.
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Affiliation(s)
- Taqwaa Sueud
- Faculty of Medicine, University of Kufa, Al-Najaf, Iraq
| | - Najah R Hadi
- Faculty of Medicine, University of Kufa, Al-Najaf, Iraq
| | | | - Dina A Jamil
- School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Hayder A Al-Aubaidy
- School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia; School of Life Sciences, La Trobe University, Bundoora, VIC, 3086, Australia.
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13
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Gan T, Liao B, Xu G. The clinical usefulness of glycated albumin in patients with diabetes and chronic kidney disease: Progress and challenges. J Diabetes Complications 2018; 32:876-884. [PMID: 30049445 DOI: 10.1016/j.jdiacomp.2018.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/25/2018] [Accepted: 07/07/2018] [Indexed: 12/12/2022]
Abstract
Prolonged hyperglycemia leads to a non-enzymatic glycation of proteins, and produces Amadori products, such as glycated albumin (GA) and glycated hemoglobin (HbA1c). The utility of HbA1c in the setting of chronic kidney disease (CKD) may be problematic since altered lifespan of red blood cells, use of iron and/or erythropoietin therapy, uremia and so on. Therefore, as an alternative marker, GA has been suggested as a more reliable and sensitive glycemic index in patients with CKD. In addition to the mean plasma glucose concentration, GA also reflects postprandial plasma glucose and glycemic excursion. Besides, with a half-life of approximately 2-3 weeks, GA may reflect the status of blood glucose more rapidly than HbA1c. GA is also an early precursor of advanced glycation end products (AGEs), which cause alterations in various cellular proteins and organelles. Thus, high GA levels may correlate with adverse outcomes of patients with CKD. In this review, the clinical usefulness of GA was discussed, including a comparison of GA with HbA1c, the utility and limitations of GA as a glycemic index, its potential role in pathogenesis of diabetic nephropathy and the correlations between GA levels and outcomes, specifically in patients with diabetes and CKD.
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Affiliation(s)
- Ting Gan
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang, China; Grade 2014, the First Clinical Medical College of Nanchang University, Nanchang, China
| | - Baoying Liao
- Grade 2014, the First Clinical Medical College of Nanchang University, Nanchang, China
| | - Gaosi Xu
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
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14
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Garg VK, Goel N, Kashyap D. The explanatory variable age is non-significant in diabetic nephropathy (DN) patients. Clin Biochem 2018; 55:96. [PMID: 29627455 DOI: 10.1016/j.clinbiochem.2018.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 03/29/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Vivek Kumar Garg
- Government Medical College and Hospital, Chandigarh 160030, India.
| | - Neelam Goel
- University Institute of Engineering & Technology, Panjab University, Chandigarh 160014, India
| | - Dharambir Kashyap
- Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
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15
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She J, Deng Y, Wu Y, Xia Y, Li H, Liang X, Shi R, Yuan Z. Hemoglobin A 1c is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty. Cardiovasc Diabetol 2017; 16:97. [PMID: 28789650 PMCID: PMC5549379 DOI: 10.1186/s12933-017-0578-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background Acute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. The underlying mechanism remains elusive and there is a shortage of serum prediction markers. In this study, we investigate the relationship between admission HbA1c and severity of coronary artery stenosis and subsequent prognosis in AMI patients with or without diabetes. Research design and methods We measured admission HbA1c, and vessel scores based on the number of diseased coronary vessels with significant stenosis in 628 patients diagnosed with AMI. Simple and multi-regression analysis were performed to investigate the correlation between HbA1c and the severity of coronary artery stenosis. Major adverse cardiovascular events (MACE), including new-onset myocardial infarction, acute heart failure and cardiac death, were documented during the follow-up. 272 non-DM participants and 137 DM participants were separated into two groups based on HbA1c levels for survival analysis during a 2-year follow up. Results 448 non-DM patients and 180 DM patients were included in the initial observational analysis. 272 non-DM patients and 137 DM patients were included in the follow-up survival analysis. The admission HbA1c level was found to be significantly positively correlated to the number of affected vessels suffering from significant coronary artery stenosis both in DM (R square = 0.012; 95% CI 0.002 to 0.623, P = 0.049) and non DM patients (R square = 0.025; 95% CI 0.009 to 0.289, P = 0.037). Kaplan–Meier survival analysis revealed no significant difference with regard to different HbA1c levels either in DM or non-DM patients at the end of follow-up. Conclusions In patients with AMI, admission HbA1c is an important predictor for the severity of coronary artery stenosis in non-DM and DM patients. Further studies are needed to determine whether longer term follow-up could further identify the prognosis effect of HbA1c on MACE.
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Affiliation(s)
- Jianqing She
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Yangyang Deng
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Yue Wu
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Yulong Xia
- Cardiovascular Department, First Affiliated Hospital of Beijing University, Beijing, 100005, People's Republic of China
| | - Hongbing Li
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Xiao Liang
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Rui Shi
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China
| | - Zuyi Yuan
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710048, People's Republic of China. .,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710048, People's Republic of China.
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