Associations of body mass index with glycated albumin and glycated albumin/glycated hemoglobin A1c ratio in Chinese diabetic and non-diabetic populations

Xingxing He; Yifei Mo; Xiaojing Ma; Lingwen Ying; Wei Zhu; Yufei Wang; Yuqian Bao; Jian Zhou

doi:10.1016/j.cca.2018.05.044

Associations of body mass index with glycated albumin and glycated albumin/glycated hemoglobin A_1c ratio in Chinese diabetic and non-diabetic populations

Clin Chim Acta. 2018 Sep:484:117-121. doi: 10.1016/j.cca.2018.05.044. Epub 2018 May 24.

Authors

Xingxing He¹, Yifei Mo¹, Xiaojing Ma², Lingwen Ying¹, Wei Zhu¹, Yufei Wang¹, Yuqian Bao¹, Jian Zhou³

Affiliations

¹ Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
² Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China. Electronic address: maxiaojing@sjtu.edu.cn.
³ Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China. Electronic address: zhoujian@sjtu.edu.cn.

PMID: 29802831
DOI: 10.1016/j.cca.2018.05.044

Abstract

Background: Recent studies have discussed the relationship between body mass index (BMI) and glycated albumin (GA) level. However, the extent of the influence of BMI on GA remains uncertain. We investigated the associations between BMI and GA, glycated hemoglobin A_1c (HbA_1c) and GA/HbA_1c, and to analyze the influence of obesity on GA, HbA_1c, and GA/HbA_1c in both Chinese diabetic and non-diabetic populations.

Methods: A total of 2562 participants, including 1177 men and 1385 women (age 20-80 y), were enrolled. Each subject underwent a 75-g oral glucose tolerance test. Serum GA was detected using a liquid enzyme method, and HbA_1c was assayed using high-performance liquid chromatography.

Results: In the diabetic patients (n = 1223), the GA, HbA_1c, and GA/HbA_1c levels were 16.7 ± 3.0%, 6.6 ± .9% (49 ± 9 mmol/mol), and 2.51 ± .33, respectively. In the non-diabetic subjects (n = 1339), the GA, HbA_1c, and GA/HbA_1c concentrations were 13.8 ± 1.7%, 5.6 ± .4% (38 ± 4 mmol/mol), and 2.47 ± .31, respectively. Decreasing trends in the GA and GA/HbA_1c concentrations and an increasing trend in the HbA_1c concentration (all P for trend <.05) were found to accompany with the increase in BMI, regardless of diabetes status. Multiple regression analysis revealed that BMI was independently related to HbA_1c in the non-diabetic population (standardized β = .158, P < .001); however, the relationship disappeared in the diabetic population (P > .05). Moreover, in the diabetic and non-diabetic populations, BMI was negatively correlated with GA (standardized β = -.167 and - .231, both P < .001) and GA/HbA_1c (standardized β = -.273 and - .310, both P < .001). Further analysis showed that a 1 kg/m² increment in BMI was associated with a .13% decrease in the absolute value of GA.

Conclusions: In both diabetic and non-diabetic populations, GA and GA/HbA_1c levels are independently and negatively associated with BMI. For every 1 kg/m² increment in BMI, the absolute value of GA decreases approximately .13%.

Keywords: Body mass index; Diabetes; Glycated albumin; Glycated hemoglobin A(1c); Non-diabetes.

MeSH terms

Adult
Aged
Aged, 80 and over
Anthropometry
Body Mass Index*
China
Chromatography, High Pressure Liquid
Diabetes Mellitus, Type 2 / diagnosis*
Female
Glucose Tolerance Test
Glycated Hemoglobin / analysis*
Glycated Serum Albumin
Glycation End Products, Advanced
Humans
Male
Middle Aged
Serum Albumin / analysis*
Young Adult

Substances

Glycated Hemoglobin A
Glycation End Products, Advanced
Serum Albumin
Glycated Serum Albumin