Title | Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: Results from the Atherosclerosis Risk in Communities Study. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Jung M, Warren B, Grams M, Kwong YD, Shafi T, Coresh JJ, Rebholz CM |
Secondary Authors | Selvin E |
Journal | J Diabetes |
Volume | 10 |
Issue | 4 |
Pagination | 276-285 |
Date Published | 2018 Apr |
ISSN | 1753-0407 |
Keywords | Aged, Aged, 80 and over, Atherosclerosis, Biomarkers, Blood Glucose, Community Health Services, Cross-Sectional Studies, Diabetes Mellitus, Fasting, Female, Fructosamine, Glycated Hemoglobin A, Humans, Hyperglycemia, Male, Renal Insufficiency, Chronic, Risk Factors, Serum Albumin |
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. |
DOI | 10.1111/1753-0407.12618 |
Alternate Journal | J Diabetes |
PubMed ID | 29055090 |
PubMed Central ID | PMC5867205 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States K01 DK107782 / DK / NIDDK NIH HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States T32 HL007024 / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States R01 HL132372 / HL / NHLBI NIH HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States K24 DK106414 / DK / NIDDK NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States R03 DK104012 / DK / NIDDK NIH HHS / United States |