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Inverse Association between Glycated Albumin and Insulin Secretory Function May Explain Higher Levels of Glycated Albumin in Subjects with Longer Duration of Diabetes

 Yong-ho Lee  ;  Mi Hyang Kown  ;  Kwang Joon Kim  ;  Eun Young Lee  ;  Daham Kim  ;  Byung-Wan Lee  ;  Eun Seok Kang  ;  Bong Soo Cha  ;  Hyun Chul Lee 
 PLOS ONE, Vol.9(9) : e108772, 2014 
Journal Title
Issue Date
C-Peptide/metabolism ; Diabetes Mellitus, Type 2/blood* ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Insulin/secretion* ; Linear Models ; Male ; Middle Aged ; Serum Albumin/metabolism* ; Time Factors
BACKGROUND: Glycated albumin (GA) has been increasingly used as a reliable index for short-term glycemic monitoring, and is inversely associated with β-cell function. Because the pathophysiologic nature of type 2 diabetes (T2D) is characterized by progressive decline in insulin secretion, the aim was to determine whether GA levels were affected by diabetes duration in subjects with T2D. METHODS: To minimize the effect of glucose variability on GA, subjects with stably maintained HbA1c levels of <0.5% fluctuation across 6 months of measurements were included. Patients with newly diagnosed T2D (n = 1059) and with duration>1 year (n = 781) were recruited and categorized as New-T2D and Old-T2D, respectively. Biochemical, glycemic, and C-peptide parameters were measured. RESULTS: GA levels were significantly elevated in HbA1c-matched Old-T2D subjects compared to New-T2D subjects. Duration of diabetes was positively correlated with GA, whereas a negative relationship was found with C-peptide increment (ΔC-peptide). Among insulin secretory indices, dynamic parameters such as ΔC-peptide were inversely related to GA (r = -0.42, p<0.001). Multiple linear regression analyses showed that duration of diabetes was associated with GA (standardized β coefficient [STDβ] = 0.05, p<0.001), but not with HbA1c (STDβ = 0.04, p<0.095). This association disappeared after additional adjustment with ΔC-peptide (STDβ = 0.02, p = 0.372), suggesting that β-cell function might be a linking factor of close relationship between duration of diabetes and GA values. CONCLUSIONS: The present study showed that GA levels were significantly increased in subjects with longer duration T2D and with decreased insulin secretory function. Additional caution should be taken when interpreting GA values to assess glycemic control status in these individuals.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biochemistry and Molecular Biology (생화학-분자생물학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kown, Mi Hyang(권미향)
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Kim, Daham(김다함) ORCID logo https://orcid.org/0000-0003-1871-686X
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Eun Young(이은영)
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
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