Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA1c reliability.
Anxious J Niwaha, Priscilla A Balungi, Timothy J McDonald, Andrew T Hattersley, Beverley M Shields, Moffat J Nyirenda, Angus G Jones
{"title":"Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA<sub>1c</sub> reliability.","authors":"Anxious J Niwaha, Priscilla A Balungi, Timothy J McDonald, Andrew T Hattersley, Beverley M Shields, Moffat J Nyirenda, Angus G Jones","doi":"10.1111/dme.70011","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>HbA<sub>1c</sub> testing in African populations may be limited due to high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment. We aimed to assess the performance of glycated albumin (GA) and fructosamine in comparison to HbA<sub>1c</sub> for determining glycaemic control in Africans living with type 2 diabetes.</p><p><strong>Methods: </strong>We compared the relationship between fructosamine, GA, and HbA<sub>1c</sub> with mean continuous glucose monitoring (CGM) glucose and assessed the impact of sickle cell trait (SCT), anaemia and renal impairment on the relationship between each measure and CGM glucose.</p><p><strong>Results: </strong>The overall association of HbA<sub>1c</sub>, GA and fructosamine with CGM glucose was similar (r = 0.88 [95%CI: 0.84, 0.91], 0.84 [0.79, 0.88] and 0.84 [0.79, 0.88]), respectively. For detecting those with mean CGM glucose >8 mmol/L HbA<sub>1c</sub> had similar diagnostic accuracy to GA and fructosamine, even in those with conditions reported to affect HbA<sub>1c</sub> performance (n = 63). We found no evidence that SCT (n = 43/192) altered the relationship between HbA<sub>1c</sub>, fructosamine or GA with CGM glucose (p > 0.3 for all). However, individuals with anaemia showed an underestimation of CGM glucose by HbA<sub>1c</sub> and fructosamine compared to those without anaemia (p for interaction <0.005 for both). In contrast, GA with average CGM glucose between those with anaemia and those without were not significantly different.</p><p><strong>Conclusions: </strong>Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA<sub>1c</sub> in a population with high prevalence of conditions reported to affect HbA<sub>1c</sub> reliability.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70011"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dme.70011","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: HbA1c testing in African populations may be limited due to high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment. We aimed to assess the performance of glycated albumin (GA) and fructosamine in comparison to HbA1c for determining glycaemic control in Africans living with type 2 diabetes.
Methods: We compared the relationship between fructosamine, GA, and HbA1c with mean continuous glucose monitoring (CGM) glucose and assessed the impact of sickle cell trait (SCT), anaemia and renal impairment on the relationship between each measure and CGM glucose.
Results: The overall association of HbA1c, GA and fructosamine with CGM glucose was similar (r = 0.88 [95%CI: 0.84, 0.91], 0.84 [0.79, 0.88] and 0.84 [0.79, 0.88]), respectively. For detecting those with mean CGM glucose >8 mmol/L HbA1c had similar diagnostic accuracy to GA and fructosamine, even in those with conditions reported to affect HbA1c performance (n = 63). We found no evidence that SCT (n = 43/192) altered the relationship between HbA1c, fructosamine or GA with CGM glucose (p > 0.3 for all). However, individuals with anaemia showed an underestimation of CGM glucose by HbA1c and fructosamine compared to those without anaemia (p for interaction <0.005 for both). In contrast, GA with average CGM glucose between those with anaemia and those without were not significantly different.
Conclusions: Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA1c in a population with high prevalence of conditions reported to affect HbA1c reliability.
期刊介绍：
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
