Estimated levels of glycated albumin and C-reactive protein/total albumin ratio might distinguish prediabetics among the apparently healthy people and predict the vulnerability for development of steatohepatitis and cardiac risk.

Background: Prediabetes precedes Type-2 diabetes development, is characterized by impaired glucose tolerance (IGT) as judged by the 75-g oral glucose tolerance test (75-OGTT) and is associated with higher cardiac risk (CR), dyslipidemia, hepatosteatosis (HS) and cancer.

Aims: The study aimed to determine the distinguishing ability of estimated levels of glycated albumin (GA) and hemoglobin A1c (HbA1c), and serum C-reactive protein (CRP) and serum total albumin (TA) levels for prediabetic out of apparently healthy subjects.

Methods: IGT was diagnosed if fasting blood glucose (FBG) was 100-125 mg/dl and if < 100 mg/dl subject is normal glucose tolerant (NGT). CR, HS and insulin resistance (IR) were suggested if the calculated atherogenic index of plasma (AIP) was >0.1, HS index (HSI) was >36 with high computerized hepatorenal index (HRI) and the homeostasis model assessment of IR (HOMA-IR) score was >2, respectively.

Results: 253 subjects (50.8%) had IGT and were older, more obese and mainly females. IGT had higher GA%, HOMA-IR score, serum CRP and lower TA with high CRP/TA ratio (CAR) than NGT. The frequency of subjects had AIP>0.1, HSI>36 and high HRI was significantly higher among IGT subjects. Statistical analyses defined high GA% and CAR as predictors for IGT, HOMA-IR>36 and AIP score >0.1, while high CAR is the only predictor for HSI score >36 and high HIR score.

Conclusion: Prediabetes is not uncommon and high GA% and CAR might differentiate them among the apparently healthy population, and could predict those at increased risk for IR, HS and at CR.