Clinical Utility of Glycosylated Serum Albumin in Type 1 and Type 2 Diabetes.

Among various glycosylated proteins, glycosylated hemoglobin (HbA[sub 1c]) is most widely used to evaluate the long-term glycemic control and the risk for the development of complications in patients with type 1 and type 2 diabetes. Glycosylated serum albumin has been repotted to be a useful indicator of glycemic control for diabetic patients. However, clinical utility of glycosylated albumin has not been fully evaluated, especially the relation with the degree of daily glycemic profile. We, therefore, compared HbA[sub 1c] and glycosylated albumin to the daily profiles of blood glucose in patients with type 1 and type 2 diabetes. Sixty three type 1 diabetic patients (age 25.5±5.3 years, duration 15.6±6.3 years) and fifty eight type2 diabetic patients (age 59.3±11.0 years, duration 12.8±7.5 years) were enrolled in this study. These patients were not suffered from advanced micro and macro diabetic angiopathy. The daily profile of glucose levels were determined by the self-monitoring blood glucose testing before and 2-hour after meals and at bedtime. Glycosylated serum albumin levels were determined by using the enzymatic glycosylated albumin assay kit (Lucica GA). Glycosylated serum albumin (GA) was highly correlated with HbA[sub 1C] in type 1 (GA 24.4 ± 4.7%, HbA[sub 1C] 7.3 ± 1.1%, r = 0.88, P< 0.0001) and type 2 diabetic patients (GA 26.4 ± 7.4%, HbA[sub 1C] 9.1 ± 2.1%, r=0.79, P<0.0001). Interestingly, the ratio of glycosylated albumin to HbA[sub 1c] in type 1 diabetes was significantly higher than that of type 2 diabetes (3.3 ± 0.3 vs 2.9 ± 0.5). Glycosylated albumin was significantly correlated with maximum blood glucose in both type 1 (r=0.421, P<0.005) and type 2 diabetes (r=0.719. P<0.0001). The stepwise multivariate regression analysis revealed in type 1 and type 2 diabetes that maximum blood glucose is independently correlated with glycosylated albumin among the various index determined from glucose profile, such as mean glucose level and MAGE. In conclusion, glycosylated serum albumin, as well as HbA[sub 1C], is a reliable indicator of averaged glucose levels in patients with type 1 and type 2 diabetes. Glycosylated albumin may partially reflect the degree of higher excursion of glucose. [ABSTRACT FROM AUTHOR]