Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?

<h4>Introduction</h4>Studies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in dia...

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Main Authors: Fernando Chimela Chume, Mayana Hernandez Kieling, Priscila Aparecida Correa Freitas, Gabriela Cavagnolli, Joíza Lins Camargo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227065&type=printable
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author Fernando Chimela Chume
Mayana Hernandez Kieling
Priscila Aparecida Correa Freitas
Gabriela Cavagnolli
Joíza Lins Camargo
author_facet Fernando Chimela Chume
Mayana Hernandez Kieling
Priscila Aparecida Correa Freitas
Gabriela Cavagnolli
Joíza Lins Camargo
author_sort Fernando Chimela Chume
collection DOAJ
description <h4>Introduction</h4>Studies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in diagnosis of type 2 diabetes mellitus (DM). Thus, the aim of this study was to assess the clinical utility of GA in diagnosis of DM.<h4>Materials and methods</h4>This diagnostic test accuracy study was performed in 242 Brazilian individuals referred for OGTT in a tertiary university hospital. ROC curves were used to access the performance of GA and HbA1c in the diagnosis of DM by oral glucose tolerance test (OGTT).<h4>Results</h4>OGTT, HbA1c and GA were performed in all 242 participants (40.5% male, age 54.4 ± 13.0 years [mean ± SD], body mass index 28.9 ± 6.3 kg/m2). DM by OGTT was detected in 31.8% of individuals. The equilibrium threshold value of GA ≥14.8% showed sensitivity of 64.9% and specificity of 65.5% for the diagnosis of DM. The AUC for GA [0.703 (95% CI 0.631-0.775)] was lower than for HbA1c [0.802 (95% CI 0.740-0.864)], p = 0.028. A GA value of 16.8% had similar accuracy for detecting DM as defined by HbA1c ≥6.5% (48 mmol/mol) with sensitivity of 31.2% and specificity of 93.3% for both tests. However, GA detects different subjects from those detected by HbA1c and OGTT.<h4>Conclusions</h4>GA detected different individuals with DM from those detected by HbA1c, though it showed overall diagnostic accuracy similar to HbA1c in the diagnosis of DM. Therefore, GA should be used as an additional test rather than an alternative to HbA1c or OGTT and its use as the sole DM diagnostic test should be interpreted with caution.
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spelling doaj-art-4e247a45c80a47a1b53b863237d647dd2025-08-20T02:00:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022706510.1371/journal.pone.0227065Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?Fernando Chimela ChumeMayana Hernandez KielingPriscila Aparecida Correa FreitasGabriela CavagnolliJoíza Lins Camargo<h4>Introduction</h4>Studies have revealed that glycated albumin (GA) is a useful alternative to HbA1c under conditions wherein the latter does not reflect glycaemic status accurately. Until now, there are few studies with non-Asians subjects that report on the validity of GA test in diagnosis of type 2 diabetes mellitus (DM). Thus, the aim of this study was to assess the clinical utility of GA in diagnosis of DM.<h4>Materials and methods</h4>This diagnostic test accuracy study was performed in 242 Brazilian individuals referred for OGTT in a tertiary university hospital. ROC curves were used to access the performance of GA and HbA1c in the diagnosis of DM by oral glucose tolerance test (OGTT).<h4>Results</h4>OGTT, HbA1c and GA were performed in all 242 participants (40.5% male, age 54.4 ± 13.0 years [mean ± SD], body mass index 28.9 ± 6.3 kg/m2). DM by OGTT was detected in 31.8% of individuals. The equilibrium threshold value of GA ≥14.8% showed sensitivity of 64.9% and specificity of 65.5% for the diagnosis of DM. The AUC for GA [0.703 (95% CI 0.631-0.775)] was lower than for HbA1c [0.802 (95% CI 0.740-0.864)], p = 0.028. A GA value of 16.8% had similar accuracy for detecting DM as defined by HbA1c ≥6.5% (48 mmol/mol) with sensitivity of 31.2% and specificity of 93.3% for both tests. However, GA detects different subjects from those detected by HbA1c and OGTT.<h4>Conclusions</h4>GA detected different individuals with DM from those detected by HbA1c, though it showed overall diagnostic accuracy similar to HbA1c in the diagnosis of DM. Therefore, GA should be used as an additional test rather than an alternative to HbA1c or OGTT and its use as the sole DM diagnostic test should be interpreted with caution.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227065&type=printable
spellingShingle Fernando Chimela Chume
Mayana Hernandez Kieling
Priscila Aparecida Correa Freitas
Gabriela Cavagnolli
Joíza Lins Camargo
Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
PLoS ONE
title Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
title_full Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
title_fullStr Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
title_full_unstemmed Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
title_short Glycated albumin as a diagnostic tool in diabetes: An alternative or an additional test?
title_sort glycated albumin as a diagnostic tool in diabetes an alternative or an additional test
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227065&type=printable
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