期刊
DIABETES CARE
卷 43, 期 10, 页码 2379-2387出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc20-0915
关键词
-
资金
- American Diabetes Association [4-15-CKD-20]
- National Institute of Diabetes and Digestive and Kidney Diseases [R01-DK-088762, R01-DK-087726, T32-DK-007247]
- Puget Sound Veterans Affairs Health Care System grant
- Northwest Kidney Centers unrestricted grant
OBJECTIVE In chronic kidney disease, glycated albumin and fructosamine have been postulated to be better biomarkers of glycemic control than HbA(1c). We evaluated the accuracy, variability, and covariate bias of three biomarkers (HbA(1c), glycated albumin, and fructosamine) compared with continuous glucose monitoring (CGM)-derived measurement of glycemia across estimated glomerular filtration rate (eGFR) in type 2 diabetes. RESEARCH DESIGN AND METHODS A prospective cohort study was conducted of 104 participants with type 2 diabetes, 80 with eGFR <60 mL/min/1.73 m(2)(not treated with dialysis) and 24 frequency-matched control subjects with eGFR >= 60 mL/min/1.73 m(2). Participants wore a blinded CGM for two 6-day periods separated by 2 weeks, with blood and urine collected at the end of each CGM period. HbA(1c), glycated albumin, and fructosamine were measured by high-performance liquid chromatographic, enzymatic, and colorimetric nitroblue tetrazolium methods, respectively. RESULTS Within-person biomarker values were strongly correlated between the two CGM periods (r= 0.92-0.95), although no marker fully captured the within-person variability of mean CGM glucose. All markers were similarly correlated with mean CGM glucose (r= 0.71-77). Compared with mean CGM glucose, glycated albumin and fructosamine were significantly biased by age, BMI, serum iron concentration, transferrin saturation, and albuminuria; HbA(1c)was underestimated in those with albuminuria. CONCLUSIONS Glycated albumin and fructosamine were not less variable than HbA(1c)at a given mean CGM glucose level, with several additional sources of bias. These results support measuring HbA(1c)to monitor trends in glycemia among patients with eGFR <60 mL/min/1.73 m(2). Direct measurements of glucose are necessary to capture short-term variability.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据