Levels of glycated albumin at different stages of diabetic nephropathy in India

Aims: Glycated haemoglobin (HbA1c) which is an index of long term glycaemic control in diabetic patients is measured in majority of patients worldwide. Glycated albumin (GA) is useful for the evaluation of short term glycaemic control (2 weeks) in patients with diabetes. The aim of this study was to assess the GA levels at different stages of diabetic nephropathy in Indian population. Materials and Methods: A total of 147 subjects (M:F; 95:52) were selected for this study and were divided into three groups based on their renal function and compared with a non diabetic control group (n = 50, M:F; 14:36). The groups were as follows; group1 (control) n = 50, group2 (normoalbuminuria) n = 42, group 3 (microalbuminuria) n = 55, group 4 (proteinuria) n = 50. GA was measured by enzymatic procedure using the Lucica GA – L kit (Asahi Kasei Pharma Corp, Japan). Results: The normal cutoff value for GA was derived using control group and it was found to be 15% (range 717%). GA was significantly higher in diabetic patients at different stages of diabetic nephropathy compared to non diabetic control group [cont: 12.9 ± 1.8, normo: 20.8 ± 5.8, micro: 26.1 ± 8.6, macro: 23.5 ± 8.3). Microalbuminuric patients had significantly higher GA levels than normoalbuminuric patients (p< 0.05). Proteinuric subjects had slightly lower GA levels compared to microalbuminuric group but it was not statistically significant. Conclusion: GA was found to be a better marker for evaluating short term glycaemic status among diabetic patients with different degree of renal impairment prior to ESRD.