Optimal glycated albumin cutoff value to diagnose diabetes in Korean adults: A retrospective study based on the oral glucose tolerance test

• Glycated albumin levels increase as the glucose tolerance deteriorates.
• The glycated albumin cutoff for the diagnosis of diabetes is 14.3% in Korean adults.
• Glycated albumin may detect diabetes earlier than glycated hemoglobin.

IntroductionGlycated albumin (GA) reflects short-term status of glycemic control. We suggest a GA cut-off value to diagnose pre-diabetes and diabetes in Korean adults. In addition, we compared the performance of GA for the diagnosis of diabetes with that of glycated hemoglobin (A1c).Materials and methodsA total of 852 subjects (498 males, 354 females) aged 20 to 83 years (mean: 52.5 years) were enrolled. A 75-g oral glucose tolerance test (OGTT) was performed and A1c and GA were measured.ResultsIn these enrolled subjects, 88% have glucose intolerance status (pre-diabetes or diabetes). The GA concentrations corresponding to fasting plasma glucose (FPG) of 7.0 mmol/l, 2-h plasma glucose during OGTT (PPG2) ≥ 11.1 mmol/l, and A1c ≥ 6.5% were 14.6%, 13.7%, and 14.7%, respectively. A meta-analysis of three GA cutoffs revealed a GA cutoff for diabetes of 14.3%. When A1c is used in combination with FPG, the sensitivity and specificity for the diagnosis of OGTT-based diabetes were 72.16% (95% CI: 66.6–72.2) and 96.4% (95% CI: 94.4–97.7), respectively. With the newly developed GA cutoff of 14.3%, GA combined with FPG resulted in a sensitivity and specificity of 77.5% (95% CI: 72.17–82.0) and 89.9% (95% CI: 87.1–92.2), respectively.ConclusionsA GA cutoff of > 14.3% is optimal for the diagnosis of diabetes in Korean adults. The measurement of FPG and GA may detect diabetes earlier than the measurement of FPG and A1c.