Association of glycated albumin, but not glycated hemoglobin, with peripheral vascular calcification in hemodialysis patients with type 2 diabetes

AimsElevated HbA1C is a predictor of mortality as well as peripheral vascular calcification in hemodialysis (HD) patients with diabetes. However, improved glycemic control as reflected by reduction in HbA1C may dismiss the relationship between HbA1C and mortality in those patients, due possibly to the underestimation of HbA1C by erythropoietin use. This study was to establish the significance of glycated albumin (GA) as a useful marker of peripheral vascular calcification in diabetic HD patients, in comparison with HbA1C.Main methodsWe examined 49 HD patients with type 2 diabetes (37 men and 12 women). Peripheral vascular calcification at hand arteries was checked on a simple X-ray photograph. GA and HbA1C were determined just before HD session.Key findingsThe prevalence of peripheral vascular calcification was significantly higher in diabetic patients (65.3%) than in non-diabetic patients (27.0%). Multiple regression analyses in diabetic patients showed that both HD duration and GA were significantly associated with the presence of peripheral vascular calcification. When GA was replaced by HbA1C in the same model, HbA1C failed to show a significant association. However, when a weekly dose of erythropoietin was simultaneously included in addition to HD duration and HbA1C, both HbA1C as well as HD duration emerged as a significant factor associated with the presence of peripheral vascular calcification.SignificanceThe present study suggested that GA might be a better indicator of glycemic control, and raise the possibility that improvement of glycemic control might prevent against the development of peripheral vascular calcification in diabetic HD patients.