Serum glycated albumin predicts the progression of carotid arterial atherosclerosis

IntroductionWe investigated the association between the ratio of serum glycated albumin (GA) levels to hyperglycemic levels (GA/A1c ratio) and the progression of carotid artery atherosclerosis.MethodsFor this retrospective longitudinal study we recruited patients who had undergone carotid IMT measurement twice and been tested consecutively for both A1c and GA levels every 3 or 6 months. The subjects were classified into two groups based on non-progression (group I) and progression (group II) of carotid IMT. Mean values of A1c and GA and the GA/A1c ratio were compared between groups.ResultsOf the 218 subjects (122 men and 96 women), group II (n=77) showed significantly higher baseline systolic BP, eGFR, GA, GA/A1c ratio, and progression of carotid IMT (Δ IMT) than group I (n = 141). The mean A1c level tended to be higher in group II than in group I (p = 0.054). By Spearman's correlation test, baseline diastolic BP, total cholesterol, triglyceride, GA, and GA/A1c were significantly associated with Δ IMT in group II but not in group I. In multivariate regression analysis, serum level of GA and GA/HbA1c ratio predicted progression of IMT after adjustment for other risk factors in both models applied.ConclusionWe suggest that glycated albumin is not only a useful glycemic index but also might be an atherogenic protein in the development of diabetic atherosclerosis.

► GA, which is strongly correlated with A1c, confers utility for the glycemic index. ► In this study, serum level of GA and GA/HbA1c ratio predicted progression of carotid IMT after adjustment for other risk factors. ► Glycated albumin also might be an atherogenic protein in the development of diabetic atherosclerosis.