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Associations of alternative markers of glycemia with hemoglobin A(1c) and fasting glucose.

ABSTRACT: BACKGROUND:1,5-Anhydroglucitol (1,5-AG), fructosamine, and glycated albumin are of increasing interest as alternative measures of hyperglycemia. We characterize the associations of these nontraditional glycemic markers with hemoglobin A(1c) (Hb A(1c)) and fasting glucose and assess their ability to identify people with diabetes. METHODS:We conducted a cross-sectional comparison of 1,5-AG, fructosamine, and glycated albumin with Hb A(1c) and fasting glucose measurements in 1719 participants from the Atherosclerosis Risk in Communities Study. We evaluated nonlinear relationships using R(2) and F-statistics. Performance for identification of cases of diabetes was determined using the area under the curve (AUC). Diabetes was defined by Hb A(1c) ?6.5%, fasting glucose ?126 mg/dL (?6.99 mmol/L), and/or a self-reported history of diagnosed diabetes. RESULTS:Median values of Hb A(1c) and fasting glucose were 5.8% and 109 mg/dL (6.05 mmol/L), respectively; 17.3% of the study population had diagnosed diabetes. Glycated albumin, fructosamine, and 1,5-AG were more strongly correlated with Hb A(1c) compared with fasting glucose (all P values <0.05). Nonlinear models provided the best fit for describing the relationships of the alternative markers to Hb A(1c). When diabetes was defined by an Hb A(1c) ?6.5%, fructosamine (AUC 0.83; 95% CI, 0.79-0.87) and glycated albumin (AUC 0.87; 95% CI, 0.83-0.90) performed comparably to fasting glucose (AUC 0.83; 95% CI, 0.79-0.87), while 1,5-AG performed worse (AUC 0.74; 95% CI, 0.69-0.78) for identifying cases of undiagnosed diabetes. CONCLUSIONS:Fructosamine and glycated albumin may be useful adjuncts to Hb A(1c) and fasting glucose. Future studies should examine these markers in situations in which fasting glucose or Hb A(1c) measurements are invalid or not available.

SUBMITTER: Juraschek SP

PROVIDER: S-EPMC3652236 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Associations of alternative markers of glycemia with hemoglobin A(1c) and fasting glucose.

Juraschek Stephen P SP Steffes Michael W MW Selvin Elizabeth E

Clinical chemistry 20120927 12

<h4>Background</h4>1,5-Anhydroglucitol (1,5-AG), fructosamine, and glycated albumin are of increasing interest as alternative measures of hyperglycemia. We characterize the associations of these nontraditional glycemic markers with hemoglobin A(1c) (Hb A(1c)) and fasting glucose and assess their ability to identify people with diabetes.<h4>Methods</h4>We conducted a cross-sectional comparison of 1,5-AG, fructosamine, and glycated albumin with Hb A(1c) and fasting glucose measurements in 1719 par ...[more]

PMID: 23019309

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Project description:Intracellular peptides were shown to derive from proteasomal degradation of proteins from mammalian and yeast cells, being suggested to play distinctive roles both inside and outside these cells. Here, the role of intracellular peptides previously identified from skeletal muscle and adipose tissues of C57BL6/N wild type (WT) and neurolysin knockout mice were investigated. In differentiated C2C12 mouse skeletal muscle cells, some of these intracellular peptides like insulin activated the expression of several genes related to muscle contraction and gluconeogenesis. One of these peptides, LASVSTVLTSKYR (Ric4; 600 µg/kg), administrated either intraperitoneally or orally in WT mice, decreased glycemia. Neither insulin (10 nM) nor Ric4 (100 µM) induced glucose uptake in adipose tissue explants obtained from conditional knockout mice depleted of insulin receptor. Ric4 (100 µM) similarly to insulin (100 nM) induced Glut4 translocation to the plasma membrane of C2C12 differentiated cells, and increased GLUT4 mRNA levels in epididymal adipose tissue of WT mice. Ric4 (100 µM) increased both Erk and Akt phosphorylation in C2C12, as well as in epididymal adipose tissue from WT mice; Erk, but not Akt phosphorylation was activated by Ric4 in tibial skeletal muscle from WT mice. Ric4 is rapidly degraded in vitro by WT liver and kidney crude extracts, such a response that is largely reduced by structural modifications such as N-terminal acetylation, C-terminal amidation, and substitution of Leu8 for DLeu8 (Ac-LASVSTV[DLeu]TSKYR-NH2; Ric4-16). Ric4-16, among several Ric4 derivatives, efficiently induced glucose uptake in differentiated C2C12 cells. Among six Ric4-derivatives evaluated in vivo, Ac-LASVSTVLTSKYR-NH2 (Ric4-2; 600 µg/kg) and Ac-LASVSTV[DLeu]TSKYR (Ric4-15; 600 µg/kg) administrated orally efficiently reduced glycemia in a glucose tolerance test in WT mice. The potential clinical application of Ric4 and Ric4-derivatives deserves further attention.

Dataset Information

Associations of alternative markers of glycemia with hemoglobin A(1c) and fasting glucose.

Publications

Associations of alternative markers of glycemia with hemoglobin A(1c) and fasting glucose.

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