TY - JOUR
T1 - Establishment of community-based reference intervals for fructosamine, glycated albumin, and 1,5-anhydroglucitol
AU - Selvin, Elizabeth
AU - Warren, Bethany
AU - He, Xintong
AU - Sacks, David B.
AU - Saenger, Amy K.
N1 - Publisher Copyright:
© 2018 American Association for Clinical Chemistry.
PY - 2018/5
Y1 - 2018/5
N2 - BACKGROUND: There is growing interest in fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG) as alternative measures of hyperglycemia, particularly for use in settings where traditional measures (glucose and HbA1c) are problematic or where intermediate (2– 4 weeks) glycemic control is of interest. However, reference intervals for these alternative biomarkers are not established. METHODS: We measured fructosamine, glycated albumin, and 1,5-AG in a community-based sample of US black and white adults who participated in the Atherosclerosis Risk in Communities (ARIC) Study. We calculated reference intervals, evaluated demographic differences, and derived cutoffs aligned with current diagnostic cutpoints for HbA1c and fasting glucose. RESULTS: In a healthy reference population of 1799 individuals (mean age, 55 years; 51% women; 15% black), the 2.5 and 97.5 percentiles, respectively, were 194.8 and 258.0 mol/L for fructosamine, 10.7% and 15.1% for glycated albumin, and 8.4 and 28.7 g/mL for 1,5-AG. Distributions differed by race, sex, and body mass index. Equivalent concentrations of fructosamine and glycated albumin corresponding to an HbA1c of 6.5% (96.5 percentile) were 270.2 mol/L and 15.6%, respectively. Equivalent concentrations of fructosamine and glycated albumin corresponding to a fasting glucose of 126 mg/dL (93.9 percentile) were 261.7 mol/L and 15.0%, respectively. CONCLUSIONS: The reference intervals for these biomarkers should inform their clinical use. Diagnostic cutpoint equivalents for fructosamine and glycated albumin could be useful to identify persons with hyperglycemia in settings where fasting glucose or HbA1c are not available or where the interpretation of these traditional measures is problematic.
AB - BACKGROUND: There is growing interest in fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG) as alternative measures of hyperglycemia, particularly for use in settings where traditional measures (glucose and HbA1c) are problematic or where intermediate (2– 4 weeks) glycemic control is of interest. However, reference intervals for these alternative biomarkers are not established. METHODS: We measured fructosamine, glycated albumin, and 1,5-AG in a community-based sample of US black and white adults who participated in the Atherosclerosis Risk in Communities (ARIC) Study. We calculated reference intervals, evaluated demographic differences, and derived cutoffs aligned with current diagnostic cutpoints for HbA1c and fasting glucose. RESULTS: In a healthy reference population of 1799 individuals (mean age, 55 years; 51% women; 15% black), the 2.5 and 97.5 percentiles, respectively, were 194.8 and 258.0 mol/L for fructosamine, 10.7% and 15.1% for glycated albumin, and 8.4 and 28.7 g/mL for 1,5-AG. Distributions differed by race, sex, and body mass index. Equivalent concentrations of fructosamine and glycated albumin corresponding to an HbA1c of 6.5% (96.5 percentile) were 270.2 mol/L and 15.6%, respectively. Equivalent concentrations of fructosamine and glycated albumin corresponding to a fasting glucose of 126 mg/dL (93.9 percentile) were 261.7 mol/L and 15.0%, respectively. CONCLUSIONS: The reference intervals for these biomarkers should inform their clinical use. Diagnostic cutpoint equivalents for fructosamine and glycated albumin could be useful to identify persons with hyperglycemia in settings where fasting glucose or HbA1c are not available or where the interpretation of these traditional measures is problematic.
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U2 - 10.1373/clinchem.2017.285742
DO - 10.1373/clinchem.2017.285742
M3 - Article
C2 - 29436378
AN - SCOPUS:85046141742
SN - 0009-9147
VL - 64
SP - 843
EP - 850
JO - Clinical chemistry
JF - Clinical chemistry
IS - 5
ER -