Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: Results from the Atherosclerosis Risk in Communities Study

Molly Jung, Bethany Warren, Morgan Grams, Yuenting D. Kwong, Tariq Shafi, Josef Coresh, Casey Rebholz, Elizabeth Selvin

Research output: Contribution to journalArticle

Abstract

Background: In people with chronic kidney disease (CKD), HbA1c may be a problematic measure of glycemic control. Glycated albumin and fructosamine have been proposed as better markers of hyperglycemia in CKD. In the present study we investigated associations of HbA1c, glycated albumin, and fructosamine with fasting glucose by CKD categories. Methods: A cross-sectional analysis was performed of 1665 Atherosclerosis Risk in Communities Study participants with diagnosed diabetes aged ≥65years. Spearman's rank correlations (r) were compared and Deming regression was used to obtain root mean square errors (RMSEs) for the associations across CKD categories defined using estimated glomerular filtration rate and urine albumin:creatinine ratio. Results: Correlations of HbA1c, glycated albumin, and fructosamine with fasting glucose were lowest in people with severe CKD (HbA1c r=0.52, RMSE=0.91; glycated albumin r=0.39, RMSE=1.89; fructosamine r=0.41, RMSE=1.87) and very severe CKD (r=0.48 and RMSE=1.01 for HbA1c; r=0.36 and RMSE=2.14 for glycated albumin; r=0.36 and RMSE=2.22 for fructosamine). Associations of glycated albumin and fructosamine with HbA1c were relatively similar across CKD categories. Conclusions: In older adults with severe or very severe CKD, HbA1c, glycated albumin, and fructosamine were not highly correlated with fasting glucose. The results suggest there may be no particular advantage of glycated albumin or fructosamine over HbA1c for monitoring glycemic control in CKD.

Original languageEnglish (US)
JournalJournal of Diabetes
DOIs
StateAccepted/In press - Jan 1 2017

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Fructosamine
Chronic Renal Insufficiency
Hyperglycemia
Atherosclerosis
Biomarkers
Fasting
Glucose
glycosylated serum albumin
Glomerular Filtration Rate
Albumins
Creatinine
Cross-Sectional Studies
Urine

Keywords

  • Biomarkers
  • Chronic kidney disease
  • Epidemiology
  • Older adults

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{b4a2c8b51c1244208a169593548374b0,
title = "Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes: Results from the Atherosclerosis Risk in Communities Study",
abstract = "Background: In people with chronic kidney disease (CKD), HbA1c may be a problematic measure of glycemic control. Glycated albumin and fructosamine have been proposed as better markers of hyperglycemia in CKD. In the present study we investigated associations of HbA1c, glycated albumin, and fructosamine with fasting glucose by CKD categories. Methods: A cross-sectional analysis was performed of 1665 Atherosclerosis Risk in Communities Study participants with diagnosed diabetes aged ≥65years. Spearman's rank correlations (r) were compared and Deming regression was used to obtain root mean square errors (RMSEs) for the associations across CKD categories defined using estimated glomerular filtration rate and urine albumin:creatinine ratio. Results: Correlations of HbA1c, glycated albumin, and fructosamine with fasting glucose were lowest in people with severe CKD (HbA1c r=0.52, RMSE=0.91; glycated albumin r=0.39, RMSE=1.89; fructosamine r=0.41, RMSE=1.87) and very severe CKD (r=0.48 and RMSE=1.01 for HbA1c; r=0.36 and RMSE=2.14 for glycated albumin; r=0.36 and RMSE=2.22 for fructosamine). Associations of glycated albumin and fructosamine with HbA1c were relatively similar across CKD categories. Conclusions: In older adults with severe or very severe CKD, HbA1c, glycated albumin, and fructosamine were not highly correlated with fasting glucose. The results suggest there may be no particular advantage of glycated albumin or fructosamine over HbA1c for monitoring glycemic control in CKD.",
keywords = "Biomarkers, Chronic kidney disease, Epidemiology, Older adults",
author = "Molly Jung and Bethany Warren and Morgan Grams and Kwong, {Yuenting D.} and Tariq Shafi and Josef Coresh and Casey Rebholz and Elizabeth Selvin",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/1753-0407.12618",
language = "English (US)",
journal = "Journal of Diabetes",
issn = "1753-0393",
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TY - JOUR

T1 - Performance of non-traditional hyperglycemia biomarkers by chronic kidney disease status in older adults with diabetes

T2 - Results from the Atherosclerosis Risk in Communities Study

AU - Jung, Molly

AU - Warren, Bethany

AU - Grams, Morgan

AU - Kwong, Yuenting D.

AU - Shafi, Tariq

AU - Coresh, Josef

AU - Rebholz, Casey

AU - Selvin, Elizabeth

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: In people with chronic kidney disease (CKD), HbA1c may be a problematic measure of glycemic control. Glycated albumin and fructosamine have been proposed as better markers of hyperglycemia in CKD. In the present study we investigated associations of HbA1c, glycated albumin, and fructosamine with fasting glucose by CKD categories. Methods: A cross-sectional analysis was performed of 1665 Atherosclerosis Risk in Communities Study participants with diagnosed diabetes aged ≥65years. Spearman's rank correlations (r) were compared and Deming regression was used to obtain root mean square errors (RMSEs) for the associations across CKD categories defined using estimated glomerular filtration rate and urine albumin:creatinine ratio. Results: Correlations of HbA1c, glycated albumin, and fructosamine with fasting glucose were lowest in people with severe CKD (HbA1c r=0.52, RMSE=0.91; glycated albumin r=0.39, RMSE=1.89; fructosamine r=0.41, RMSE=1.87) and very severe CKD (r=0.48 and RMSE=1.01 for HbA1c; r=0.36 and RMSE=2.14 for glycated albumin; r=0.36 and RMSE=2.22 for fructosamine). Associations of glycated albumin and fructosamine with HbA1c were relatively similar across CKD categories. Conclusions: In older adults with severe or very severe CKD, HbA1c, glycated albumin, and fructosamine were not highly correlated with fasting glucose. The results suggest there may be no particular advantage of glycated albumin or fructosamine over HbA1c for monitoring glycemic control in CKD.

AB - Background: In people with chronic kidney disease (CKD), HbA1c may be a problematic measure of glycemic control. Glycated albumin and fructosamine have been proposed as better markers of hyperglycemia in CKD. In the present study we investigated associations of HbA1c, glycated albumin, and fructosamine with fasting glucose by CKD categories. Methods: A cross-sectional analysis was performed of 1665 Atherosclerosis Risk in Communities Study participants with diagnosed diabetes aged ≥65years. Spearman's rank correlations (r) were compared and Deming regression was used to obtain root mean square errors (RMSEs) for the associations across CKD categories defined using estimated glomerular filtration rate and urine albumin:creatinine ratio. Results: Correlations of HbA1c, glycated albumin, and fructosamine with fasting glucose were lowest in people with severe CKD (HbA1c r=0.52, RMSE=0.91; glycated albumin r=0.39, RMSE=1.89; fructosamine r=0.41, RMSE=1.87) and very severe CKD (r=0.48 and RMSE=1.01 for HbA1c; r=0.36 and RMSE=2.14 for glycated albumin; r=0.36 and RMSE=2.22 for fructosamine). Associations of glycated albumin and fructosamine with HbA1c were relatively similar across CKD categories. Conclusions: In older adults with severe or very severe CKD, HbA1c, glycated albumin, and fructosamine were not highly correlated with fasting glucose. The results suggest there may be no particular advantage of glycated albumin or fructosamine over HbA1c for monitoring glycemic control in CKD.

KW - Biomarkers

KW - Chronic kidney disease

KW - Epidemiology

KW - Older adults

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U2 - 10.1111/1753-0407.12618

DO - 10.1111/1753-0407.12618

M3 - Article

C2 - 29055090

AN - SCOPUS:85038835653

JO - Journal of Diabetes

JF - Journal of Diabetes

SN - 1753-0393

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