Glycated albumin is low in obese, non-diabetic children

doi:10.1016/j.diabres.2005.07.008

Diabetes Research and Clinical Practice

Volume 71, Issue 3, March 2006, Pages 334-338

https://doi.org/10.1016/j.diabres.2005.07.008 Get rights and content

Abstract

The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c), plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any differences in these indices.

GA, HbA1c, casual PG and casual IRI in obese children (n = 209) were compared to those of non-obese children (n = 1060) in Ina town, Saitama Prefecture, in 2002–2003.

In obese children, the levels of HbA1c, PG and IRI were statistically higher when compared to those of non-obese children. In contrast, the median and intra-quartile range (IQR) of GA of obese children (13.6%: 12.6–14.7) was statistically lower when compared to that of non-obese children (14.3%: 13.5–15.4, p < 0.001). The low GA (%) in obese children is mainly due to the low absolute value of GA (g/dl) rather than a higher albumin value (g/dl).

This is the first report to reveal that GA levels are low in obese, non-diabetic children. Additional data collection and an experimental approach are necessary to reveal the reasons behind lower GA levels in obese children.

Introduction

The increasing prevalence of type 2 diabetes is a global problem, especially in Asian countries [1], [2]. The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c) [3], [4], plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any differences in these indices.

Section snippets

Materials and methods

Annual projects promoting a healthy lifestyle in children have been performed since 1994 [5], [6], in conjunction with annual health checks as per Japanese school law in Ina town, Saitama Prefecture; this area has a population of approximately 35,000 and is located approximately 30 km north of Tokyo. The subjects of this study were participants in the health promotion plans rolled out in September 2002 and September 2003, and were composed of 9–10-year-old children (i.e., fourth graders) from

Results

A total of 1269 children (i.e., 350 boys and 318 girls aged 9–10 years, and 315 boys and 286 girls aged 12–13 years) agreed to participate in this study. Participation rates by calendar year were 98.9% for 2002 and 99.7% for 2003.

The prevalence rates of obesity were 19.3% (boys/girls: 22.3%/16.0%) for children aged 9–10 years, which was statistically higher than the rates of obesity for children aged 12–13 years, 13.3% (boys/girls: 14.0%/12.6%, p = 0.004 for total, p = 0.007 for boys and p = 0.249

Discussions

We hypothesized before the implementation of the study that the levels of GA, HbA1c, PG and IRI would be higher in obese, non-diabetic children compared to non-obese, non-diabetic children. We have already found that the level of GA was lower in obese children than in non-obese children in 2002; however, we postponed reporting this fact until we were able to perform the exact the same health examinations on a completely different sample of children in 2003 to examine the reliability of the

Acknowledgements

We are indebted to all the study participants and their parents as well as the members of the Board of Education in Ina town of Saitama Prefecture and the Ina town Conference for the Promotion and Operation of Childhood Lifestyle-Related Diseases Prevention Examination (Chairman: Dr. Michio Sato). Measurements of GA were conducted courtesy of the Asahi Kasei Corporation and the Daiichi Pure Chemicals Company Limited.

Grant support: This study was supported by a grant from the Ministry of

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2023, Clinical Neurology and Neurosurgery
There is growing interest in the use of new biomarkers such as glycated albumin (GA). In contrast to glycated hemoglobin (HbA1c), GA showed an inverse correlation with prestroke obesity status, but data are limited for ischemic stroke (IS).
We explored the association between GA and body mass index (BMI) and investigated inflammatory cytokines to support the academic background. In total, 155 patients with hyperacute IS (HIS) between 2011 and 2019 were included. To identify the association between GA and BMI, patients were divided into four groups according to BMI quartiles. Levels of inflammatory cytokines, including IL-1β, IL-10, IL-6, TNF-α, and TNF-R1, were determined by ELISA using a ProcartaPlex multiplex immunoassay.
The mean age of the 155 patients was 68 ± 12 years, and 67.1% were men. The lowest BMI group had higher GA levels (GA 2 T and 3 T = 80%) (p-value=0.017), and these U-shaped associations were maintained only for small vessel occlusion etiology (p-value= 0.004). Plasma IL-10 levels were positively correlated with BMI and showed a U-shaped pattern (p-value= 0.001).
GA levels and BMI had U-shaped associations with HIS. IL-10, which acts as a protective cytokine for cardiovascular disease, may play a novel role in this association. Although GA is an emerging favorable clinical marker of cardiovascular outcomes, obesity status should be considered when interpreting these associations.
Potential Markers of Dietary Glycemic Exposures for Sustained Dietary Interventions in Populations without Diabetes
2020, Advances in Nutrition
There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to postprandial hyperglycemic excursions. The accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, although this is used in clinical practice to monitor glycemic control in patients with diabetes, it has a number of drawbacks as a marker of efficacy of dietary interventions that might beneficially affect glycemic control in people without diabetes. Other markers that reflect shorter-term glycemic exposures have been studied and proposed, but consensus on the use and relevance of these markers is lacking. We have carried out a systematic search for studies that have tested the responsiveness of 6 possible alternatives to HbA1c as markers of sustained variation in glycemic exposures and thus their potential applicability for use in dietary intervention trials in subjects without diabetes: 1,5-anhydroglucitol (1,5-AG), dicarbonyl stress, fructosamine, glycated albumin (GA), advanced glycated end products (AGEs), and metabolomic profiles. The results suggest that GA may be the most promising for this purpose, but values may be confounded by effects of fat mass. 1,5-AG and fructosamine are probably not sensitive enough to the range of variation in glycemic exposures observed in healthy individuals. Use of measures based on dicarbonyls, AGEs, or metabolomic profiles would require further research into possible specific molecular species of interest. At present, none of the markers considered here is sufficiently validated and sensitive for routine use in substantiating the effects of sustained variation in dietary glycemic exposures in people without diabetes.
Influence of Sex Hormones on the Relationship Between Body Fat and Glycated Albumin Levels
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Previous studies have reported that glycated albumin (GA) is affected by body fat distribution. Sex hormones are reported to play an important role in fat metabolism.
This study aimed to explore the influence of sex hormones on the relationship between body fat and GA in a community population.
We recruited 763 middle-aged and elderly subjects with normal glucose tolerance from communities. GA was determined using the enzyme method, and serum estradiol (E₂), total testosterone, and sex hormone–binding globulin (SHBG) were detected using chemiluminescent microparticle immunoassays.
There was a statistically significant association between SHBG and GA remained after adjusting for body fat in both men and women.
The average serum GA levels were 13.40 ± 1.10% in the 298 men and 465 postmenopausal women included in this study. GA presented a significant downward trend with increasing quartiles of total fat mass (FM), limb FM, and trunk FM in both men and women (all P for trend < .01). In men, total testosterone, free testosterone, and SHBG were positively correlated with GA (both P < .01), and the correlation between SHBG and GA remained after adjusting for body fat (P < .01). In women, E2, free testosterone, bioactive testosterone, and SHBG were correlated with GA (all P < .01); furthermore, the positive correlation between SHBG and GA and the inverse correlation between E2 and GA remained after adjusting for body fat (both P < .05). Multivariate linear regression analyses showed that in addition to trunk FM, SHBG was positively correlated with GA in both men and women (standardized β = 0.136, P = .035; standardized β = 0.101, P = .033); however, E2 was not independently correlated with GA in women.
SHBG may contribute to the influence of body fat, especially trunk fat on GA levels.
This study used an automated bioelectrical impedance analyzer to measure segmental body composition including limb FM and trunk FM and further investigated the role of segmental body fat in the correlation between SHBG and GA. Sex hormones may explain in part why body fat content and distribution can alter GA levels.
SHBG is positively correlated with serum GA levels, and this correlation is independent of total or segmental body fat.
Xu Y, Ma X, Shen Y, et al. Influence of Sex Hormones on the Relationship Between Body Fat and Glycated Albumin Levels. J Sex Med 2020;17:903–910.
Glycated proteins in nutrition: Friend or foe?
2019, Experimental Gerontology
Advanced glycation end products (AGEs) are formed in in vivo, and accumulate in tissues and body fluids during ageing. Endogenous AGE-modified proteins show altered structure and function, and may interact with receptor for AGEs (RAGE) resulting in production of reactive oxygen species, inflammatory, atherogenic and diabetogenic responses. AGEs are also formed in thermally processed foods. Studies in rodents document that dietary AGEs are partially absorbed into circulation, and accumulate in different tissues. Knowledge on the health effects of high dietary intake of AGEs is incomplete and contradictory. In this overview we discuss the data from experimental and clinical studies, either those supporting the assumption that restriction of dietary AGEs associated with health benefits, or data suggesting that dietary intake of AGEs associates with positive health outcomes. We polemicize whether the effects of exaggerated intake or restriction of highly thermally processed foods might be straightforward interpreted as the effects of AGEs-rich vs. AGEs-restricted diets. We also underline the lack of studies, and thus a poor knowledge, on the effects of different single chemically defined AGEs administration, concurrent intake of different dietary AGEs, of load with dietary AGEs corresponding to the habitual diet in humans, and on those of dietary AGEs in vulnerable populations, such as infants and particularly elderly.
Glycated albumin level is significantly decreased in patients suffering nephrotic syndrome
2019, Progress in Molecular Biology and Translational Science
Citation Excerpt :
However, among the 57 diseases presented in current study, serum GA levels were either increased or decreased in a disease-dependent manner, indicating the serum GA levels were regulated by mechanisms beyond the blood glucose level. Indeed, several published reports revealed the similar observations.15,56–58 Generally, patients with a thinner body have higher serum GA levels.
Serum glycated albumin (GA) level is used along with that of glucose and glycated hemoglobin (HbA1c) as indicators of glycemic control for diabetic patients. Although serum GA levels are affected by blood glucose level, they are also influenced by serum albumin metabolism and other pathological conditions. However, a systematic comparison of the serum GA levels in different types of human diseases has not been reported. In current study, 86,319 clinical lab test results of GA levels from healthy individuals and patients with 57 different types of diseases during the past 5 years in our hospital were retrieved and analyzed. Based on the mean (SD), median, and p (− Log₁₀ p) values, we found 29/57 diseases including type 2 diabetes, diabetic nephropathy, uremia, pancreatic cancer, liver cancer, hepatic encephalopathy, and azotemia had significantly (p < 0.05, − Log₁₀ p > 1.30) increased GA levels whereas 18/57 diseases including nephrotic syndrome, preeclampsia, Wilms' tumor, lupus erythematosus, and sepsis had significantly decreased GA levels compared to that of healthy controls. Moreover, the highest − Log₁₀ p values (> 100) were observed in nephrotic syndrome, type 2 diabetes, preeclampsia, coronary heart disease, uremia, acute cerebral infarction, leukemia, and cerebrovascular disease in a descending order. These data indicated that the serum GA levels could be increased or decreased significantly in a disease-specific manner. Revealing the molecular mechanisms underlying these observations might make the increased or decreased serum GA levels indicators for different types of diseases, especially as an indicator that distinguishes nephrotic syndrome from other types of kidney diseases.
Associations of body mass index with glycated albumin and glycated albumin/glycated hemoglobin A<inf>1c</inf> ratio in Chinese diabetic and non-diabetic populations
2018, Clinica Chimica Acta
Citation Excerpt :
Additionally, fat mass and visceral adipose tissue were found to be independently and negatively associated with GA in both male and female [6]. Similar conclusions have been validated in other studies [7,8]. Consistently, our results revealed a negative correlation between BMI and GA in a non-diabetic population, as the decreasing trend in serum GA concentration was found to accompany with the increase in BMI.
Recent studies have discussed the relationship between body mass index (BMI) and glycated albumin (GA) level. However, the extent of the influence of BMI on GA remains uncertain. We investigated the associations between BMI and GA, glycated hemoglobin A_1c (HbA_1c) and GA/HbA_1c, and to analyze the influence of obesity on GA, HbA_1c, and GA/HbA_1c in both Chinese diabetic and non-diabetic populations.
A total of 2562 participants, including 1177 men and 1385 women (age 20–80 y), were enrolled. Each subject underwent a 75-g oral glucose tolerance test. Serum GA was detected using a liquid enzyme method, and HbA_1c was assayed using high-performance liquid chromatography.
In the diabetic patients (n = 1223), the GA, HbA_1c, and GA/HbA_1c levels were 16.7 ± 3.0%, 6.6 ± .9% (49 ± 9 mmol/mol), and 2.51 ± .33, respectively. In the non-diabetic subjects (n = 1339), the GA, HbA_1c, and GA/HbA_1c concentrations were 13.8 ± 1.7%, 5.6 ± .4% (38 ± 4 mmol/mol), and 2.47 ± .31, respectively. Decreasing trends in the GA and GA/HbA_1c concentrations and an increasing trend in the HbA_1c concentration (all P for trend <.05) were found to accompany with the increase in BMI, regardless of diabetes status. Multiple regression analysis revealed that BMI was independently related to HbA_1c in the non-diabetic population (standardized β = .158, P < .001); however, the relationship disappeared in the diabetic population (P > .05). Moreover, in the diabetic and non-diabetic populations, BMI was negatively correlated with GA (standardized β = −.167 and − .231, both P < .001) and GA/HbA_1c (standardized β = −.273 and − .310, both P < .001). Further analysis showed that a 1 kg/m² increment in BMI was associated with a .13% decrease in the absolute value of GA.
In both diabetic and non-diabetic populations, GA and GA/HbA_1c levels are independently and negatively associated with BMI. For every 1 kg/m² increment in BMI, the absolute value of GA decreases approximately .13%.

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Glycated albumin is low in obese, non-diabetic children

Abstract

Introduction

Section snippets

Materials and methods

Results

Discussions

Acknowledgements

Public Health

Prev. Med.

Clin. Chim. Acta

Increased incidence of non-insulin dependent diabetes mellitus among Japanese schoolchildren correlates with an increased intake of animal protein and fat

Clin. Pediatr.

Global prevalence of diabetes: estimates for the year 2000 and projections for 2030

Diab. Care