ARIC: Fructosamine, glycated albumin associated with incident diabetes

Fructosamine and glycated albumin were independently associated with the risk for incident diabetes, prevalent retinopathy and incident chronic kidney disease, according to researchers. However, these associations were modest compared with HbA1c, according to data published in The Lancet.

“These results suggest that measurement of these non-traditional markers of hyperglycemia might be useful in clinical practice,” researchers wrote.

They measured glycated albumin and fructosamine of 11,348 adults without diabetes and 958 adults diagnosed with type 1 and type 2 diabetes who participated in the second examination of the Atherosclerosis Risk in Communities (ARIC) study in 1990-1992.

They analyzed data from the community-based population of more than 10,000 patients with 20 years of follow-up. The researchers compared the associations of fructosamine and glycated albumin with risk of incident diabetes, retinopathy, and risk for incident chronic kidney disease (CKD), with those of HbA1c with incident diabetes, retinopathy, and CKD, according to data.

The risk for incident diabetes was 4.96 (95% CI, 4.36-5·64) for fructosamine >95th percentile and 6.17 (5.45-6.99) for glycated albumin >95th percentile, according to data.

Moreover, the associations continued after adjustments for HbA1c values. Fructosamine and glycated albumin were independently associated with retinopathy (P<.0001 for trend), researchers wrote.

Multivariate analysis showed the risk for CKD was 1.5 (95% CI, 1.22-1.85) in patients with fructosamine >95th percentile, and 1.48 (95%CI, 1.2-1.83) in patients with glycated albumin >95th percentile, compared with patients without diabetes and fructosamine or glycated albumin below the 75th percentile.

“Prediction of incident CKD by fructosamine ([C statistic], 0.717) and glycated albumin ([C statistic], 0.717) were nearly as strong as by HbA1c (0.726) but, as might be expected, HbA1c outperformed fructosamine and glycated albumin for prediction of incident diabetes with C statistics of 0.76, 0.706, and 0.703, respectively,” researchers wrote.

For more information:

Cohen RM. Lancet; 2014; doi: 10.1016/S2213-858(14)70003-8.

Selvin E. Lancet; 2014; doi: 10.1016/S2213-8587(13)70199-2.

Disclosure: The researchers report no relevant financial disclosures.