Evidence for consistency of the glycation gap in diabetes.
Nayak, Ananth U. Holland, Martin R. Macdonald, David R. Nevill, Alan M. Singh, Baldev M.
Nayak, Ananth U.
Holland, Martin R.
Macdonald, David R.
Nevill, Alan M.
Singh, Baldev M.
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2011
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Abstract
OBJECTIVE Discordance between HbA(1c) and fructosamine estimations in the assessment of glycemia is often encountered. A number of mechanisms might explain such discordance, but whether it is consistent is uncertain. This study aims to coanalyze paired glycosylated hemoglobin (HbA(1c))-fructosamine estimations by using fructosamine to determine a predicted HbA(1c), to calculate a glycation gap (G-gap) and to determine whether the G-gap is consistent over time. RESEARCH DESIGN AND METHODS We included 2,263 individuals with diabetes who had at least two paired HbA(1c)-fructosamine estimations that were separated by 10 ± 8 months. Of these, 1,217 individuals had a third pair. The G-gap was calculated as G-gap = HbA(1c) minus the standardized fructosamine-derived HbA(1c) equivalent (FHbA(1c)). The hypothesis that the G-gap would remain consistent in individuals over time was tested. RESULTS The G-gaps were similar in the first, second, and third paired samples (0.0 ± 1.2, 0.0 ± 1.3, and 0.0 ± 1.3, respectively). Despite significant changes in the HbA(1c) and fructosamine, the G-gap did not differ in absolute or relative terms and showed no significant within subject variability. The direction of the G-gap remained consistent. CONCLUSIONS The G-gap appears consistent over time; thus, by inference any key underlying mechanisms are likely to be consistent. G-gap calculation may be a method of exploring and evaluating any such underlying mechanisms.
Citation
Diabetes Care
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Journal
Research Unit
PubMed ID
21715524
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Journal article
Language
en
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Epub ahead of print
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ISSN
1935-5548