ABSTRACT
Objective To investigate the level of glycosylated albumin (GA) in liver cirrhosis patients with different Child-Pugh classes and its application value in predicting liver function. Methods A total of 486 patients with liver cirrhosis who were hospitalized in Tianjin Third Central Hospital from January 1 to December 31, 2019, were enrolled, among whom 227 patients had liver cirrhosis without diabetes and 259 patients had liver cirrhosis with diabetes. The patients were divided into groups according to Child-Turcotte-Pugh (CTP) score, and fasting blood glucose, glycosylated hemoglobin, and percentage of GA (GA%) were measured. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups, and the Dwass-Steel-Critchlow-Fligner test was used for further comparison between two groups. Scatter plots and fitting curves were plotted for CTP score and GA% to evaluate the association between them and calculate the cut-off value. Results For the cirrhosis patients without diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =24.809, P < 0.001), fasting blood glucose ( χ 2 =11.899, P =0.003), and glycosylated hemoglobin ( χ 2 =13.607, P =0.001); further pairwise comparison showed that there was a significant difference in GA% between Child-Pugh class A/B liver cirrhosis patients without diabetes and Child-Pugh class C liver cirrhosis patients ( P < 0.05), Child-Pugh class A patients had a significantly higher level of fasting blood glucose than Child-Pugh class B patients ( P < 0.05), and Child-Pugh class A patients had a significantly higher level of glycosylated hemoglobin than Child-Pugh class B/C patients ( P < 0.05). For the patients with liver cirrhosis and diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =10.734, P =0.005) and fasting blood glucose ( χ 2 =16.295, P < 0.001); further pairwise comparison showed that Child-Pugh class C liver cirrhosis patients with diabetes had a significantly lower GA% than Child-Pugh class A/B patients ( P < 0.05) and Child-Pugh class A patients had a significantly lower fasting blood glucose level than Child-Pugh class B patients ( P < 0.05). The fitting curve showed that GA% increased with the increase in CTP score in the liver cirrhosis patients without diabetes, reached the highest value at the CTP score of 6.5, and then started to decrease, with the lower value at the CTP score of 11.5, which showed a curvilinear relationship; in the liver cirrhosis patients with diabetes, GA% first increased and then decreased with the increase in CTP score, with a cut-off value of 8. Conclusion GA% first increases and then decreases along with the progression of liver cirrhosis. There is a significant difference in GA between liver cirrhosis patients with different Child-Pugh classes, suggesting that the reduction in GA is closely associated with liver function decompensation in end-stage liver cirrhosis.
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Objective: To investigate the relationship between glycated albumin levels and diabetic nephropathy in patients with type 2 diabetes mellitus.Methods: From January 2006 to June 2009,78 patients with type 2 diabetes mellitus in our hospital were enrolled in the study. We used liquid enzymatic to detect glycated albumin,and compare with 50 cases of healthy in the same period as the control group.Results: The glycated albumin was different between the control group and the diabetic nephropathy groups(F=8.953,P=0.000). Glycated albumin in each diabetes group was higher than that in the control group;glycated albumin in diabetic nephropathy groups was higher than that in non-diabetic nephropathy group;glycated albumin in end-stage diabetic nephropathy group was higher than that in the rest of groups.The severity of diabetic nephropathy and level of glycated albumin were related,rs was 0.754(t=6.547,P=0.008).Logistic regression showed that glycated albumin was an independent risk factor impacting on the incidence of diabetic nephropathy and the severity of the disease,multi-adjusted OR value was 2.326,and 95%CI was 2.114-2.538.Conclusions:Glyeated albumin plays an important role in the pathogenesis of diabetic nephropathy ,and it is closely related to the phases of diabetic nephropathy.
ABSTRACT
Glucose intolerance commonly occurs in patients with renal failure undergoing hemodialysis. whether this mild glucose intolerance contributes to pathogenesis of uremic complication in unknown. Abnormally elevated levels of Hb A1 have been reported in patients with chronic renal failure, whether or not they were undergoing hemodialysis. However serum levels of glycosylated albumin and fructosamine were not evaluated well. Our study was designed to examine fructosamine and glycosylated albumin to assess non-enzymatic glycosylation in patients with chronic renal failure undergoing maintenance dialysis(15 CAPD and 35 hemodialysis patients) and 33 healthy control subjects. Serum fructosamine levels were high in the hemodialysis patients(391.00+/-128.43micromol/L, P<0.05) than control(268.91+/-58.31micromol/L) and CAPD patients(267.7+/-41.27micromo/L). And serum glycosylated albumin levels were also high in the hemodialysis patients(240.40+/-43.99micromol/L, P<0.05) than control (146.22+/-24.88micromol/L) and CAPD patients(172.3+/-42.89micromol/L). After correction for serum albumin concentration, glycosylated albumin was raised in hemodialysis patients(6365.74+/-1307.98micromol/g, P< 0.05) compare with control subject(3259.74+/-581.07micromol/g) and CAPD patients(4988.13+/-1316.47micromol/g). And after correction for serum albumin or protein , fructosmaine was raised in the hemodialysis patients (10282.06+/-3927.37, 3760.00+/-12600.00micromol/g, respectively, P<0.05) compared with control(5705.81+/-1411.36, 1906.67+/-6869.50micromol/g, respectively) and CAPD patients(7752.33+/-2260.16, 869.05+/-5919.35micromol/ g, respectively) This result suggest that dialysis patients have increased protein glycosylation especially in case of hemodialysis patients, most likely reflecting increased non-enzymatic glycosylation of serum protein by impaired glucose tolerance.