GA/HbA1c ratio is a simple and practical indicator to evaluate the risk of metabolic dysfunction-associated fatty liver disease in type 2 diabetes: an observational study.

BACKGROUND: It is still debatable whether glycated albumin/glycated hemoglobin A1C (GA/HbA1C) ratio is associated with metabolic dysfunction-associated fatty liver disease (MAFLD), and few studies have been conducted in type 2 diabetes mellitus (T2DM). Therefore, we aimed to investigate the association between GA/HbA1C ratio and MAFLD and to evaluate whether GA/HbA1C ratio can be used an indicator of MAFLD in Chinese patients with T2DM. METHODS: This cross-sectional study consisted of 7117 T2DM patients including 3296 men and 3821 women from real-world settings. Abdominal ultrasonography was performed to diagnose MAFLD. In addition to comparing the clinical characteristics among the GA/HbA1C ratio quartile groups, we also investigated the associations of GA/HbA1C ratio and quartiles with MAFLD in T2DM subjects. RESULTS: There was a significantly decreased trend in the MAFLD prevalence across the GA/HbA1C ratio quartiles (56.3%, 47.4%, 37.8%, and 35.6% for the first, second, third, and fourth quartile, respectively, P < 0.001 for trend) after adjusting for gender, age, and diabetes duration. Fully adjusted Binary logistic regression indicated that both GA/HbA1C ratio (OR: 0.575, 95% CI: 0.471 to 0.702, P < 0.001) and quartiles (P < 0.001 for trend) were inversely associated with the presence of MAFLD among T2DM patients. Additionally, HOMA2-IR values were clearly increased in the T2DM subjects with MAFLD compared with those without MAFLD (P < 0.001), and markedly increased from the highest to the lowest GA/HbA1C ratio quartile (P < 0.001 for trend). CONCLUSIONS: GA/HbA1C ratio is closely and negatively associated with MAFLD in T2DM subjects, which may attribute to that GA/HbA1C ratio reflects the degree of insulin resistance. GA/HbA1C ratio may act as a simple and practical indicator to evaluate the risk of MAFLD in T2DM.

The Glycated Albumin (GA) to HbA1c Ratio Reflects Shorter-Term Glycemic Control than GA: Analysis of Patients with Fulminant Type 1 Diabetes.

BACKGROUND: Glycated albumin (GA) reflects shorter-term glycemic control than HbA1c. We have reported that HbA1c is paradoxically increased in diabetic patients whose glycemic control deteriorated before ameliorating. In this study, we analyzed paradoxical increases of glycemic control indicators after treatment in patients with fulminant type 1 diabetes (FT1D). We also investigated whether the GA/HbA1c ratio may reflect shorter-term glycemic control than GA. METHODS: Five FT1D patients whose post-treatment HbA1c and GA levels were measured were enrolled. We also used a formula to estimate HbA1c and GA from the fictitious models of changes in plasma glucose in FT1D patients. In this model, the periods during which HbA1c, GA, and the GA/HbA1c ratio were higher than at the first visit were compared. In addition, the half-life for the GA/HbA1c ratio was calculated in accordance with the half-lives for HbA1c and GA (36 and 14 days, respectively). RESULTS: In all FT1D patients, HbA1c levels 2-4 weeks after treatment were increased, with three patients (60%) experiencing an increase of GA levels. In contrast, an increase of the GA/HbA1c ratio was observed in only one patient. In all of the different models of changes in plasma glucose in FT1D patients, the length of time during which the values were higher than at the first visit was in the order of HbA1c > GA > GA/HbA1c ratio. The half-life for the GA/HbA1c ratio was 9 days, shorter than GA. CONCLUSIONS: These findings suggest that the GA/HbA1c ratio reflects shorter-term glycemic control than GA.

Association of GA/HbA1c ratio and cognitive impairment in subjects with type 2 diabetes mellitus.

AIMS: The aim of this study was to search for factors influencing cognitive impairment and to clarify the association between the fluctuation of blood glucose levels and cognitive impairment in elderly Japanese subjects with type 2 diabetes. METHODS: We recruited 88 relatively elderly subjects (≥65years old) with type 2 diabetes who were hospitalized in Kawasaki Medical School from January 2014 to December 2015. We evaluated the fluctuation of blood glucose levels with glycoalbumin (GA)/hemoglobin A1c (HbA1c) ratio, and estimated cognitive impairment with Hasegawa dementia scale-revised (HDS-R) score and mini mental state examination (MMSE) score. RESULTS: Multivariate analyses showed that GA/HbA1c ratio and urinary albumin excretion, but not hypoglycemia, were independent determinant factors for cognitive impairment in elderly Japanese subjects with type 2 diabetes. CONCLUSIONS: The fluctuation of blood glucose levels per se is closely associated with cognitive impairment in elderly subjects with type 2 diabetes even when hypoglycemia is not accompanied. Since it is very easy to calculate GA/HbA1c ratio, we should check this ratio so that we can reduce the fluctuation of blood glucose levels especially in elderly subjects with type 2 diabetes.

Correlation of GA/HbA1c ratio with carotid atherosclerosis in type 2 diabetes / 实用医学杂志

Objective To investigate the association between the glycated albumin to glycated hemoglobin (GA/A1c) ratio and carotid plaque. Methods Type 2 diabetic (T2DM) patients in endocrine inpatient department of Sichuan Provincial People′s Hospital were chosen whose clinical data were collected. Results Of the recruited 154 T2DM patients , GA/HbA1c ratio was negatively correlated with BMI , blood uric acid and was positively correlated with age, HCY, FBG, PBG, left carotid IMT and right carotid IMT. In terms of carotid plaque, GA, GA/HbA1c ratio and HCY were higher in carotid plaque positive patients than those without carotid plaque. The results of logistic regression analysis showed that GA/HbA1c ratio was significantly associated with the presence of carotid plaque (P=0.008). Conclusions GA/HbA1c ratio was positively correlated with the presence of carotid artery IMT in T2DM This suggests that GA/HbA1c ratio will serve as a useful clinical marker for predicting diabetic cardiovascular complications.

Diagnostic and therapeutical value of FPG,GA,HbA1c and GA/HbA1c ratio in T1 DM/T2 DM / 中国免疫学杂志

Objective:To investigate the diagnostic and terapeutical value of FPG,GA,HbA1c and GA/HbA1c ratio in T1DM/T2DM.Methods:The study was made by case-control method.In our study,30 healthy subjects were selected from health physical ex-amination as control group while 160 diabetics were selected as case group,in which there are 76 TIDM and 84 T2DM.Analyzing the difference of relevance of FPG,GA and HbA1c,the difference of GA/HbA1c and threshold of the case and the control,and this analysis was also used between the T1DM and the T2DM.The data was managed by independent-sample t test,ROCK and Pearson correlation test of SPSS.Results:The results of FPG,GA ,HbA1c and GA/HbA1c ratio of T1DM and T2DM were significantly higher than those in the control group(P0.05),and weakly negative correlative with HbA1c(P>0.05);in T2DM group,there were positive correlation among FPG,GA and HbA1c(PFPG/GA>FPG/HbA1c;analyzing the ROC of measures in T1DM group,the sensitivity and specificity were re-spectively 86.8% and 100% for diagnosing DM when FPG threshold was set on 5.86 mmol/L ( AUC=0.922 ) ( P0.05).Conclusion:FPG,GA, HbA1c and GA/HbA1c ratio are of high value in monitoring of blood glucose, diagnosis and typing in T1DM and T2DM.There are missed diagnosis when we diagnose T1DM and T2DM by the upper limit of reagent instruestion of FPG,GA,HbA1c.It is more important for a person with T1DM to monitor FPG than others.