RESUMO
BACKGROUND: Glycated albumin (GA), the non-enzymatic glycation product of albumin in plasma, became a glycemic marker in the beginning of the 21st century. The assay is not affected by hemoglobin levels and reflects the glycemic status over a shorter period as compared to HbA1c measurements. Thus, GA may contributes as an intermediate glucose index in the current diabetes mellitus (DM) diagnostic system. AIM: To search and summarize the available data on glycated albumin measurements required for the diagnosis of diabetes mellitus. METHODS: Databases, including PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL), among others, were systematically searched. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was applied for the assessment of quality, and the bivariate model was used to pool the sensitivity and specificity. The hierarchical summary receiver operator characteristic curves (HSROC) model was utilized to estimate the summary receiver operating characteristics curve (SROC). Sensitivity analysis was performed to investigate the association of the study design and patient characteristics with the test accuracy and meta-regression to find the source of heterogeneity. RESULTS: Three studies regarding gestational diabetes mellitus (GDM) and a meta-analysis of 16 non-GDM studies, comprising a total sample size of 12876, were included in the work. Results reveal that the average cut-off values of GA reported for the diagnosis of GDM diagnosis was much lower than those for non-GDM. For non-GDM cases, diagnosing DM with a circulating GA cut-off of 14.0% had a sensitivity of 0.766 (95%CI: 0.539, 0.901), specificity of 0.687 (95%CI: 0.364, 0.894), and area under the curve of 0.80 (95%CI: 0.76, 0.83) for the SROC. The estimated SROC at different GA cut-off values for non-GDM exhibited that the average location parameter lambda of 16 non-GDM studies was 2.354 (95%CI: 2.002, 2.707), and the scale parameter beta was -0.163 (95%CI: -0.614, 0.288). These non-GDM studies with various thresholds had substantial heterogeneity, which may be attributed to the type of DM, age, and body mass index as possible sources. CONCLUSION: Glycated albumin in non-DM exhibits a moderate diagnostic accuracy. Further research on the diagnostic accuracy of GA for GDM and combinational measurements of GA and other assays is suggested.
RESUMO
During the period from December 2012 to December 2014, three dripping water sites (S1, S2, S3) and one pool water site (SC) have been selected for a long-term monitoring of geochemical indexes in Naduo Cave, Guanling county of Guizhou Province, China. Based on the local meteorological data, this paper analyzed the seasonal change of hydro-geochemical indicators and their feedbacks to climate events. The results indicated that the hydro-geochemical type of cave water was HCO3â»-Ca²âº. Dripping water and pool water were in deposition all the year, except in the month with the maximum precipitation. There were some discrepancies of main ions' concentration among three dripping water sites due to the difference of the migration pathways and migration time. Affected by mixed water and high CO2 concentration of cave air, the ion concentration of pool water was higher than dripping water, and there was considerable fluctuation. The geochemistry indexes of water in Naduo Cave showed extraordinary seasonal variation rules and could perfectly respond to the external climate environment. The concentration of ions was sensitive to the response of the annual precipitation change caused by extreme climate events. During the rainy season, the concentrations of Ca²âº, Mg²âº and SO4²â» in 2013 were relatively higher and more stable than those in 2014. The response time and susceptivity of each monitoring site were inconsistent.
