Clinical utility of glycated albumin and 1,5-anhydroglucitol in the screening and prediction of diabetes: A multi-center study

Table 1 Agreement in diagnostic classification between different biomarkers

		Normoglycemia	Prediabetes	Diabetes	Total
Concordance in diagnostics classification (HbA1c vs FPG)
		Classification based on FPG
Classification based on HbA1c	Normoglycemia	151	41	6	198
	Prediabetes	71	60	18	149
	Diabetes	7	20	88	115
	Total	229	121	112	462
Concordance in diagnostics classification (GA vs FPG)
		Classification based on FPG
Classification based on GA	Normoglycemia	127	31	9	167
	Prediabetes	90	67	21	178
	Diabetes	12	23	82	117
	Total	229	121	112	462
Concordance in diagnostics classification (GA vs HbA1c)
		Classification based on HbA1c
Classification based on GA	Normoglycemia	127	31	9	167
	Prediabetes	66	99	13	178
	Diabetes	5	19	93	117
	Total	198	149	115	462
Concordance in diagnostics classification (HbA1c/GA vs FPG)
		Classification based on FPG
Classification based on HbA1c/GA	Normoglycemia	112	15	0	127
	Prediabetes	104	77	15	196
	Diabetes	13	29	97	139
	Total	229	121	112	462

The number of subjects with the same diagnosis by both tests are underlined. Optimal cutoffs for prediabetes: Glycated albumin (GA): 13.06%; 1,5-anhydroglucitol (1,5-AG): 130.39 μmol/L; fasting plasma glucose (FPG): 5.43 mmol/L; glycated hemoglobin (HbA1c): 5.65%. Optimal cutoffs for diabetes: GA: 16.39%; 1,5-AG: 68.87 μmol/L; FPG: 6.43 mmol/L; HbA1c: 6.45%. GA: Glycated albumin; 1,5-AG: 1,5-anhydroglucitol; FPG: Fasting plasma glucose; HbA1c: Glycated hemoglobin.

Table 2 Circulating levels of fasting plasma glucose, glycated hemoglobin, glycated albumin and 1,5-anhydroglucitol of morbidly-obese patients with diabetes at baseline, one and three months after the bariatric surgery

	Baseline (n = 24)	1-month (n = 13)	3-month (n = 14)	P for trend
FPG (mmol/L)	8.27 ± 2.77	5.37 ± 0.83	5.23 ± 0.86	< 0.001
HbA1c (%)	7.18 ± 1.56	6.24 ± 1.14	5.33 ± 0.52	< 0.001
GA (%)	19.00 ± 5.98	10.85 ± 3.16	11.72 ± 2.97	< 0.001
1,5-AG (µmol/L)	61.09 ± 48.17	75.05 ± 53.77	80.28 ± 40.79	< 0.001

Data are presented as mean ± SD. FPG: Fasting plasma glucose; HbA1c: Glycated hemoglobin; GA: Glycated albumin; 1,5-AG: 1,5-anhydroglucitol.

Table 3 Predictive performance of the different prediction models

Prediction models	AUC (95%CI)	DeLong P value	Sensitivity (%)	Specificity (%)
Clinical Model 1 (BMI, HbA1c, FPG, 2hG)	0.783 (0.733-0.834)	0.736	72.78	73.72
Clinical Model 2 (BMI, HbA1c, FPG, TG1)	0.729 (0.673-0.784)	0.027	61.15	75.00
‘B3A’ Model [BMI and 3 biomarkers (HbA1c, GA, 1,5-AG)]	0.793 (0.744-0.843)	Reference	77.22	72.44

¹Natural-log transformed before analysis.

BMI: Body mass index; FPG: Fasting plasma glucose; HbA1c: Glycated hemoglobin; 1:5-AG: 1:5-anhydroglucitol; GA: Glycated albumin; TG: Triglyceride; AUC: Area under the receiver operating characteristic curve; 2hG: 2-hour glucose.