ISPAD2014_Conference Resources _Abstracts Library - page 258

Conference Resources | Abstracts
September 3 rd – 6 th, 2014 | Toronto, Canada |www.ispad.org/2014 258
P169
Estimation of recent past glycemic control using glycoalbumin/ A1C ratio
I. Musha1, M. Mochizuki2, J. Akatsuka 1, A. Ohtake1, K. Kobayashi2, T. Kikuchi1, N. Kikuchi3, T.
Kawamura4, T. Urakami5, S. Sugihara6, T. Hoshino7, S. Amemiya 1, The Japanese Study Group of
Insulin Therapy for Childhood and Adolescent Diabetes
1Saitama Medical University, Pediatrics, Saitama, Japan, 2Yamanashi University, Pediatrics,
Yamanashi, Japan, 3Yokohama City Minato Red Cross Hospital, Pediatrics, Kanagawa, Japan,
4Osaka City University, Pediatrics, Osaka, Japan, 5Surugadai Nihon University Hospital, Pediatrics,
Tokyo, Japan, 6Tokyo Women's Medical University Medical Center East, Pediatrics, Tokyo, Japan,
7Institute of Biopathological Medicine, Kanagawa, Japan
Objectives: Long-term glycemic control has been assessed by A1C as a gold standard, usually
measured every 3 or 4 months not enough to assess the recent past change. On the basis of each
glycated protein half-life, we try to clarify whether glycoalbumin (GA)/ A1C ratio obtained by
simultaneous measurement can estimate the glycemic control for approximately past one month.
Methods: Three hundreds six patients with T1DM obtained each individual intrinsic GA/ A1C ratio
over time by the average value using simultaneous measurement of GA and A1C more than ten times.
The SD scores (SDS) of GA/ A1C ratio were also applied. ΔA1C between A1C at estimation and that
one month ago were individually evaluated totally 937 occasions by %ΔGA/A1C = (GA/A1C ratio at
estimation - each patient's intrinsic GA/A1C ratio) ÷ each patient's intrinsic GA/A1C ratio*100.
Results: The individual consistency of GA/ A1C ratio over time was confirmed by the product of any
pairs between SDS at each term and average SDS in each patient with significant quadratic curves
(R2=0.77 to 0.81). If the increases of %ΔGA/A1C were divided into four groups, A:0~< +3%,
B:+3~< +6%, C:+6~< +9% and D:≥+9%, average ΔA1C were revealed to be -0.03, -0.06, +0.16 and
+0.25 %, respectively. The worsened ΔA1C defined by ≥+0.2% one month apart were seen in 99 of
309 and 109 of 206 occasions in groups A+B and C+D, respectively, significantly different (p< 0.0001).
If the decreases of %ΔGA/A1C were divided into four groups, E:0~>-3%, F:-3~>-6%, G:-6~>-9% and
H:≤-9%, average ΔA1C were revealed to be -0.07, -0.27, -0.19 and -0.28 %, respectively. The
improved ΔA1C defined by ≤-0.2% one month apart were seen in 53 of 174 and 100 of 248 occasions
in groups E and F+G+H, respectively, significantly different (p=0.004).
Conclusions: We suggest that the fluctuation of GA/ A1C ratio in our real practice may estimate
glycemic control past one month, especially worsening and improving if ≥+6% and ≤-3% ΔGA/A1C,
respectively.