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Glycated albumin to glycated hemoglobin ratio and mortality in diabetic patients on dialysis: a new association.
Hoshino, Junichi; Abe, Masanori; Hamano, Takayuki; Hasegawa, Takeshi; Wada, Atsushi; Nakai, Shigeru; Hanafusa, Norio; Masakane, Ikuto; Nitta, Kosaku.
Afiliação
  • Hoshino J; The Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
  • Abe M; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
  • Hamano T; The Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
  • Hasegawa T; Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
  • Wada A; The Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
  • Nakai S; Department of Nephrology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
  • Hanafusa N; The Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
  • Masakane I; Showa University Research Administration Center (SURAC); Division of Nephrology, Department of Medicine, School of Medicine; Department of Hygiene, Public Health and Preventive Medicine, Graduate School of Medicine, Showa University, Tokyo, Japan.
  • Nitta K; The Committee of Renal Data Registry, the Japanese Society for Dialysis Therapy, Tokyo, Japan.
Nephrol Dial Transplant ; 38(5): 1309-1317, 2023 05 04.
Article em En | MEDLINE | ID: mdl-36309475
BACKGROUND: Hemoglobin A1c (A1c) and glycated albumin (GA) are two blood glycated proteins commonly used to monitor glycemic control in dialysis patients with diabetes. However, little is known about the association between the GA/A1c ratio and mortality in these populations. Here, we examine these associations using a nationwide cohort. METHODS: We enrolled 28 994 dialysis patients with diabetes who met our inclusion criteria (female, 32.9%; mean age, 67.4 ± 11.6 years; mean dialysis duration, 6.3 ± 5.8 years). After dividing the patients into groups based on GA/A1c quantiles and adjusting for 18 potential confounders, adjusted hazard ratios (HR) and 95% confidence limits were calculated for 3-year mortality and cause-specific mortalities. Additionally, propensity score matching analyses were used to compare mortalities between the low and high GA/A1c groups. RESULTS: After adjusting for possible confounders, significantly increased mortality was found in patients with GA/A1c ratios of 3.6-4.0 [HR 1.21 (1.10-1.34)] or higher [HR 1.43 (1.30-1.58)] than in those with GA/A1c ratios of 3.0-3.3. The risks of infectious and cardiovascular death were higher in these patients regardless of their nutritional status. In the propensity score matching analyses, significantly increased mortality was consistently found in those with a higher ratio (≥3.3) [HR 1.23 (1.14-1.33)] than in those with a lower ratio. CONCLUSIONS: The GA/A1c ratio was significantly associated with 3-year mortality, especially infectious and cardiovascular mortality, in dialysis patients with diabetes. This ratio may be a promising new clinical indicator of survival in these patients, independent of their current glycemic control and nutritional markers.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus / Diabetes Mellitus Tipo 2 Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans / Middle aged Idioma: En Revista: Nephrol Dial Transplant Assunto da revista: NEFROLOGIA / TRANSPLANTE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus / Diabetes Mellitus Tipo 2 Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans / Middle aged Idioma: En Revista: Nephrol Dial Transplant Assunto da revista: NEFROLOGIA / TRANSPLANTE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Japão