Serum glycated albumin predicts the progression of carotid arterial atherosclerosis

Introduction: We investigated the association between the ratio of serum glycated albumin (GA) levels to hyperglycemic levels (GA/A1c ratio) and the progression of carotid artery atherosclerosis. Methods: For this retrospective longitudinal study we recruited patients who had undergone carotid IMT measurement twice and been tested consecutively for both A1c and GA levels every 3 or 6 months. The subjects were classified into two groups based on non-progression (group I) and progression (group II) of carotid IMT. Mean values of A1c and GA and the GA/A1c ratio were compared between groups. Results: Of the 218 subjects (122 men and 96 women), group II (n=77) showed significantly higher baseline systolic BP, eGFR, GA, GA/A1c ratio, and progression of carotid IMT (Δ IMT) than group I (n = 141). The mean A1c level tended to be higher in group II than in group I (p = 0.054). By Spearman's correlation test, baseline diastolic BP, total cholesterol, triglyceride, GA, and GA/A1c were significantly associated with Δ IMT in group II but not in group I. In multivariate regression analysis, serum level of GA and GA/HbA1c ratio predicted progression of IMT after adjustment for other risk factors in both models applied. Conclusion: We suggest that glycated albumin is not only a useful glycemic index but also might be an atherogenic protein in the development of diabetic atherosclerosis.