Alternative Markers of Hyperglycemia and Risk of Diabetes
- Stephen P. Juraschek, BA1,
- Michael W. Steffes, MD, PHD2,
- Edgar R. Miller III, MD, PHD1 and
- Elizabeth Selvin, PHD, MPH1⇓
- 1The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions, Baltimore, Maryland
- 2University of Minnesota Medical School, Department of Laboratory Medicine and Pathology, Minneapolis, Minnesota
- Corresponding author: Elizabeth Selvin, .
OBJECTIVE Fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG) are of interest for monitoring short-term glycemic control in patients with diabetes; however, their associations with diabetes risk are uncharacterized.
RESEARCH DESIGN AND METHODS We used Cox proportional hazards models to examine the associations of fructosamine, glycated albumin, and 1,5-AG with incident diabetes in 1,299 participants, from the Atherosclerosis Risk in Communities (ARIC) Study (2005–2006), who had no history of diagnosed diabetes at baseline. Incident diabetes was self-reported during annual telephone calls.
RESULTS There were 119 new cases of diabetes during a median follow-up of 3.3 years. When compared with the lowest quartile, the fourth quartiles of fructosamine and glycated albumin were significantly associated with diabetes risk (hazard ratio [HR] 3.99 [95% CI 1.93-8.28] and 5.22 [2.49-10.94], respectively). The fourth quartile of 1,5-AG was associated with a significantly lower diabetes risk (0.27 [0.14-0.55]). Associations were attenuated but still significant after adjustment for hemoglobin A1c (A1C) or fasting glucose.
CONCLUSIONS Fructosamine, glycated albumin, and 1,5-AG were associated with the subsequent development of diabetes independently of baseline A1C and fasting glucose. Our results suggest these alternative biomarkers may be useful in identifying persons at risk for diabetes.
- Received April 25, 2012.
- Accepted May 30, 2012.
- © 2012 by the American Diabetes Association.
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