Glycated albumin and direct low density lipoprotein cholesterol levels in type 2 diabetes mellitus

Background: Diabetes mellitus is a major risk factor for coronary heart disease (CND), renal failure, retinopathy. and neuropathy. Lowering glycosylated hemoglobin (HbA1c) as well as low-density lipoprotein-cholesterol (LDL-C) has been associated with a decreased risk of these complications. We evaluated the utility of glycated albumin (GA) and direct LDL-C, 2 novel assay, as compared to HbA1c and calculated LDL-C, in evaluating diabetes control and lipid in a heterogeneous population and in specific subgroups of patients with type 2 diabetes mellitus. Methods: We obtained fasting blood samples and measured HbA1c, GA, and direct LDL-C, as well as other parameters, in a multi-ethnic population of 616 male and female patients with type 2 diabetes and 895 nondiabetic controls. Results: HbA1c and GA levels, which measure different periods of glycemia, had a correlation of r = 0.70 (p < 0.001), and mean values in patients were 38.7% and 43.4% higher, respectively, than controls in men, and 41.1% and 40.1% higher, respectively, than controls, in women (both p < 0.001). Calculated and direct LDL-C values correlated very highly (r = 0.96, p < 0.001). The correlations between HbA1c and GA, and between calculated and direct LDL-C were similar for subgroups defined by gender, race, age, and other factors. Conclusions: Calculated LDL-C provides an accurate assessment of fasting LDL-C compared with a direct measurement in most subjects, except for those with hypertriglyceridemia, and GA correlates with HbA1c in diabetic and non-diabetic subjects and may serve as a reasonable marker of short term diabetic control. (C) 2009 Elsevier B.V. All rights reserved.