Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients

Tariq Shafi, Stephen M. Sozio, Laura C. Plantinga, Bernard G. Jaar, Edward T. Kim, Rulan S. Parekh, Michael W Steffes, Neil R. Powe, Josef Coresh, Elizabeth Selvin

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

OBJECTIVE - Assays for serum total glycated proteins (fructosamine) and the more specific glycated albumin may be useful indicators of hyperglycemia in dialysis patients, either as substitutes or adjuncts to standard markers such as hemoglobin A1c, as they are not affected by erythrocyte turnover. However, their relationship with long-termoutcomes in dialysis patients is not well described. RESEARCH DESIGN AND METHODS - We measured fructosamine and glycated albumin in baseline samples from 503 incident hemodialysis participants of a national prospective cohort study, with enrollment from 1995-1998 and median follow-up of 3.5 years. Outcomes were all-cause and cardiovascular disease (CVD) mortality and morbidity (first CVD event and first sepsis hospitalization) analyzed using Cox regression adjusted for demographic and clinical characteristics, and comorbidities. RESULTS - Mean age was 58 years, 64% were white, 54% were male, and 57% had diabetes. There were 354 deaths (159 from CVD), 302 CVD events, and 118 sepsis hospitalizations over follow-up. Both fructosamine and glycated albumin were associated with all-cause mortality; adjusted HR per doubling of the biomarker was 1.96 (95% CI 1.38 - 2.79) for fructosamine and 1.40 (1.09- 1.80) for glycated albumin. Both markers were also associated with CVD mortality [fructosamine 2.13 (1.28 - 3.54); glycated albumin 1.55 (1.09 - 2.21)]. Higher values of both markers were associated with trends toward a higher risk of hospitalization with sepsis [fructosamine 1.75 (1.01-3.02); glycated albumin 1.39 (0.94-2.06)]. CONCLUSIONS - Serum fructosamine and glycated albumin are risk factors for mortality and morbidity in hemodialysis patients.

Original languageEnglish (US)
Pages (from-to)1522-1533
Number of pages12
JournalDiabetes care
Volume36
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Fructosamine
Serum Albumin
Renal Dialysis
Mortality
Cardiovascular Diseases
Sepsis
Hospitalization
Dialysis
Morbidity
glycosylated serum albumin
Hyperglycemia
Comorbidity
Hemoglobins
Cohort Studies
Research Design
Erythrocytes
Biomarkers
Demography
Prospective Studies
Serum

Cite this

Shafi, T., Sozio, S. M., Plantinga, L. C., Jaar, B. G., Kim, E. T., Parekh, R. S., ... Selvin, E. (2013). Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients. Diabetes care, 36(6), 1522-1533. https://doi.org/10.2337/dc12-1896

Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients. / Shafi, Tariq; Sozio, Stephen M.; Plantinga, Laura C.; Jaar, Bernard G.; Kim, Edward T.; Parekh, Rulan S.; Steffes, Michael W; Powe, Neil R.; Coresh, Josef; Selvin, Elizabeth.

In: Diabetes care, Vol. 36, No. 6, 01.06.2013, p. 1522-1533.

Research output: Contribution to journalArticle

Shafi, T, Sozio, SM, Plantinga, LC, Jaar, BG, Kim, ET, Parekh, RS, Steffes, MW, Powe, NR, Coresh, J & Selvin, E 2013, 'Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients', Diabetes care, vol. 36, no. 6, pp. 1522-1533. https://doi.org/10.2337/dc12-1896
Shafi, Tariq ; Sozio, Stephen M. ; Plantinga, Laura C. ; Jaar, Bernard G. ; Kim, Edward T. ; Parekh, Rulan S. ; Steffes, Michael W ; Powe, Neil R. ; Coresh, Josef ; Selvin, Elizabeth. / Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients. In: Diabetes care. 2013 ; Vol. 36, No. 6. pp. 1522-1533.
@article{46b061fef81d483e991c0c054eb5e092,
title = "Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients",
abstract = "OBJECTIVE - Assays for serum total glycated proteins (fructosamine) and the more specific glycated albumin may be useful indicators of hyperglycemia in dialysis patients, either as substitutes or adjuncts to standard markers such as hemoglobin A1c, as they are not affected by erythrocyte turnover. However, their relationship with long-termoutcomes in dialysis patients is not well described. RESEARCH DESIGN AND METHODS - We measured fructosamine and glycated albumin in baseline samples from 503 incident hemodialysis participants of a national prospective cohort study, with enrollment from 1995-1998 and median follow-up of 3.5 years. Outcomes were all-cause and cardiovascular disease (CVD) mortality and morbidity (first CVD event and first sepsis hospitalization) analyzed using Cox regression adjusted for demographic and clinical characteristics, and comorbidities. RESULTS - Mean age was 58 years, 64{\%} were white, 54{\%} were male, and 57{\%} had diabetes. There were 354 deaths (159 from CVD), 302 CVD events, and 118 sepsis hospitalizations over follow-up. Both fructosamine and glycated albumin were associated with all-cause mortality; adjusted HR per doubling of the biomarker was 1.96 (95{\%} CI 1.38 - 2.79) for fructosamine and 1.40 (1.09- 1.80) for glycated albumin. Both markers were also associated with CVD mortality [fructosamine 2.13 (1.28 - 3.54); glycated albumin 1.55 (1.09 - 2.21)]. Higher values of both markers were associated with trends toward a higher risk of hospitalization with sepsis [fructosamine 1.75 (1.01-3.02); glycated albumin 1.39 (0.94-2.06)]. CONCLUSIONS - Serum fructosamine and glycated albumin are risk factors for mortality and morbidity in hemodialysis patients.",
author = "Tariq Shafi and Sozio, {Stephen M.} and Plantinga, {Laura C.} and Jaar, {Bernard G.} and Kim, {Edward T.} and Parekh, {Rulan S.} and Steffes, {Michael W} and Powe, {Neil R.} and Josef Coresh and Elizabeth Selvin",
year = "2013",
month = "6",
day = "1",
doi = "10.2337/dc12-1896",
language = "English (US)",
volume = "36",
pages = "1522--1533",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "6",

}

TY - JOUR

T1 - Serum fructosamine and glycated albumin and risk of mortality and clinical outcomes in hemodialysis patients

AU - Shafi, Tariq

AU - Sozio, Stephen M.

AU - Plantinga, Laura C.

AU - Jaar, Bernard G.

AU - Kim, Edward T.

AU - Parekh, Rulan S.

AU - Steffes, Michael W

AU - Powe, Neil R.

AU - Coresh, Josef

AU - Selvin, Elizabeth

PY - 2013/6/1

Y1 - 2013/6/1

N2 - OBJECTIVE - Assays for serum total glycated proteins (fructosamine) and the more specific glycated albumin may be useful indicators of hyperglycemia in dialysis patients, either as substitutes or adjuncts to standard markers such as hemoglobin A1c, as they are not affected by erythrocyte turnover. However, their relationship with long-termoutcomes in dialysis patients is not well described. RESEARCH DESIGN AND METHODS - We measured fructosamine and glycated albumin in baseline samples from 503 incident hemodialysis participants of a national prospective cohort study, with enrollment from 1995-1998 and median follow-up of 3.5 years. Outcomes were all-cause and cardiovascular disease (CVD) mortality and morbidity (first CVD event and first sepsis hospitalization) analyzed using Cox regression adjusted for demographic and clinical characteristics, and comorbidities. RESULTS - Mean age was 58 years, 64% were white, 54% were male, and 57% had diabetes. There were 354 deaths (159 from CVD), 302 CVD events, and 118 sepsis hospitalizations over follow-up. Both fructosamine and glycated albumin were associated with all-cause mortality; adjusted HR per doubling of the biomarker was 1.96 (95% CI 1.38 - 2.79) for fructosamine and 1.40 (1.09- 1.80) for glycated albumin. Both markers were also associated with CVD mortality [fructosamine 2.13 (1.28 - 3.54); glycated albumin 1.55 (1.09 - 2.21)]. Higher values of both markers were associated with trends toward a higher risk of hospitalization with sepsis [fructosamine 1.75 (1.01-3.02); glycated albumin 1.39 (0.94-2.06)]. CONCLUSIONS - Serum fructosamine and glycated albumin are risk factors for mortality and morbidity in hemodialysis patients.

AB - OBJECTIVE - Assays for serum total glycated proteins (fructosamine) and the more specific glycated albumin may be useful indicators of hyperglycemia in dialysis patients, either as substitutes or adjuncts to standard markers such as hemoglobin A1c, as they are not affected by erythrocyte turnover. However, their relationship with long-termoutcomes in dialysis patients is not well described. RESEARCH DESIGN AND METHODS - We measured fructosamine and glycated albumin in baseline samples from 503 incident hemodialysis participants of a national prospective cohort study, with enrollment from 1995-1998 and median follow-up of 3.5 years. Outcomes were all-cause and cardiovascular disease (CVD) mortality and morbidity (first CVD event and first sepsis hospitalization) analyzed using Cox regression adjusted for demographic and clinical characteristics, and comorbidities. RESULTS - Mean age was 58 years, 64% were white, 54% were male, and 57% had diabetes. There were 354 deaths (159 from CVD), 302 CVD events, and 118 sepsis hospitalizations over follow-up. Both fructosamine and glycated albumin were associated with all-cause mortality; adjusted HR per doubling of the biomarker was 1.96 (95% CI 1.38 - 2.79) for fructosamine and 1.40 (1.09- 1.80) for glycated albumin. Both markers were also associated with CVD mortality [fructosamine 2.13 (1.28 - 3.54); glycated albumin 1.55 (1.09 - 2.21)]. Higher values of both markers were associated with trends toward a higher risk of hospitalization with sepsis [fructosamine 1.75 (1.01-3.02); glycated albumin 1.39 (0.94-2.06)]. CONCLUSIONS - Serum fructosamine and glycated albumin are risk factors for mortality and morbidity in hemodialysis patients.

UR - http://www.scopus.com/inward/record.url?scp=84878253841&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878253841&partnerID=8YFLogxK

U2 - 10.2337/dc12-1896

DO - 10.2337/dc12-1896

M3 - Article

VL - 36

SP - 1522

EP - 1533

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 6

ER -