Correlation of glycosylated hemoglobin with microalbuminuria to predict renal damage in diabetic patients

Authors

  • Dipsha Kriplani Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi (M), Wardha, Maharashtra
  • Akshay Kriplani Department of Surgery, MRM College, Gulbarga, Karnataka
  • Vivek Gupta Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi (M), Wardha, Maharashtra
  • N. Samal Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi (M), Wardha, Maharashtra
  • Arvind Bhake Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi (M), Wardha, Maharashtra
  • Satish Mahajan Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi (M), Wardha, Maharashtra

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150318

Keywords:

Glycosylated hemoglobin, Microalbuminuria, Diabetic nephropathy, Glycemic control

Abstract

Background: Regular screening of levels of glycosylated hemoglobin and microalbuminuria, diabetic nephropathy can be prevented. The aim was to assess and compare the levels of glycosylated hemoglobin, microalbuminuria and serum creatinine in type 2 diabetic patients divided in groups of those on default antidiabetic treatment compared with those on regular antidiabetic treatment and to assess its correlation in type 2 of diabetic nephropathy.

Methods:Two hundred diabetic patients above 40 years of age and 200 age matched control subjects with levels of glycosylated hemoglobin < 6.5% and on regular antiglycemic therapy were selected. Fasting plasma sugar was estimated by the glucose oxidase (GOD) - glucose peroxidase (POD). Glycosylated hemoglobin and microalbuminuria level was measured by the immunoturbidimetric method and serum creatinine estimation was done by the Jaffe’s kinetic method. p value was drawn using the student’s paired t-test.

Results: There is a strong correlation between the increase in the levels of glycosylated hemoglobin with the corresponding rise in the levels of microalbuminuria and serum creatinine.

Conclusion: Periodic surveillance of the levels of microalbuminuria should be carried out in the type 2 diabetic patients to prevent further damage by early detection of diabetic nephropathy.

 

References

Maitra A, Abbas A. The Endocrine System. Kumar V, Abbas A, Fausto N. Robins and Cotran Pathologic Basis of Disease. 8th edition. Elsevier. India.

Report of a WHO Consultation, Part 1: Diagnosis and Classification of Diabetes Mellitus. World Health Organization, Department of Noncommunicable Disease Surveillance, Geneva.

Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease: with emphasis on the stage of incipient diabetic nephropathy. Diabetes. 1983;32(2):64-78.

Moser M, Sowers J, Black H. Microalbuminuria, Chronic Renal disease and the effects of metabolic syndrome on cardiovascular events. The Journal of Clinical Hypertension. 2007;9(7):551-6.

James MT, Hemmelgran BR, Tonelli M. Early recognition and prevention of chronic kidney disease. Lancet. 2010;375:1296-309.

Taylor, E. Howard. Clinical Chemistry. New York: John Wiley and Sons. 1989;4:58–62.

Rossini AA. Special speculations on etiology of Diabetes Mellitus. Diabetes. 1998;37:257.

Saudek C, Kalyani R, Derr R. Assessment of Glycemia in Diabetes Mellitus. JAPI. 2005;53:299-305.

UK Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-53.

Aleyassine H, Gardiner R, Tonks D, Koch P. Glycosylated hemoglobin in diabetes: Correlation with fasting plasma glucose, serum lipids and glycosuria. Diabetes Care. 1980;3(4):508-14.

Mattock M, Morrish N, Viberti G, Keen H, Fitzgerald A and Jackson G. Prospective Study of Microalbuminuria as Predictor of Mortality in NIDDM. Diabetes. 1992;41:736-41.

Neil A, Hawkins M, Potok M, Thorogood M, Cohen D, Mann J. A Prospective Population- Based Study of Microalbuminuria as a Predictor of Mortality in NIDDM. Diabetes Care. 1993;16(7):996-1003.

Tahara Y, Shima K. Kinetics of HbA1c, Glycated Albumin, and Fructosamine and Analysis of Their Weight Functions against Preceding Plasma Glucose Level. Diabetes Care. 1995;18(4):440-7.

Beisswenger P, Makita Z, Curphey T, Moore L, Jean S, Johnsen T, et al. Formation of Immunochemical Advanced Glycosylation End Products Precedes and Correlates with Early Manifestations of Renal and Retinal Disease in Diabetes. Diabetes. 1995;44:824-9.

Forsblom C, Groop P, Ekstrand A, Tötterman K, Sane T, Saloranta C, et al. Predictors of Progression from Normoalbuminuria to Microalbuminuria in NIDDM. Diabetes Care. 1998;21(11):1932-38.

Stratton I, Adler A, Neil A, Matthews D, Manley S, Cull C, et al. On behalf of the UK Prospective Diabetes Study Group. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405-12.

Tabaei B, Al-Kassab A, Ilag L, Zawacki C, Herman W. Does Microalbuminuria Predict Diabetic Nephropathy? Diabetes Care. 2001;24(9):1560-6.

Bruno G, Merletti F, Biggeri A, Bargero G, Ferrero S, Pagano G, et al. Progression to Overt Nephropathy In Type 2 Diabetes. Diabetes Care. 2003;26(7):2150-5.

Adler A, Stevens R, Manley S, Bilous R, Cull C, Holman R. On behalf of UKPDS group. Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney International. 2003;63:225-32.

Verhave J, Gansevoort R, Hillege H, Bakker S, Zeeuw D, De Jong P. The Prevend Study Group. An elevated urinary albumin excretion predicts de novo development of renal function impairment in the general population. Kidney International. 2004;66(92):S18–S21.

Rossing K, Christensen P, Hovind P, Tarnow L, Rossing P, Parving H. Progression of nephropathy in type 2 diabetic patients, Kidney International, 2004;66:1596–605.

Wu A, Kong N, de Leon F, Pan C, Tai T, Yeung V, et al. The MAPS Investigators. An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study. Diabetologia. 2005;48:17–26.

Retnakaran R, Cull C, Thorne K, Adler A, Holman R. The UKPDS Study Group. Risk Factors for Renal Dysfunction in Type 2 Diabetes U.K. Prospective Diabetes Study 74. Diabetes. 2006;55:1832-9.

Parvanova A, Trevisan R, Iliev I, Dimitrov B, Vedovato M, Tiengo A, et al. Insulin Resistance and Microalbuminuria. A Cross-Sectional, Case-Control Study of 158 Patients With Type 2 Diabetes and Different Degrees of Urinary Albumin Excretion. Diabetes. 2006;22:1456-62.

Parving H, Lewis J, Ravid M, Remuzzi G, Hunsicker L. The DEMAND investigators. Prevalence and risk factors for microalbuminuria in a referred cohort of type II diabetic patients: A global perspective, Kidney International. 2006;69:2057–63.

Nathan D, Turgeon Hand Regan S. Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia. 2007;50:2239–44.

Kaur S, Mahajan M. Declining Age of Onset of Type 2 Diabetes Mellitus in the North-West Punjabi Population. Journal of Clinical and Diagnostic Research. 2011;5(3):425-9.

Naveen P, Kannan N, Vamseedhar A, Bhanu PG and Aravind K. Evaluation of Glycated hemoglobin and Microalbuminuria as early risk markers of Nephropathy in Type 2 Diabetes Mellitus. International Journal of Biological & Medical Research. 2012;3(2):1724-6.

Makita Z, Radoff S, Rayfield E, Yang Z, Skolnik E, Delaney V, et al. Advanced glycosylation end products in patients with Diabetic Nephropathy. The New England Journal of Medicine. 1991;836-42.

Sacks D, Arnold M, Bakris G, Bruns D, Horvath A, Kirkman M, et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care. 2011;34:61-99.

American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2013;36(1):S67-S74.

Oh M. Evaluation of renal function, water, electrolytes and acid-base balance. McPherson R. and Pincus M. Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd edition. India: Elsevier; 2012.

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Published

2017-01-10

How to Cite

Kriplani, D., Kriplani, A., Gupta, V., Samal, N., Bhake, A., & Mahajan, S. (2017). Correlation of glycosylated hemoglobin with microalbuminuria to predict renal damage in diabetic patients. International Journal of Research in Medical Sciences, 3(8), 2014–2019. https://doi.org/10.18203/2320-6012.ijrms20150318

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Original Research Articles