Optimal glycated albumin cutoff value to diagnose diabetes in Korean adults: A retrospective study based on the oral glucose tolerance test

Introduction: Glycated albumin (GA) reflects short-term status of glycemic control. We suggest a GA cut-off value to diagnose pre-diabetes and diabetes in Korean adults. In addition, we compared the performance of GA for the diagnosis of diabetes with that of glycated hemoglobin (A1c). Materials and methods: A total of 852 subjects (498 males, 354 females) aged 20 to 83. years (mean: 52.5. years) were enrolled. A 75-g oral glucose tolerance test (OGTT) was performed and A1c and GA were measured. Results: In these enrolled subjects, 88% have glucose intolerance status (pre-diabetes or diabetes). The GA concentrations corresponding to fasting plasma glucose (FPG) of 7.0. mmol/l, 2-h plasma glucose during OGTT (PPG2). ≥. 11.1. mmol/l, and A1c. ≥. 6.5% were 14.6%, 13.7%, and 14.7%, respectively. A meta-analysis of three GA cutoffs revealed a GA cutoff for diabetes of 14.3%. When A1c is used in combination with FPG, the sensitivity and specificity for the diagnosis of OGTT-based diabetes were 72.16% (95% CI: 66.6-72.2) and 96.4% (95% CI: 94.4-97.7), respectively. With the newly developed GA cutoff of 14.3%, GA combined with FPG resulted in a sensitivity and specificity of 77.5% (95% CI: 72.17-82.0) and 89.9% (95% CI: 87.1-92.2), respectively. Conclusions: A GA cutoff of >. 14.3% is optimal for the diagnosis of diabetes in Korean adults. The measurement of FPG and GA may detect diabetes earlier than the measurement of FPG and A1c.