Limited predictive value of HbA1c, fructosamine, hemoglobin glycation index and glycation gap for early kidney injury in newly diagnosed type 2 diabetes mellitus

Diep Thao Pham; Tram Thuy Nguyen; Minh Thi Hoang; Thuan Quang Huynh

Diep Thao Pham Department of Biochemistry, Viet Duc University Hospital, Hanoi, Vietnam
Tram Thuy Nguyen Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
Minh Thi Hoang Department of Biochemistry, Military Hospital 103, Hanoi, Vietnam
Thuan Quang Huynh Department of Biochemistry, Military Hospital 103, Hanoi, Vietnam https://orcid.org/0000-0002-0162-171X

Keywords: ype 2 diabetes mellitus, hemoglobin glycation index, glycation gap, fructosamine, albuminuria, diabetic kidney disease

Abstract

This study aims to evaluate the predictive value of protein glycation markers, including glycated hemoglobin (HbA1c), fructosamine, glycation gap (GG), and hemoglobin glycation index (HGI), for early kidney injury in patients with newly diagnosed type 2 diabetes mellitus (T2DM). A cross-sectional analytical study was conducted in 103 patients with newly diagnosed T2DM. Early kidney injury was assessed using the urinary albumin-to-creatinine ratio (uACR). The predictive performance of HbA1c, fructosamine, GG, and HGI for albuminuria was evaluated using univariate and multivariable logistic regression analyses adjusted for age, sex, and body mass index (BMI), along with receiver operating characteristic (ROC) curve analysis. The study showed that in logistic regression analyses, none of the glycation markers independently predicted albuminuria after adjustment for age, sex, and BMI (all p>0.05). ROC analysis demonstrated poor discriminatory performance for HbA1c (AUC=0.597), fructosamine (AUC=0.602), and the combined model (AUC=0.599), and none of the AUC values reached statistical significance (all p>0.05). In patients with newly diagnosed T2DM, HbA1c, fructosamine, HGI, and GG did not independently predict albuminuria. These findings suggest that protein glycation markers have limited value as biomarkers for identifying early kidney injury at the time of T2DM diagnosis.