Glycated albumin offers clues to mortality risk even in nondiabetic individuals

Elevated levels of glycated albumin appear to indicate a greater risk of all-cause and cardiovascular mortality among adults, regardless of their diabetes status, according to a study.

Researchers looked at 12,147 individuals, of whom 1,319 had diabetes and 10,828 were diabetes-free, who participated in the 1999-2004 cycles of the National Health and Nutrition Examination Survey (NHANES). They examined the association between glycated albumin and mortality outcomes by linking NHANES data with those from the National Death Index.

Over a median follow-up of 13 years, 2,785 participants (619 participants in the diabetes cohort and 2,166 in the diabetes-free cohort) died, including 651 of cardiovascular causes.

Multivariable Cox proportional hazard analysis revealed that elevated baseline glycated albumin levels were significantly associated with a higher incidence of both mortality outcomes in the diabetes cohort (all-cause: hazard ratio [HR], 1.03, 95 percent confidence interval [CI], 1.01–1.04; cardiovascular: HR, 1.04, 95 percent CI, 1.02–1.07) and in the diabetes-free cohort (all-cause: HR, 1.05, 95 percent CI, 1.03–1.08; cardiovascular: HR, 1.08, 95 percent CI, 1.02–1.14).

On the other hand, there was a trend for increased mortality with increasing haemoglobin A1c levels among patients with known diabetes but not among participants without the condition.

The findings show that glycated albumin represents a potential alternative to HbA1c as a marker for predicting hard clinical outcomes.