Glycated albumin and the risk of micro- and macrovascular complications in subjects with Type 1 Diabetes

BACKGROUND: We investigated the relationship between the glycemic indices glycated albumin (GA) and glycated hemoglobin (HbA(1c)) and the progression of diabetic vascular complications [diabetic nephropathy (DN) and carotid artery atherosclerosis (CAA)] in subjects with type 1 diabetes (T1D). METHODS: A total of 154 participants with a median follow-up of 2.8 years were enrolled in this retrospective longitudinal study. We recruited T1D subjects who had regularly measured urine albumin-creatinine ratios and estimated glomerular filtration rates, as well as tested HbA(1c) and GA levels consecutively every 3 or 6 months. A subgroup of 54 subjects was measured repeated carotid intima-media thickness (IMT). RESULTS: We classified subjects into the DN progression (Group I; n = 30) with either deteriorated stages of chronic kidney disease (n = 18) or albuminuria progression (n = 17), and the non-progression (Group II; n = 124). In multiple logistic regression analyses, baseline albuminuria (odds ratio [OR] = 2.64, 95 % confidence interval [CI] = 1.03–6.74), mean GA levels (OR = 2.03, 95 % CI = 1.27–3.26) were significantly associated with progression of DN. However, there was no association with mean HbA(1c) (OR = 0.98, 95 % CI = 0.62–1.54). In a subgroup analysis for follow-up measurements of carotid IMT, age was independently associated with the presence of plaque and the mean IMT. However glycemic indices were not significantly associated with CAA. CONCLUSIONS: Mean GA levels were more closely associated with DN progression than mean HbA(1c) in subjects with T1D. However, they were not associated with the CAA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12933-015-0219-y) contains supplementary material, which is available to authorized users.