ESPE Abstracts

Introduction: Traditionally, HbA1c has been used as a preferred glycemic index in diabetes patients. However, as many acute leukemia patients often present with anemia and/or pancytopenia, HbA1c may not accurately represent blood glucose level in this group. Glycated albumin represents the average level of blood glucose in recent 2-3 weeks, independent of red blood cell life. In this study, we aim to evaluate the usefulness of glycated albumin as glycemic monitoring index in pediatric patients diagnosed with acute leukemia.

Methods: We performed retrospective analysis of a total of 208 pediatric patients from The Seoul St. Mary’s hospital, Catholic university of Korea. Medical records of 25 patients diagnosed with type 2 DM and 68 patients with acute leukemia were investigated for serum glycated albumin, HbA1c, fasting blood glucose level, and demographic data such as sex, age, height, weight and BMI z-scores. 115 children and adolescents who visited our outpatient center for routine child health examination were enrolled as the control group.

Results: The median serum glycated albumin levels were 12.6%, 19.1% for acute leukemia and T2DM patients. HbA1c and fasting blood glucose levels, 5.35% and 7.6%, 93.5mg/dl and 129mg/dl respectively, also differed in the two groups. All glycated albumin, HbA1c and fasting blood glucose level did not appear different in between the control and acute leukemia group. In type 2 DM patients, glycated albumin and HbA1c showed positive correlations (r=0.926, P<0.01). Fasting blood glucose level was positively correlated to glycated albumin (r=0.821, P<0.001) and HbA1c (r=0.773, P<0.001). While glycated albumin did not appear related to HbA1c in the normal control group (r=-0.02, P=0.831), patients with acute leukemia also revealed a positive correlation between glycated albumin and HbA1c(r=0.275, P=0.023). Glycated albumin was negatively related to BMI z-scores in the control group (r=0.554, P<0.001); however, the level showed no correlation to BMI z-scores in acute leukemia group and in T2DM patients (r=-0.122, P=0.323 and r=-0.292, P=0.156). HbA1c level was positively related to BMI z-scores in the control group (r=0.249, P=0.007) and showed no relations in the other two groups. Multiple regression analysis found glycated albumin to be positively correlated to HbA1c both in acute leukemia pediatric patients and T2DM patients even when adjusted for age, sex and BMI z-score (P=0.038, P<0.001).

Conclusion: Glycated albumin showed positive relation to HbA1c in type 2 diabetic patients and acute leukemia patients, whereas it showed no correlation in the normal control group.