Glycated albumin and risk of mortality in the US adult population
Open accessAbstract
Background: Glycated albumin is of growing interest as an alternative biomarker of glycemia. However, the association of glycated albumin with long-term outcomes in the general population is uncharacterized. We evaluated the associations of glycated albumin and hemoglobin A1c (HbA1c) with mortality in US adults. Methods: We conducted a prospective analysis of 12 915 participants in the National Health and Nutrition Examination Survey 1999–2004. We used Cox regression to characterize associations of glycated albumin and HbA1c with all-cause and cardiovascular mortality through 2014. We categorized glycated albumin based on percentiles corresponding to clinical cut-points for HbA1c. No diagnosed diabetes: <5.0% (<12th percentile), 5.0% to 5.6% (12th–82nd percentile, reference), 5.7% to 6.4% (83rd–97th percentile), and ≥6.5% (≥98th percentile). Diagnosed diabetes: <7.0% (<50th percentile), 7.0% to 8.9% (50th–83rd percentile), and ≥9.0% (≥84th percentile). Results: Among US adults (mean age 46 years), the prevalence of diagnosed diabetes was 6.8%. Glycated albumin and HbA1c were highly correlated (r = 0.76). Over the median 16.8 years follow-up, there were 2818 deaths (652 cardiovascular). Adults with diagnosed diabetes and glycated albumin ≥84th percentile had the highest risk for all-cause mortality [hazard ratio (HR) 3.96, 95% CI 3.06–5.13] and cardiovascular mortality (HR 6.80, 95% CI 4.20–11.03). HbA1c had associations with all-cause and cardiovascular mortality that were similar to those for glycated albumin. Conclusions: Among US adults, increased values of glycated albumin and HbA1c were associated with all-cause and cardiovascular mortality, particularly in persons with diagnosed diabetes. Glycated albumin may be a useful alternative test of glycemia.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Fructosamine and glycated albumin have been linked to long-term complications in epidemiologic cohort studies.
“Fructosamine and glycated albumin have been linked to long-term complications in epidemiologic cohort studies (14)(15)(16)(17)(18).”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [15]
The Discussion reports that glycated albumin was associated with mortality in this study and with microvascular and cardiovascular outcomes in earlier cohort work. The References name cohort studies of both fructosamine and glycated albumin, but this paper does not itself report a fructosamine–complications association; that part rests on the cited studies’ titles. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
A New Equation to Estimate Glomerular Filtration Rate
Levey, A. S., Stevens, L. A., Schmid, C. H., Zhang, Y. (., Castro, A. F., Feldman, H. I., Kusek, J. W., Eggers, P., Van Lente, F., Greene, T., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-9-200905050-00006 · Cited by 25,603 · see citing works
Self-citationAn Efficient Method of Estimating Seemingly Unrelated Regressions and Tests for Aggregation Bias
Zellner, A. (1962) · Journal of the American Statistical Association · doi:10.1080/01621459.1962.10480664 · Cited by 8,138 · see citing works
Diagnosis and classification of diabetes mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc10-s062 · Cited by 5,491 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s002 · Cited by 4,792 · see citing works
Diagnosis and Classification of diabetes mellitus
Rossi, G. (2014) · Diapedia.org eBooks · doi:10.14496/dia..20 · Cited by 3,212 · see citing works
International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes
The International Expert Committee (2009) · Diabetes Care · doi:10.2337/dc09-9033 · Cited by 3,185 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2021</i>
American Diabetes Association (2021) · Diabetes Care · doi:10.2337/dc21-s002 · Cited by 3,116 · see citing works
National health and nutrition examination survey: analytic guidelines, 1999-2010.
Cl, J., Paulose‐Ram, R., Ogden, C. L., Carroll, Kruszon‐Moran, D., Dohrmann, S. M., & Curtin, L. R. (2013) · PubMed · Cited by 1,522 · see citing works
Diabetic kidney disease: a report from an ADA Consensus Conference
Tuttle, K. R., Bakris, G. L., Bilous, R. W., Chiang, J. L., de Boer, I. H., Goldstein-Fuchs, J., Hirsch, I. B., Kalantar-Zadeh, K., Narva, A. S., Navaneethan, S. D., et al. (2014) · Diabetes Care · doi:10.2337/dc14-1296 · Cited by 1,153 · see citing works
Prevalence of Iron Deficiency in the United States
Looker, A. C. (1997) · JAMA · doi:10.1001/jama.1997.03540360041028 · Cited by 1,137 · see citing works
Nutritional anaemias. Report of a WHO scientific group.
(1968) · PubMed · Cited by 941 · see citing works
Trends in diabetes treatment and control in U.S. adults, 1999-2018
Fang, M., Wang, D., Coresh, J., & Selvin, E. (2021) · New England Journal of Medicine · doi:10.1056/nejmsa2032271 · Cited by 690 · see citing works
Self-citationTrends in Prevalence and Control of Diabetes in the United States, 1988–1994 and 1999–2010
Selvin, E., Parrinello, C. M., Sacks, D. B., & Coresh, J. (2014) · Annals of Internal Medicine · doi:10.7326/m13-2411 · Cited by 532 · see citing works
Self-citationGlycemic Control, Complications, and Death in Older Diabetic Patients
Huang, E. S., Liu, J. Y., Moffet, H. H., John, P. M., & Karter, A. J. (2011) · Diabetes Care · doi:10.2337/dc10-2377 · Cited by 341 · see citing works
Selvin, E., Rawlings, A. M., Grams, M., Klein, R., Sharrett, A. R., Steffes, M., & Coresh, J. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(13)70199-2 · Cited by 262 · see citing works
Self-citationNathan, D. M., McGee, P., Steffes, M. W., Lachin, J. M., & the DCCT/EDIC Research Group (2014) · Diabetes · doi:10.2337/db13-0782 · Cited by 214 · see citing works
Parrinello, C. M., & Selvin, E. (2014) · Current Diabetes Reports · doi:10.1007/s11892-014-0548-3 · Cited by 154 · see citing works
Self-citationFructosamine and glycated albumin and the risk of cardiovascular outcomes and death
Selvin, E., Rawlings, A. M., Lutsey, P. L., Maruthur, N., Pankow, J. S., Steffes, M., & Coresh, J. (2015) · Circulation · doi:10.1161/circulationaha.115.015415 · Cited by 151 · see citing works
Self-citationNontraditional Markers of Glycemia
Selvin, E., Francis, L., Ballantyne, C. M., Hoogeveen, R. C., Coresh, J., Brancati, F. L., & Steffes, M. W. (2011) · Diabetes Care · doi:10.2337/dc10-1945 · Cited by 125 · see citing works
Self-citationBasic Performance of an Enzymatic Method for Glycated Albumin and Reference Range Determination
Kohzuma, T., Yamamoto, T., Uematsu, Y., Shihabi, Z. K., & Freedman, B. I. (2011) · Journal of Diabetes Science and Technology · doi:10.1177/193229681100500619 · Cited by 122 · see citing works
Low Hemoglobin A1c and Risk of All-Cause Mortality Among US Adults Without Diabetes
Carson, A. P., Fox, C. S., McGuire, D. K., Levitan, E. B., Laclaustra, M., Mann, D. M., & Muntner, P. (2010) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.110.957936 · Cited by 115 · see citing works
Serum glycated albumin predicts the progression of carotid arterial atherosclerosis
Song, S. O., Kim, K. J., Lee, B., et al. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.09.005 · Cited by 72 · see citing works
A New Zealand Linkage Study Examining the Associations Between A1C Concentration and Mortality
Brewer, N., Wright, C., Travier, N., Cunningham, C. W., Hornell, J., Pearce, N. E., & Jeffreys, M. (2008) · Diabetes Care · doi:10.2337/dc07-2374 · Cited by 67 · see citing works
GHb Level and Subsequent Mortality Among Adults in the U.S.
Saydah, S., Tao, M., Imperatore, G., & Gregg, E. W. (2009) · Diabetes Care · doi:10.2337/dc09-0117 · Cited by 67 · see citing works
HbA1c measured in stored erythrocytes and mortality rate among middle-aged and older women
Levitan, E. B., Liu, S., Stampfer, M. J., Cook, N. R., Rexrode, K. M., Ridker, P. M., Buring, J. E., & Manson, J. E. (2007) · Diabetologia · doi:10.1007/s00125-007-0882-y · Cited by 62 · see citing works
Determining Stability of Stored Samples Retrospectively: The Validation of Glycated Albumin
Nathan, D. M., Steffes, M. W., Sun, W., Rynders, G. P., & Lachin, J. M. (2010) · Clinical Chemistry · doi:10.1373/clinchem.2010.150250 · Cited by 56 · see citing works
Wang, F., Ma, X., Hao, Y., Yang, R., Ni, J., Xiao, Y., Tang, J., Bao, Y., & Jia, W. (2012) · PLoS ONE · doi:10.1371/journal.pone.0051098 · Cited by 51 · see citing works
Mukai, N., Ninomiya, T., Hata, J., Hirakawa, Y., Ikeda, F., Fukuhara, M., Hotta, T., Koga, M., Nakamura, U., Kang, D., et al. (2015) · Cardiovascular Diabetology · doi:10.1186/s12933-015-0247-7 · Cited by 46 · see citing works
Glycated Albumin for the Diagnosis of Diabetes in US Adults
Fang, M., Daya, N. R., Coresh, J., Christenson, R. H., & Selvin, E. (2021) · Clinical Chemistry · doi:10.1093/clinchem/hvab231 · Cited by 37 · see citing works
Self-citationYANG, Z. K., Shen, Y. H., Shen, W. F., Pu, L. J., Meng, H., Zhang, R., Zhang, Q., Chen, Q., Caterina, R. D., & Lu, L. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.06.003 · Cited by 34 · see citing works
Rooney, M. R., Tang, O., Pankow, J. S., & Selvin, E. (2020) · Diabetologia · doi:10.1007/s00125-020-05285-3 · Cited by 33 · see citing works
Self-citationYoon, H. J., Lee, Y., Kim, S. R., Rim, T. H., Lee, E. Y., Kang, E. S., Soo, B., Lee, H. C., & Lee, B. (2015) · Cardiovascular Diabetology · doi:10.1186/s12933-015-0219-y · Cited by 28 · see citing works
Pan, J., Li, Q., Zhang, L., et al. (2014) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2014.06.015 · Cited by 26 · see citing works
Low HbA1c and mortality: causation and confounding
Rutter, M. K. (2012) · Diabetologia · doi:10.1007/s00125-012-2620-3 · Cited by 24 · see citing works
Comparative associations of diabetes risk factors with five measures of hyperglycemia
Poon, A. K., Juraschek, S. P., Ballantyne, C. M., Steffes, M. W., & Selvin, E. (2014) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2013-000002 · Cited by 24 · see citing works
Self-citationSelvin, E., & Sacks, D. B. (2017) · Annals of Internal Medicine · doi:10.7326/m17-1231 · Cited by 17 · see citing works
Self-citationMongraw‐Chaffin, M., Bertoni, A. G., Golden, S. H., Mathioudakis, N. N., Sears, D. D., Szklo, M., & Anderson, C. A. M. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2019-00033 · Cited by 17 · see citing works
Monitoring Glycemic Control in End-Stage Renal Disease: What Should Be Measured?
Selvin, E., & Sacks, D. B. (2016) · Clinical Chemistry · doi:10.1373/clinchem.2016.265744 · Cited by 12 · see citing works
Self-citationHarrell, F., Jr. (1996) · doi:10.1002/(sici)1097-0258(19960229)15:4
Flagged first, then by citations
Cited by
Sorted by citations
6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s006 · Cited by 440 · see citing works
Self-citation13. Older Adults: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s013 · Cited by 209 · see citing works
13. Older Adults: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s013 · Cited by 161 · see citing works
6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026.
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s006 · Cited by 172 · see citing works
13. Older Adults: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s013 · Cited by 87 · see citing works
- Authors
- Rooney, M. R., Daya, N., Tang, O., McEvoy, J. W., Coresh, J., Christenson, R. H., & Selvin, E.
- Affiliations
- Johns Hopkins University (US)
- Ollscoil na Gaillimhe – University of Galway (IE)
- University of Maryland, Baltimore (US)
- Corresponding author
- Selvin, Elizabeth
- ORCID
- Venue
- Clinical Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-01-29
- Volume
- 68
- Issue
- 3
- Pages
- 422-430
- ISSN
- 0009-9147 (ISSN-L)
- 1530-8561
- PMC
- PMC8897960
- OpenAlex
- W4205588773
- Cited by
- 32
- References
- 40
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 5 · 2021: 2
- FWCI
- 3.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Chemistry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Biomarkers Consortium of the Foundation for the National Institutes of Health and NIH/NHLBI (K24 HL152440, T32 HL007024)
- NIH/NIDDK (F30 DK120160)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Keywords
- glycated albumin, HbA1c, glycemic markers, mortality, cardiovascular mortality, all-cause mortality, diabetes mellitus, glycemia, NHANES
- MeSH terms
- Glycated Serum Albumin, Adult, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Glycated Hemoglobin, Humans, Middle Aged, Nutrition Surveys, Risk Factors, Serum Albumin, Glycation End Products, Advanced
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
