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Fructosamine and Glycated Albumin and the Risk of Cardiovascular Outcomes and Death
Open accessAbstract
Background—: Hemoglobin A1c (HbA1c) is the standard measure to monitor glucose control in diabetes mellitus and is a marker of future cardiovascular risk. Fructosamine and glycated albumin are markers of short-term glycemic control, but their associations with cardiovascular outcomes are uncharacterized. Methods and Results—: We measured glycated albumin and fructosamine in 11 104 participants with and without diabetes in the community-based Atherosclerosis Risk in Communities (ARIC) Study in 1990 to 1992 (baseline). We evaluated associations of fructosamine and glycated albumin with risk of coronary heart disease, ischemic stroke, heart failure, and mortality. We compared associations with those observed for HbA1c. During two decades of follow-up there were 1096 new cases of coronary heart disease, 605 of ischemic stroke, 1432 of heart failure, and 2860 deaths. Elevated baseline concentrations of fructosamine and glycated albumin were significantly associated with each of the outcomes even after adjustment for traditional cardiovascular risk factors, with especially strong associations in persons with diabetes mellitus. Associations were of similar magnitude to those observed for HbA1c and—as has been previously observed for HbA1c—the associations tended to be J-shaped, with an elevation of risk at the lowest levels of each biomarker. Conclusions—: The acceptance of new measures of hyperglycemia is partly dependent on establishing their association with long-term outcomes. We found that fructosamine and glycated albumin were associated with vascular outcomes and mortality and that these associations were similar to those observed for HbA1c.
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“Although, nontraditional glycemic targets, such as fructosamine and glycated albumin, have also been associated with CV outcomes and mortality in a cohort study (51), the broader utility of such targets and their correlation with A1C has not yet been established.”
From Targets for Glycemic Control (2018) · cites this paper as [51]
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Metadata
- Authors
- Selvin, E., Rawlings, A. M., Lutsey, P. L., Maruthur, N., Pankow, J. S., Steffes, M., & Coresh, J.
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Circulation
- Published
- 2015-07-28
- Volume
- 132
- Issue
- 4
- Pages
- 269-277
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4612521
- OpenAlex
- W2141579512
- Cited by
- 151
- References
- 39
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 20 · 2023: 12 · 2022: 17 · 2021: 19 · 2020: 14 · 2019: 13 · 2018: 13 · 2017: 16 · 2016: 8 · 2015: 1
- FWCI
- 10.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Asahi Kasei Pharma Corporation
- National Institutes of Health (HHSN268201100012C, HHSN268201100008C, HHSN268201100006C, HHSN26820- 1100005C, HHSN268201100007C, HHSN268201100011C, HHSN268201100010C, UL1TR001079, HHSN268201100009C)
- U.S. Public Health Service (HHSN268201100012C), HHSN2682 01100010C, HHSN268201100007 C, HHSN2682011-00008C, HHSN268201100 006C, HHSN2682‐01100011C, HHSN268201100009C, HHSN 268201100005C)
- National Heart, Lung, and Blood Institute (HHSN268201 100012C, HHSN268201100007I, HHSN268201100007C, HHSN2682 01100008C, HH-SN-268201100006C, HHSN268201100011C, HHSN2682011-00005I, HHSN2682011-00009I, HHSN268201100005C, HHSN268201100005G, HHSN268201100010C, HHSN268201100011I, HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C, HHSN26820 1100009C, HHSN2682011-00008I, T32HL007024, U01HL096812)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK089174, R01DK089174)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- fructosamine, glycated albumin, glycemic control, HbA1c, diabetes mellitus, cardiovascular risk, coronary artery disease, ischemic stroke, heart failure, mortality, Atherosclerosis Risk in Communities Study
- MeSH terms
- Glycated Serum Albumin, Coronary Disease, Female, Heart Failure, Glycated Hemoglobin, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Serum Albumin, Biomarkers, Survival Rate, Glycation End Products, Advanced, Fructosamine, Stroke, Diabetes Complications
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