ホシノ　ジユンイチ   Hoshino Jiyun'ichi   星野　純一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Glycated albumin to glycated hemoglobin ratio and mortality in diabetic patients on dialysis: a new association.
掲載誌名	正式名：Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 略　 称：Nephrol Dial Transplant ISSNコード：14602385/09310509
巻・号・頁	38(5),pp.1309-1317
著者・共著者	Hoshino Junichi, Abe Masanori, Hamano Takayuki, Hasegawa Takeshi, Wada Atsushi, Nakai Shigeru, Hanafusa Norio, Masakane Ikuto, Nitta Kosaku
担当区分	筆頭著者
発行年月	2023/05/04
概要	BACKGROUND:Hemoglobin A1c (A1c) and glycated albumin (GA) are two blood glycated proteins commonly used to monitor glycemic control in dialysis patients with diabetes. However, little is known about the association between the GA/A1c ratio and mortality in these populations. Here, we examine these associations using a nationwide cohort.METHODS:We enrolled 28 994 dialysis patients with diabetes who met our inclusion criteria (female, 32.9%; mean age, 67.4 ± 11.6 years; mean dialysis duration, 6.3 ± 5.8 years). After dividing the patients into groups based on GA/A1c quantiles and adjusting for 18 potential confounders, adjusted hazard ratios (HR) and 95% confidence limits were calculated for 3-year mortality and cause-specific mortalities. Additionally, propensity score matching analyses were used to compare mortalities between the low and high GA/A1c groups.RESULTS:After adjusting for possible confounders, significantly increased mortality was found in patients with GA/A1c ratios of 3.6-4.0 [HR 1.21 (1.10-1.34)] or higher [HR 1.43 (1.30-1.58)] than in those with GA/A1c ratios of 3.0-3.3. The risks of infectious and cardiovascular death were higher in these patients regardless of their nutritional status. In the propensity score matching analyses, significantly increased mortality was consistently found in those with a higher ratio (≥3.3) [HR 1.23 (1.14-1.33)] than in those with a lower ratio.CONCLUSIONS:The GA/A1c ratio was significantly associated with 3-year mortality, especially infectious and cardiovascular mortality, in dialysis patients with diabetes. This ratio may be a promising new clinical indicator of survival in these patients, independent of their current glycemic control and nutritional markers.
DOI	10.1093/ndt/gfac297
PMID	36309475