Glycated albumin and post-transplant diabetes mellitus in kidney transplant recipients

• Published in: Annals of clinical biochemistry Vol. 60; no. 2; p. 109
• Main Authors: Bleskestad, Inger H, Skadberg, Øyvind, Åsberg, Anders, Gøransson, Lasse G
• Format: Journal Article
• Language: English
• Published: England 01.03.2023
• Subjects: Adolescent; Adult; Blood Glucose - analysis; Diabetes Mellitus - diagnosis; Diabetes Mellitus - etiology; Diabetes Mellitus, Type 2 - diagnosis; Glycated Hemoglobin; Glycation End Products, Advanced; Humans; Hyperglycemia - diagnosis; Hyperglycemia - etiology; Kidney Transplantation - adverse effects; Serum Albumin - chemistry; Glycated albumin; kidney transplant recipients; liquid chromatography coupled with tandem mass spectrometry; glycated haemoglobin A1c; post-transplant diabetes mellitus; 95% reference interval
• ISSN: 1758-1001
• DOI: 10.1177/00045632231152074

Post-transplant diabetes mellitus is one of the most important cardiovascular risk factors after solid organ transplantation. Factors other than hyperglycaemia found in patients post-transplant, affect the level of haemoglobin A (HbA ), and new markers of hyperglycaemia are needed. Our aim was to establish a 95% reference interval for glycated albumin in kidney transplant recipients, and to compare glycated albumin concentrations to the diagnostic criteria for diabetes mellitus post-transplant using oral glucose tolerance test and HbA . A total of 341 non-diabetic kidney transplant recipients aged ≥18 years who underwent an oral glucose tolerance test at 8 weeks and 1 year after transplantation were included. Glycated albumin was determined by liquid chromatography coupled with tandem mass spectrometry. The 95% reference interval for glycated albumin was 8.2 (90% CI: 7.2-8.5) to 12.8% (90% CI: 12.2-13.5) which is not significantly different from our laboratory's 95% reference interval for persons without diabetes. At both 8 weeks and 1 year after transplantation, 35 patients (10.3%) fulfilled one, two or all three diagnostic criteria for diabetes mellitus. One year after transplantation, eight additional patients had glycated albumin concentration >12.8%. Our findings are in accordance with the notion that kidney transplant recipients form glycation end products like normal controls as estimated by glycated albumin and HbA . Further studies should address glycated albumin as a supplemental tool for the diagnosis of post-transplant diabetes mellitus in kidney transplant recipients.