5. Role of glycated albumin and glycated hemoglobin in prediction of coronary artery disease using regression model in South Indian population

Author : Malini S, Malligai E, Pradeep G Nayar

Background: Glycated proteins through the formation of Advanced Glycation Endproducts (AGE), have a role in the development of atherosclerosis. Keeping this background in mind, we have designed a study as prediction of coronary artery disease using clinical value of Glycated Albumin and Glycated Hemoglobin. Materials and Methods: Subjects (n= 79) were categorized into CAD positive (n=63) and CAD negative group (n=16) by angiographically proven stenosis. After obtaining informed consent, clinical History, Baseline Parameters were recorded. Serum levels of Glycated albumin and Glycated hemoglobin as well as other variables were determined. Predictors of CAD were analyzed using logistic regression model and Receiver Operating Characteristic (ROC) curve. Results: Unpaired "t" test showed significant increase in Glycated albumin and Glycated hemoglobin values in CAD positive group. Logistic regression analysis was used to find out the sensitivity & specificity, odds ratio of Glycated hemoglobin and Glycated albumin. The model for predicting CAD was P/ (1-P) = EXP (-6.97+ 0.12 AGE + 1.08 GENDER + 0.113 BMI + 1.09 DIABETES + 0.50 HYPERTENSION + 0.978 SMOKING + 0.008 ALCOHOLIC + 0.009 GLYCATED ALBUMIN + 0.137 HbA1c). In ROC curve, Area under the Curve (AUC) of Glycated albumin is 0.791(95% CI 0.678 0.904, p<0.001) and for Glycated hemoglobin 0.713(95% CI 0.569 0.856, p <0.05). The regression model showed AUC of 0.80(95% CI 0.694 -0.918 p value <0.001). Conclusion: The mean of both groups showed highly significant difference, regression analysis and ROC curve showed the Glycated albumin is highly significant than Glycated haemoglobin.

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