albumin - publications

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1. J Pharmacokinet Pharmacodyn. 2012 Apr 21. [Epub ahead of print]

A pharmacokinetic model for the glycation of albumin.

Alskär O, Korell J, Duffull SB.

Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical
Biosciences, University of Uppsala, PO Box 591, SE-751 24, Uppsala, Sweden,
oskar.alskar@farmbio.uu.se.

Glycated haemoglobin (HbA1c) concentrations can be falsely lowered in
circumstances when red blood cell (RBC) survival is reduced, e.g. in patients
with chronic kidney disease (CKD). Glycated albumin (GA) has been suggested as an
alternative marker of glycaemic control in these patients since it is independent
of the RBC life span. The primary aim of this work was to develop a
pharmacokinetic model that describes the time course of GA. The secondary aim was
to assess the performance of GA as marker for glycaemic control in comparison to
HbA1c based on simulations. For the second aim, three different scenarios were
considered in the simulations: 1) assessment of the effect of large intra-day
fluctuations in mean blood glucose on GA concentrations, 2) initiation of
antidiabetic treatment on the GA profile, and 3) a hypothetical phase II study
for a new antidiabetic compound. The GA model, as well as a previously developed
HbA1c model described literature data well. GA concentrations appear to be stable
even in the presence of high intra-day fluctuations in mean blood glucose
concentrations. Simulation of a decrease in mean blood glucose concentrations
resulted in a faster change in GA compared to HbA1c. GA also provided a time to
90 % power of the effect of a hypothetical antidiabetic drug that was 16 days
shorter than when using HbA1c. These results indicate that GA could be used as
alternative marker to assess blood glucose control in diabetic patients with CKD
and also to follow an individual patient over time.

PMID: 22528035 [PubMed - as supplied by publisher]