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. 2024 Sep;16(9):e13600.
doi: 10.1111/1753-0407.13600.

Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China

Jiawen Mao  1 , Meng Wang  1   2   3 , Chunjuan Wang  1   2   3 , Hongqiu Gu  1   2   3 , Xia Meng  1   2   3 , Yong Jiang  1   2   3 , Xin Yang  1   2   3 , Jing Zhang  1   2   3 , Yunyun Xiong  2   3 , Xingquan Zhao  1   2 , Liping Liu  1   2 , Yilong Wang  1   2 , Yongjun Wang  1   2   3   4 , Zixiao Li  1   2   3   4 , Bihong Zhu  5
Affiliations

Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China

Jiawen Mao et al. J Diabetes. 2024 Sep.

Abstract

Background and aim: Glycated albumin (GA) is a biomarker monitoring glycemia 2-4 weeks before stroke onset. This study was designed to explore the association between GA levels with poststroke outcomes in patients with acute ischemic stroke or transient ischemic attack (TIA).

Method: Participants with ischemic stroke or TIA who had a baseline GA measurement were included in the Third China National Stroke Registry study. The effect of GA on stroke recurrence, poor functional outcomes, and combined vascular events was examined during the 1-year follow-up period. Multivariate Cox and logistic regression models were performed to evaluate the association. Discrimination tests were used to examine the incremental predictive value of GA when incorporating it into the conventional model.

Results: A total of 3861 participants were enrolled. At the 3-month follow-up, the elevated GA level was associated with an increased risk of poor functional outcomes (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.01-2.09). A similar increase was observed for stroke recurrence (adjusted hazard ratio [HR], 1.56; 95% CI, 1.09-2.24), poor functional outcomes (adjusted OR, 1.62; 95% CI, 1.07-2.45), and combined vascular events (adjusted HR, 1.55; 95% CI, 1.09-2.20) at the 1-year follow-up. In nondiabetic patients, the association between GA and poor functional outcomes was more pronounced (adjusted OR, 1.62; 95% CI, 1.05-2.50). Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes (net reclassification improvement [NRI]: 12.30% at 1 year).

Conclusion: This study demonstrated that elevated GA levels in serum were associated with stroke adverse outcomes, including stroke recurrence, poor functional outcomes, and combined vascular events, in patients with ischemic stroke or TIA.

Keywords: diabetes; glycated albumin; poststroke outcome; stroke.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of patient selection. CNSR‐III, Third China National Stroke Registry; GA, glycated albumin; Q, quartile.
FIGURE 2
FIGURE 2
Spline models of the association between glycated albumin (GA) and stroke adverse outcomes. The association between GA levels and (A) stroke recurrence, (B) modified Rankin Scale (mRS) score >2, and (C) combined vascular events at 3 months is shown in the first line, and the relationship between GA and (D) stroke recurrence, (E) mRS score >2, and (F) combined vascular events at the 1‐year follow‐up is shown in the second line. The hazard ratios from the Cox regression model were adjusted for the variables in model 2 in Table 2. The red lines indicate the adjusted hazard ratio, and the green lines indicate the 95% confidence interval.
See this image and copyright information in PMC

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