High Dose Prednisolone Lowers Plasma Glycated Albumin Levels Compared to Actual Glycemic Control: A Retrospective Observational Study

Diabetes Ther. 2019 Feb;10(1):269-276. doi: 10.1007/s13300-018-0552-8. Epub 2018 Dec 13.

Abstract

Introduction: Glycated hemoglobin (A1c) and glycated albumin (GA) are often used as indicators of glycemic control. In this study, we determined whether prednisolone (PSL) administration lowers plasma GA.

Methods: We investigated the factors affecting GA using multivariate analysis in 48 subjects with connective tissue diseases (CTDs).

Results: Multiple regression analysis of GA showed that the dose of PSL [β = - 1.36; 95% confidence interval (CI) - 2.59 to - 0.14; p = 0.03], age (β = 0.06; 95% CI 0.03-0.09; p < 0.001), body mass index (BMI) (β = - 0.14; 95% CI - 0.28 to - 0.01; p = 0.042), and A1c (β = 1.4; 95% CI 0.38-2.42; p = 0.008) significantly correlated with GA (adjusted R2 = 0.518). Moreover, GA levels adjusted for age, sex, BMI, plasma albumin (Alb) and creatinine (Cre), and A1c in the subjects taking ≥ 5 mg PSL was significantly lower than those in those taking < 5 mg PSL. Finally, the dose of PSL (as a continuous variable) was negatively correlated with GA adjusted for age, sex, BMI, Alb, Cre, and A1c.

Conclusion: High dose (≥ 5 mg) PSL reduces GA concentration more than glycemia.

Keywords: Connective tissue diseases; Glycated albumin; Glycated hemoglobin; Prednisolone.