J Rheum Dis 2018; 25(2): 131-139  
Hemoglobin A1c, Not Glycated Albumin, Can Independently Reflect the Ankylosing Spondylitis Disease Activity Score
Sejin Byun, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Sang-Won Lee http://orcid.org/orcid.org/0000-0002-8038-3341
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. E-mail:sangwonlee@yuhs.ac
Received: January 24, 2018; Revised: February 27, 2018; Accepted: February 28, 2018; Published online: April 1, 2018.
© Korean College of Rheumatology. All rights reserved.

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Abstract
Objective. This study examined whether glycated hemoglobin (HbA1c) and glycated albumin (GA) are well correlated with the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), and ASDAS-C-reactive protein (CRP) in AS patients without medical conditions affecting the glycated protein levels. Methods: The data of 76 patients with AS were analyzed. Univariate and multivariate analyses of the variables associated with ASDAS-ESR and ASDAS-CRP were performed using a linear regression test. The patients were divided into active and inactive AS groups based on an ASDAS-CRP of 2.1, and the variables between the two groups were compared. Results. ASDAS-ESR did not correlated with either HbA1c or GA. ASDAS-CRP was positively correlated with HbA1c (r=0.315, p=0.006) and the white blood cell (r=0.288, p=0.012), and inversely correlated with hemoglobin (r=-0.241, p=0.036) and serum albumin (r=-0.262, p=0.022), but not GA. Multivariate analysis revealed HbA1c and white blood cell to be significantly correlated with ASDAS-CRP (β=0.234, p=0.033 and β=0.265, p=0.017). The mean HbA1c, not GA, of the active group was significantly higher than that of the inactive group (p=0.020). In addition, the optimal cut-off value of HbA1c was set to 5.6, and the patients with HbA1c ≥5.6 were found to have a 3.3 times higher risk of active AS than those without. Conclusion. HbA1c was significantly correlated with ASDAS-CRP, and could be a useful marker to reflect ASDAS-CRP in AS patients without medical conditions affecting the glycated protein levels.
Keywords: Ankylosing spondylitis, Glycated hemoglobin A, Glycosylated serum albumin


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