Total Short-term Variability in Biomarkers of Hyperglycemia in Older Adults

To the Editor:There is growing interest in the use of nontraditional short-term biomarkers of hyperglycemia [fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG)]1 to complement fasting glucose and hemoglobin A1c (Hb A1c) for prognosis and management of diabetes (1). Within-person variability in Hb A1c and fasting glucose has been previously characterized (2–4), but little is known about the variability of these alternative biomarkers of hyperglycemia in the general population. We quantified the 6-week total variability in fructosamine, glycated albumin, and 1,5-AG in older adults with and without diabetes and compared it to that of fasting glucose and Hb A1c.We included 153 participants from the Atherosclerosis Risk in Communities (ARIC) Study (5) who attended the initial visit-5 exam (2011–13), returned for a second visit scheduled 4–8 weeks later, had complete data, fasted ≥8 h at both visits, and did not have outlying values. Institutional review boards approved all procedures, and all study participants provided written informed consent.Serum fructosamine, glycated albumin, and 1,5-AG were measured with the Roche Cobas 6000 (Roche Diagnostics). Fructosamine was measured with a colorimetric method (Roche Diagnostics). Glycated albumin (Asahi Kasei Lucica GA-L) and 1,5-AG (GlycoMark) were measured with enzymatic methods. Glucose was measured in plasma with an Olympus 480 analyzer (Beckman Coulter) and a hexokinase …