Glycated albumin and risk of cardiovascular diseases and mortality in patients with and without dialysis: A meta-analysis

Background: Several studies have shown that glycated albumin (GA) is a more accurate measure of short-term blood sugar control in patients with dialysis. We aim to investigate the relationship between GA and the risk of cardiovascular diseases (CVDs) and mortality in patients both with and without dialysis.Materials and Methods: We searched cohort studies of associations between GA level and CVD and mortality in PubMed, Cochrane Library and Embase databases. The effect size was summarized by the random effects model, and the dose-response association was determined by robust error meta-regression method.Results: This meta-analysis included data from 80 024 participants in 17 cohort studies, 12 of which were prospective and five were retrospective. The results showed that higher levels of GA were associated with increased risk of CV mortality [hazard ratio = 1.90; 95% confidence interval (CI) 1.22-2.98], all-cause mortality (hazard ratio = 1.64; 95% CI 1.41-1.90), major adverse cardio-cerebral events (risk ratio = 1.41; 95% CI 1.17-1.71), coronary artery disease (odds ratio = 2.24; 95% CI 1.75-2.86) and stroke (risk ratio = 1.72; 95% CI 1.24-2.38). The dose-response analysis showed that GA levels were positively and linearly associated with the risk of CV mortality (p = .38), all-cause mortality (p = .57) and coronary artery disease (p = .18). Subgroup analysis showed that high levels of GA were associated with the risk of CV and all-cause mortality, regardless of dialysis status, with significant differences between subgroups of dialysis (CV mortality: p = .02; all-cause mortality: p = .03).Conclusion: High GA levels are associated with an increased risk of CVDs and mortality, regardless of dialysis status.