Glycated albumin and composite glycemic-lipid indices: complementary tools for type 2 diabetes diagnosis

Glycated albumin (GA) is a promising glycemic biomarker that offers advantages over glycated hemoglobin (HbA1c), especially under conditions that affect red blood cell turnover. In type 2 diabetes (T2DM), disturbances in glucose and lipid metabolism often coexist. This study aimed at evalute the diagnostic utility of GA, HbA1c, and their composite indices incorporating high-density lipoprotein cholesterol (HDL-C) in a Serbian cohort. A total of 124 adults (including both T2DM patients and healthy controls) were analyzed for GA, HbA1c, glucose, and lipid profiles. Composite indices, namely, GA/HDL-C and HbA1c/HDL-C, were calculated. Logistic regression and ROC analyses were used to assess diagnostic performance. GA and HbA1c levels were significantly higher in T2DM patients, while HDL-C levels were lower. Both GA/HDL-C and HbA1c/HDL-C showed strong associations with T2DM. HbA1c exhibited the highest AUC (0.966), followed by HbA1c/HDL-C (0.883), GA/HDL-C (0.859), and GA (0.855). The GA/HDL-C index exhibited particularly high specificity (92.06%). GA levels in the control group were consistent with reference values reported in other populations, and this is the first study to provide GA data for a Serbian cohort. The findings highlight GA as a useful complementary marker for T2DM. Composite indices, particularly GA/HDL-C and HbA1c/HDL-C, offer enhanced specificity and may serve as simple, cost-effective tools for integrated metabolic risk evaluation and early T2DM detection.