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Harris NS, Weaver KD, Beal SG, Winter WE. The Interaction between Hb A1C and Selected Genetic Factors in the African American Population in the USA. J Appl Lab Med 2020; 6:167-179. [PMID: 33367812 DOI: 10.1093/jalm/jfaa202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND The global prevalence of diabetes mellitus has been growing in recent decades and the complications of longstanding type 2 diabetes continue to place a burden on healthcare systems. The hemoglobin A1c (Hb A1c) content of the blood is used to assess an individual's degree of glycemic control averaged over 2 to 3 months. In the USA, diabetes is the seventh leading cause of death. Black, indigenous, people of color (BIPOC) are disproportionately affected by diabetes compared to non-Hispanic whites. There are many reports of interaction of Hb A1c and hematologic conditions that have a high prevalence in the Black population; some of these effects are contradictory and not easily explained. This review attempts to document and categorize these apparently disparate effects and to assess any clinical impact. METHODS Hb A1C can be determined by a variety of techniques including cation-exchange chromatography, electrophoresis, immunoassays, and affinity chromatography. The amount of Hb A1c present in a patient specimen depends not only on blood glucose but is strongly influenced by erythrocyte survival and by structural variations in the globin chains. Sickling hemoglobinopathies are well-represented in the USA in African Americans and the effects of these hemoglobin disorders as well as G6PD deficiency is examined. CONCLUSION Hb A1c measurement should always be performed with a cautious approach. The laboratory scientist should be aware of possible pitfalls in unquestioningly determining Hb A1c without a consideration of hematologic factors, both inherited and acquired. This presents a challenge as often times, the laboratory is not aware of the patient's race.
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Affiliation(s)
- Neil S Harris
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL
| | - Kaitlin D Weaver
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL
| | - Stacy G Beal
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL
| | - William E Winter
- Department of Pathology, Immunology & Laboratory Medicine, University of Florida, Gainesville, FL
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Wang Z, Xing G, Zhang L. Glycated albumin level is significantly decreased in patients suffering nephrotic syndrome. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 162:307-319. [DOI: 10.1016/bs.pmbts.2019.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Shiga K, Urakami T, Suzuki J, Igarashi Y, Tajima H, Amemiya S, Sugihara S. Fulminant type 1 diabetes mellitus in Japanese children and adolescents: multi-institutional joint research of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes. Endocr J 2018; 65:795-803. [PMID: 29794414 DOI: 10.1507/endocrj.ej18-0029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Fulminant type 1 diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus characterized by a remarkably abrupt onset. In Japan, FT1DM accounts for approximately 20% of acute-onset adult type 1 diabetes mellitus cases; however, reports of pediatric-onset FT1DM are rare. We aimed to determine the frequency and clinical characteristics of FT1DM in Japanese children and adolescents by conducting a 2-phase questionnaire survey among the members of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT) regarding their clinical experience with FT1DM. Responses were obtained from 54 of the 79 participating hospitals (68.4%). Of these, 8 hospitals managed a total of 15 pediatric patients with FT1DM (4 patients in each of 2 hospitals, 2 patients in 1 hospital, and 1 patient in each of 5 hospitals). The distribution of patient age was biphasic, with peaks in children younger than 5 years and older than 8 years of age. The clinical characteristics of FT1DM in this population (such as the duration from onset of symptoms to diagnosis, severity of symptoms, preceding flu-like episodes, and abnormal laboratory data) did not differ from those of patients with adult-onset FT1DM. The frequency of pediatric-onset FT1DM is low compared with that of adult-onset FT1DM. The genetic background and susceptibility patterns of pediatric patients with FT1DM may differ from those typical of adults with FT1DM, but both age groups share similar clinical characteristics.
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Affiliation(s)
- Kentaro Shiga
- Children's Medical Center, Yokohama City University Medical Center, Kanagawa 232-0024, Japan
| | - Tatsuhiko Urakami
- Department of Pediatrics, Nihon University School of Medicine, Tokyo 101-8309, Japan
| | - Junichi Suzuki
- Department of Pediatrics, Nihon University School of Medicine, Tokyo 101-8309, Japan
| | | | - Hanako Tajima
- Department of Pediatrics, Nippon Medical School, Tokyo 113-8602, Japan
| | - Shin Amemiya
- Department of Pediatrics, Saitama Medical University, Saitama 350-0495, Japan
| | - Shigetaka Sugihara
- Department of Pediatrics, Tokyo Women's Medical University Medical Center East, Tokyo 116-8567, Japan
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Yazdanpanah S, Rabiee M, Tahriri M, Abdolrahim M, Rajab A, Jazayeri HE, Tayebi L. Evaluation of glycated albumin (GA) and GA/HbA1c ratio for diagnosis of diabetes and glycemic control: A comprehensive review. Crit Rev Clin Lab Sci 2017; 54:219-232. [PMID: 28393586 DOI: 10.1080/10408363.2017.1299684] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose. However, these measurements did not provide information about glycemic control over a long period of time. To address this problem, there has been a switch in the past decade to diagnosing diabetes and its severity through measurement of blood glycated proteins such as Hemoglobin A1c (HbA1c) and glycated albumin (GA). Diagnosis and evaluation of diabetes using glycated proteins has many advantages including high accuracy of glycemic control over a period of time. Currently, common laboratory methods used to measure glycated proteins are high-performance liquid chromatography (HPLC), immunoassay, and electrophoresis. HbA1c is one of the most important diagnostic factors for diabetes. However, some reports indicate that HbA1c is not a suitable marker to determine glycemic control in all diabetic patients. GA, which is not influenced by changes in the lifespan of erythrocytes, is thought to be a good alternative indicator of glycemic control in diabetic patients. Here, we review the literature that has investigated the suitability of HbA1c, GA and GA:HbA1c as indicators of long-term glycemic control and demonstrate the importance of selecting the appropriate glycated protein based on the patient's health status in order to provide useful and modern point-of-care monitoring and treatment.
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Affiliation(s)
- Sara Yazdanpanah
- a Biomaterials Group, Faculty of Biomedical Engineering , Amirkabir University of Technology , Tehran , Iran
| | - Mohammad Rabiee
- a Biomaterials Group, Faculty of Biomedical Engineering , Amirkabir University of Technology , Tehran , Iran
| | - Mohammadreza Tahriri
- a Biomaterials Group, Faculty of Biomedical Engineering , Amirkabir University of Technology , Tehran , Iran.,b Marquette University School of Dentistry , Milwaukee , WI , USA.,c Dental Biomaterials Department , School of Dentistry, Tehran University of Medical Sciences , Tehran , Iran
| | - Mojgan Abdolrahim
- a Biomaterials Group, Faculty of Biomedical Engineering , Amirkabir University of Technology , Tehran , Iran
| | | | | | - Lobat Tayebi
- b Marquette University School of Dentistry , Milwaukee , WI , USA
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Furuya A, Suzuki S, Oshima M, Amamiya S, Nakao A, Araki M, Mizutani K, Hayano S, Ushijima K, Imamoto A, Nagano N, Urakami T, Matsuo K, Tanahashi Y, Azuma H, Koga M. Age-Adjusted Glycated Albumin at Diagnosis is more Correlated with the Product of Age and Plasma Glucose than Plasma Glucose Alone in Patients with Neonatal Diabetes Mellitus. J Clin Lab Anal 2016; 30:1086-1091. [PMID: 27121214 DOI: 10.1002/jcla.21985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/30/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We previously showed that glycated albumin (GA) is a useful glycemic control indicator in patients with neonatal diabetes mellitus (NDM), and that age-adjusted GA (Aa-GA) can reflect more accurately glycemic control status. Here, we investigated whether the age at diagnosis influences Aa-GA at diagnosis of NDM. METHODS Eight patients with NDM whose GA was measured at diagnosis (age at diagnosis: 39 ± 18 days; GA: 31.3 ± 7.6%; Aa-GA: 47.1 ± 10.3%; plasma glucose: 525 ± 194 mg/dl) were included. Aa-GA was calculated as follows: Aa-GA = GA × 14.0/[1.77 × log-age (days) + 6.65]. Correlations of GA or Aa-GA at diagnosis with its logarithmically transformed age in days (log-age), plasma glucose, and their product were investigated. RESULTS GA at diagnosis was not significantly correlated with log-age or plasma glucose. On the other hand, Aa-GA at diagnosis was significantly positively correlated with plasma glucose (R = 0.75, P = 0.031) and was more strongly positively correlated with the product of plasma glucose and log-age (R = 0.82, P = 0.012) although it was not correlated with log-age. CONCLUSION Aa-GA at diagnosis is influenced by both age in days and plasma glucose. This finding is likely to show the aspect that age in days is almost equal to diabetes duration because glycemic control indicators including GA reflect the weighted mean of plasma glucose.
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Affiliation(s)
- Akiko Furuya
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Shigeru Suzuki
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan.
| | - Miho Oshima
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan
| | - Satoshi Amamiya
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan
| | - Atsushi Nakao
- Department of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mariko Araki
- Department of Pediatrics, Kochi Medical School, Kochi, Japan
| | - Kayo Mizutani
- Department of Neonatology, Kameda Medical Center, Kamogawa, Japan
| | - Satoshi Hayano
- Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
| | - Katsumi Ushijima
- Department of Pediatrics, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Aya Imamoto
- Department of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Tottori, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Tatsuhiko Urakami
- Department of Pediatrics, Surugadai Nihon University Hospital, Tokyo, Japan
| | - Kumihiro Matsuo
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Yusuke Tanahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroshi Azuma
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Japan
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Suzuki S, Furuya A, Oshima M, Amamiya S, Nakao A, Wada K, Okuhara K, Hayano S, Imamoto A, Matsuo K, Tanahashi Y, Azuma H, Koga M. Age-adjusted glycated albumin accurately reflects blood glucose in patients with neonatal diabetes mellitus: comparison with calculated glycated albumin determined by past blood glucose concentrations. Ann Clin Biochem 2015; 53:117-23. [DOI: 10.1177/0004563215589382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2015] [Indexed: 11/15/2022]
Abstract
Background Glycated albumin is a useful glycaemic control indicator for neonatal diabetes mellitus. However, glycated albumin concentrations in infants are lower than those in adults and increase in an age-dependent manner. Based on our investigation of non-diabetic subjects, we proposed the possibility that the reference range for adults may be used regardless of age, provided that age-adjusted glycated albumin is employed. In the present study, we evaluate the usefulness of age-adjusted glycated albumin in neonatal diabetes mellitus patients. Methods Six neonatal diabetes mellitus patients (four patients with permanent neonatal diabetes mellitus and two patients with transient neonatal diabetes mellitus) were included. Measured glycated albumin or age-adjusted glycated albumin was compared to calculated glycated albumin, which was determined using calculation formulae we had reported based on past blood glucose over the 50 days before measurement of glycated albumin. Results Measured glycated albumin was significantly lower than calculated glycated albumin (20.5 ± 4.9% versus 28.2 ± 6.1%; p < 0.0001), whereas age-adjusted glycated albumin was equivalent to calculated glycated albumin, showing no significant difference (27.5 ± 6.8% versus 28.2 ± 6.1%). Measured glycated albumin concentrations in patients with transient neonatal diabetes mellitus in remission were lower than the reference range for adults, whereas age-adjusted glycated albumin concentrations were within the reference range for adults. Conclusion We demonstrated that age-adjusted glycated albumin concentrations were consistent with calculated glycated albumin. Age-adjusted glycated albumin is therefore a useful glycaemic control indicator for neonatal diabetes mellitus patients.
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Affiliation(s)
- Shigeru Suzuki
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Akiko Furuya
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Miho Oshima
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan
| | - Satoshi Amamiya
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan
- Amamiya Shounika Clinic, Sapporo, Japan
| | - Atsushi Nakao
- Department of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Keiko Wada
- Department of Neonatology, Hyogo Prefectural Kobe Children’s Hospital Perinatal Center, Kobe, Japan
| | - Koji Okuhara
- Department of Pediatrics, Tenshi Hospital, Sapporo, Japan
| | - Satoshi Hayano
- Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aya Imamoto
- Department of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kumihiro Matsuo
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Yusuke Tanahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroshi Azuma
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Japan
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Furuya A, Suzuki S, Koga M, Oshima M, Amamiya S, Nakao A, Wada K, Okuhara K, Hayano S, Matsuo K, Tanahashi Y, Azuma H. HbA1c can be a useful glycemic control marker for patients with neonatal diabetes mellitus older than 20 weeks of age. Clin Chim Acta 2014; 436:93-6. [PMID: 24854496 DOI: 10.1016/j.cca.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/10/2014] [Accepted: 05/12/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND The accuracy of most HbA1c analysis methods is affected by the presence of increased fetal hemoglobin (HbF). The objective of this study was to investigate the age at which HbA1c measurements become useful for monitoring glycemic control in patients with neonatal diabetes mellitus (NDM). METHODS We retrospectively analyzed the data of 5 NDM patients diagnosed at 38±20 days of age, who each had several available HbA1c measurements during the first year of life, with a control group of HbA1c values over the course of 1 year for 13 patients with type 1 diabetes mellitus (T1DM). Mean blood glucose (MBG) levels derived from premeal or premeal plus bedtime blood glucose measurements prior to HbA1c measurements were compared to HbA1c values. RESULTS The NDM patients' age at which the difference in the HbA1c/MBG ratios became not significant between the NDM patients and the T1DM patients was 21 weeks of age and over. Even after the HbA1c was adjusted for HbF, this ratio was significantly lower in the NDM patients at <21 weeks of age than in the T1DM patients. CONCLUSIONS HbA1c can be a useful glycemic control marker for NDM patients >20 weeks of age.
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Affiliation(s)
- Akiko Furuya
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan
| | - Shigeru Suzuki
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan.
| | - Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Japan
| | - Miho Oshima
- Department of Pediatrics, Sapporo Tokushukai Hospital, Japan
| | - Satoshi Amamiya
- Department of Pediatrics, Sapporo Tokushukai Hospital, Japan
| | - Atsushi Nakao
- Department of Neonatology, Japanese Red Cross Medical Center, Japan
| | - Keiko Wada
- Department of Pediatrics, Bell Land General Hospital, Japan; Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Japan
| | - Koji Okuhara
- Department of Pediatrics, Tenshi Hospital, Japan
| | | | - Kumihiro Matsuo
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan
| | - Yusuke Tanahashi
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan
| | - Hiroshi Azuma
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan
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Suzuki S, Koga M, Niizeki N, Furuya A, Matsuo K, Tanahashi Y, Tsuchida E, Nohara F, Okamoto T, Nagaya K, Azuma H. Evaluation of glycated hemoglobin and fetal hemoglobin-adjusted HbA1c measurements in infants. Pediatr Diabetes 2013; 14:267-72. [PMID: 23350671 DOI: 10.1111/pedi.12013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/16/2012] [Accepted: 11/30/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND As the presence of fetal hemoglobin (HbF) affects the accuracy of hemoglobin A1c (HbA1c) analysis methods, HbA1c measurement may not be a good indicator for patients with neonatal diabetes mellitus, whereas glycated albumin (GA) may be a good indicator. OBJECTIVE To investigate whether total glycated hemoglobin (GHb) or HbF-adjusted HbA1c (adj-HbA1c) can act as a glycemic control marker in infants. SUBJECTS AND METHODS Plasma glucose (PG), GA, HbF, GHb measured using the affinity method, and HbA1c measured using the latex-immunoturbidimetry (LA) or the high-performance liquid chromatography (HPLC) methods were determined in 26 full-term newborn infants aged 4-234 d. Adj-HbA1c was calculated as HbA1c/(total Hb - HbF). RESULTS GHb, adj-HbA1c measured using the LA and the HPLC methods were 4.8 ± 0.5%, 4.5 ± 0.5%, and 4.7 ± 0.6%, respectively. GA was most positively correlated with PG (r = 0.696, p < 0.0001). GHb was positively correlated with both PG (r = 0.479, p = 0.013) and GA (r = 0.727, p < 0.0001). Adj-HbA1c measured using the LA method was positively correlated with GA (r = 0.465, p = 0.017), but not PG (r = 0.304, p = 0.132). Adj-HbA1c measured using the HPLC method was correlated with neither PG (r = -0.077, p = 0.710) nor GA (r = 0.360, p = 0.071). CONCLUSIONS GHb measured using the affinity method may be a useful glycemic control marker in infants. Although adj-HbA1c measured using the LA method was correlated with GA, it may not be a practical measure because it was not correlated with PG and determining HbF levels using HPLC method can be troublesome. Adj-HbA1c measured using the HPLC method should not be used as a glycemic marker in infants.
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Affiliation(s)
- Shigeru Suzuki
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan.
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Comparison of hemoglobin A1c measurements of samples with elevated fetal hemoglobin by three commercial assays. Clin Chim Acta 2012; 413:1712-3. [DOI: 10.1016/j.cca.2012.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 05/18/2012] [Accepted: 05/21/2012] [Indexed: 11/19/2022]
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Suzuki S, Koga M, Amamiya S, Nakao A, Wada K, Okuhara K, Hayano S, Sarhat AR, Takahashi H, Matsuo K, Tanahashi Y, Fujieda K. Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus. Diabetologia 2011; 54:2247-53. [PMID: 21644010 DOI: 10.1007/s00125-011-2211-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 05/05/2011] [Indexed: 01/14/2023]
Abstract
AIMS/HYPOTHESIS It is difficult to use HbA(1c) as an indicator of glycaemic control in patients with neonatal diabetes mellitus (NDM) because of high levels of fetal haemoglobin (HbF) remaining in the blood. In this study, glycated albumin (GA), which is not affected by HbF, and HbA(1c) were compared to evaluate whether they reflect glycaemic control in patients with NDM. METHODS This study included five patients with NDM. Age at diagnosis was 38 ± 20 days. Insulin therapy was started in all patients, and levels of GA, HbA(1c) and HbF were measured monthly for 6 months. One-month average preprandial plasma glucose (aPPG) was calculated using self-monitoring of blood glucose. RESULTS Plasma glucose and GA were elevated (29.7 ± 13.1 mmol/l [n = 5] and 33.3 ± 6.9% [n = 3], respectively) but HbA(1c) was within normal limits (5.4 ± 2.6% [35.5 ± 4.9 mmol/mol]; n = 4) at diagnosis. With diabetes treatment, aPPG (r = -0.565, p = 0.002), GA (r = -0.552, p = 0.003) and HbF (r = -0.855, p < 0.0001) decreased with age, whereas HbA(1c) increased (r = 0.449, p = 0.004). GA was strongly positively correlated with aPPG (r = 0.784, p < 0.0001), while HbA(1c) showed no correlation with aPPG (r = 0.221, p = 0.257) and was significantly inversely correlated with HbF (r = -0.539, p = 0.004). CONCLUSIONS/INTERPRETATION GA is a useful indicator of glycaemic control in patients with NDM, whereas HbA(1c) is influenced by age-related changes in HbF and does not accurately reflect glycaemic control.
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Affiliation(s)
- S Suzuki
- Department of Pediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa 078-8510, Japan.
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Koga M, Murai J, Saito H, Yamada Y, Mori T, Suno S, Takeuchi K, Suzuki S, Fujieda K, Kasayama S. Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates. J Perinatol 2011; 31:430-3. [PMID: 21164428 DOI: 10.1038/jp.2010.144] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE As neonatal blood contains a high proportion of fetal hemoglobin (HbF), it is difficult to use high-performance liquid chromatography (HPLC) method, latex-immunoturbidimetry (LA) method and enzymatic methods, which determine hemoglobin A(1C) (HbA(1C)) in order to provide the glycemic control indicators of neonates. In this study, we evaluated glycated hemoglobin (GHb) and glycated albumin (GA) as appropriate indicators of the glycemic control in the neonatal period. STUDY DESIGN Umbilical cord blood samples collected during delivery were subjected to measurements of GHb (HPLC methods using two different instruments, LA method, enzymatic method and affinity method) and serum GA. RESULT HbA(1C) levels determined by the HPLC method, the LA method and the enzymatic method were as low as <3.0% in all the cases. Although GHb determined by the affinity method was 3.6 ± 0.2%, this method may not measure accurately the values of glycated HbF plus glycated HbA. Serum GA was 9.4 ± 1.1%. CONCLUSION We speculate that serum GA, but not GHb, could be used as glycemic control indicators in neonates.
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Affiliation(s)
- M Koga
- Department of Internal Medicine, Kinki Central Hospital, Hyogo, Japan
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Escribano-Serrano J, García-Domínguez L, Díaz-Pintado M. Glucohemoglobina HbA1c. Segunda parte: medirla. Semergen 2010. [DOI: 10.1016/j.semerg.2009.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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