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[Determination of glycated hemoglobins (Hb A1c)]
Theresa Lahousen1, Regina E Roller, Rainer W Lipp
1Medizinische Universitätsklinik, Karl-Franzens Universität, Graz, Osterreich.
Insights
Glycated hemoglobin (HbA1c) assessment for diabetes management faces challenges due to diverse measurement methods and interfering factors. Standardization efforts are crucial for accurate long-term glycemic control monitoring.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Laboratory Medicine
Background:
- Glycated hemoglobin (HbA1c) reflects long-term glycemic control in diabetes mellitus.
- HbA1c is formed by non-enzymatic glycation of hemoglobin A.
Purpose of the Study:
- To review current information on hemoglobin glycation and HbA1c determination methods.
- To highlight interferences and standardization challenges in HbA1c measurement.
- To describe measures for accurate HbA1c assessment.
Main Methods:
- Review of existing literature on HbA1c determination techniques.
- Analysis of various methods including chromatography, electrophoresis, and immunoassays.
- Examination of factors affecting HbA1c measurement accuracy.
Main Results:
- Over 20 methods exist for HbA1c determination, measuring different glycated hemoglobin fractions.
- Genetic hemoglobin variants and chemical modifications interfere with HbA1c measurements.
- Current methods face challenges in standardization and accurate interpretation.
Conclusions:
- Accurate HbA1c measurement is critical for effective diabetes management.
- Interferences from hemoglobin variants complicate standardization efforts.
- Standardization and careful method selection are necessary for reliable glycemic control assessment.
Abstract:
Glycated hemoglobin is measured as HbA1c and is the result of an irreversible non-enzymatic glycation of the beta chain of hemoglobin A. HbA1c is used routinely to assess long term glycemic control in patients with diabetes mellitus. There are more than 20 determination methods, the techniques used are cation-exchange chromatography, electrophoresis, affinity chromatography and immunoassays, although each of these techniques measures a different fraction of the glycated hemoglobin. In addition, genetic hemoglobin variants and chemically modified derivates of hemoglobin can affect the HbA1c measurement and thus can not be included in international attempts for standardization. This manuscript reviews the current information on glycation of hemoglobin, HbA1c determination methods, interferences and attempts for standardization. We aim at pointing out to the reader the current problems of glycated hemoglobin determination and to describe the necessary measures which need to be taken for proper measurement of HbA1c.