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Biochemical Titration of Glycogen In vitro
Published on: November 24, 2013
Measuring postmortem glycated hemoglobin - A comparison of three methods.
Terhi Keltanen1, Antti Sajantila, Tiina Valonen
1Hjelt-Institute, Department of Forensic Medicine, PL 40, University of Helsinki, 00300 Helsinki, Finland. terhi.keltanen@helsinki.fi
Legal Medicine (Tokyo, Japan)
|October 24, 2012
Summary
Postmortem glycated hemoglobin (HbA1c) analysis reliably indicates long-term glucose control. Mono S HPLC with EDTA preservation is effective for medicolegal autopsy metabolic state determination.
Area of Science:
- Forensic Biochemistry
- Clinical Chemistry
- Analytical Toxicology
Background:
- Glycated hemoglobin (HbA1c) reflects average blood glucose over 1-2 months.
- HbA1c is crucial for differentiating causes of death in acetonemic cases.
- Distinguishing diabetic ketoacidosis (DKA) from starvation/alcoholic ketoacidosis (AKA) and intoxication is vital.
Purpose of the Study:
- To evaluate postmortem HbA1c measurement methods.
- To optimize sample storage and preservative conditions.
- To assess HbA1c's utility in medicolegal autopsies.
Main Methods:
- Evaluation of Mono S cation exchange HPLC, affinity chromatography, and enzymatic methods.
- Optimization of sample storage at +4°C with preservatives.
- Analysis of postmortem samples for HbA1c, glucose, and ketone bodies.
Main Results:
- Mono S HPLC reliably measures postmortem HbA1c levels.
- EDTA is the preferred preservative, allowing measurement up to 4 weeks post-collection.
- Postmortem HbA1c analysis aids in determining metabolic status.
Conclusions:
- HbA1c measurement is a valuable tool in forensic investigations.
- Reliable postmortem HbA1c determination aids in cause of death analysis.
- Combined analysis of HbA1c, glucose, and ketones provides comprehensive metabolic insights.
