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Minor hemoglobin components in diabetic and uremic patients
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|December 1, 1981
Summary
Glycosylated hemoglobin (HbA1c) levels are elevated in diabetics and correlate with blood glucose. In renal failure patients, HbA1c requires careful interpretation, and methods distinguishing HbA1a+b are recommended.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Nephrology
Background:
- Glycosylated hemoglobin (HbA1c) is a key biomarker for long-term glycemic control.
- Renal failure can potentially affect glycosylated hemoglobin levels, complicating diabetes management interpretation.
- Automated chromatographic methods allow for the differentiation of various hemoglobin A1 fractions.
Purpose of the Study:
- To investigate and compare Hemoglobin A1c (HbA1c) and Hemoglobin A1a+b (HbA1a+b) levels in diabetic patients, non-diabetic patients with renal failure, and control subjects.
- To assess the impact of renal failure and hemodialysis on HbA1c and HbA1a+b values.
- To evaluate the clinical utility of "HbA1" as a routine measure in patients with renal impairment.
Main Methods:
- Measurement of HbA1c and HbA1a+b using an automated chromatographic method.
- Comparison of glycosylated hemoglobin levels across three groups: healthy controls, diabetic patients, and non-diabetic patients with renal failure.
- Analysis of HbA1c changes in diabetic patients undergoing intensive therapy and in hemodialyzed versus non-hemodialyzed renal failure patients.
Main Results:
- HbA1c was significantly higher in diabetics compared to controls and correlated with preceding blood glucose levels.
- HbA1c levels were also elevated in non-dialyzed uremic patients but normalized in hemodialyzed patients.
- HbA1a+b was elevated in both diabetic and uremic patients, with persistently high levels in hemodialyzed patients.
Conclusions:
- Routine "HbA1" measurements should be interpreted with caution in patients with renal failure due to potential alterations in glycosylated hemoglobin fractions.
- Methods capable of discriminating between HbA1a+b are necessary for accurate assessment in patients with renal impairment.
- The findings highlight the importance of considering renal function when evaluating glycosylated hemoglobin for glycemic control.