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Clinical implications of labile HbA1 as assayed by the electrophoretic method
Clinica Chimica Acta; International Journal of Clinical Chemistry
|December 23, 1982
Summary
The labile fraction of glycosylated hemoglobin (HbA1) is small and its measurement is variable. Total HbA1 is sufficient for clinical diabetes management, making the labile fraction unnecessary for routine use.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Hematology
Background:
- Glycosylated hemoglobin (HbA1) reflects average blood glucose levels.
- A labile fraction of HbA1 exists, but its clinical significance is debated.
Purpose of the Study:
- To investigate the characteristics and clinical utility of the labile fraction of glycosylated hemoglobin (HbA1).
- To determine if measuring the labile HbA1 fraction provides additional clinical value beyond total HbA1.
Main Methods:
- Agar gel electrophoresis was used to detect and quantify the labile HbA1 fraction.
- Blood samples were incubated in isotonic sodium chloride solution at 37°C to remove the labile fraction.
- Intra-individual variation and precision of HbA1 measurements were assessed.
Main Results:
- The labile HbA1 fraction was found to be a small percentage (mean 5%) of total HbA1.
- The size of the labile fraction correlated with total HbA1 and plasma glucose levels.
- Incubation did not alter the clinical classification of glycemic control based on HbA1.
Conclusions:
- The labile fraction of HbA1 is not clinically significant for routine diabetes management.
- Total HbA1 measurements are adequate for clinical purposes.
- Colorimetric methods for HbA1 are less precise and convenient than electrophoretic methods.