Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Fitzgibbons, James F.; Koler, Robert D.; Jones, Richard T.

doi:10.1172/jci108534

Cited by 168 publications

(81 citation statements)

References 22 publications

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“…Because erythropoietin accelerates the production of new erythrocytes and the proportion of young erythrocytes in peripheral blood must increase after erythropoietin administration. HbA 1c is the product of the chemical condensation of hemoglobin and glucose, and the glycated rate of just-produced young erythrocytes is reported to be lower than that of old cells (26). Therefore, it seems that the decrease of HbA 1c levels relative to PG or GA in HD patients who have diabetes and are treated with erythropoietin might be due to the increasing proportion of young erythrocytes over old erythrocytes in peripheral blood of those patients (11).…”

Section: Discussionmentioning

confidence: 99%

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

Inaba¹,

Okuno²,

Kumeda³

et al. 2007

Journal of the American Society of Nephrology

470

415

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The significance of glycated albumin (GA), compared with casual plasma glucose (PG) and glycated hemoglobin (HbA 1c ), was evaluated as an indicator of the glycemic control state in hemodialysis (HD) patients with diabetes. The mean PG, GA, and HbA 1c levels were 164.5 ؎ 55.7 mg/dl, 22.5 ؎ 7.5%, and 5.85 ؎ 1.26%, respectively, in HD patients with diabetes (n ‫؍‬ 538), which were increased by 51.5, 31.6, and 17.7%, respectively, compared with HD patients without diabetes (n ‫؍‬ 828). HbA 1c levels were significantly lower than simultaneous PG and GA values in those patients in comparison with the relationship among the three parameters in patients who had diabetes without renal dysfunction (n ‫؍‬ 365), as reflected by the significantly more shallow slope of regression line between HbA 1c and PG or GA. A significant negative correlation was found between GA and serum albumin (r ‫؍‬ ؊0.131, P ‫؍‬ 0.002) in HD patients with diabetes, whereas HbA 1c correlated positively and negatively with hemoglobin (r ‫؍‬ 0.090, P ‫؍‬ 0.036) and weekly dose of erythropoietin injection (r ‫؍‬ ؊0.159, P < 0.001), respectively. Although PG and GA did not differ significantly between HD patients with diabetes and with and without erythropoietin injection, HbA 1c levels were significantly higher in patients without erythropoietin. Categorization of glycemic control into arbitrary quartile by HbA 1c level led to better glycemic control in a significantly higher proportions of HD patients with diabetes than those assessed by GA. Multiple regression analysis demonstrated that the weekly dose of erythropoietin, in addition to PG, emerged as an independent factor associated with HbA 1c in HD patients with diabetes, although PG but not albumin was an independent factor associated with GA. In summary, it is suggested that GA provides a significantly better measure to estimate glycemic control in HD patients with diabetes and that the assessment of glycemic control by HbA 1c in these patients might lead to underestimation likely as a result of the increasing proportion of young erythrocyte by the use of erythropoietin.

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Section: Discussionmentioning

confidence: 99%

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

Inaba¹,

Okuno²,

Kumeda³

et al. 2007

Journal of the American Society of Nephrology

470

415

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“…Glucose was unequivocally identified to generate the most abundant HbA 1 fraction HbA 1c , which was shown to be an Amadori product formed by the irreversible binding of glucose to the β -N-terminal valine residues of globin chains, rearranged into 1-deoxy-1-N-valyl-fructose [8 -12] and present in the ring form [13] . This process was demonstrated to occur during the 120-day lifespan of the erythrocytes [14] , glycated Hb content being higher in older than in younger red blood cells [15,16] . Although mentioned in 1966 [6] , the intermediary formation of a labile Schiff base (labile HbA 1c , Hb pre-A 1c ) preceding the Amadori rearrangement and the formation of the characteristic keto-amine linkage was formally described in 1981 only [17] .…”

Section: The Times Of Pioneers and Discoveriesmentioning

confidence: 99%

A history of HbA_1c through Clinical Chemistry and Laboratory Medicine

Gillery¹

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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HbA 1c was discovered in the late 1960s and its use as marker of glycemic control has gradually increased over the course of the last four decades. Recognized as the gold standard of diabetic survey, this parameter was successfully implemented in clinical practice in the 1970s and 1980s and internationally standardized in the 1990s and 2000s. The use of standardized and well-controlled methods, with well-defined performance criteria, has recently opened new directions for HbA 1c use in patient care, e.g., for diabetes diagnosis. Many reports devoted to HbA 1c have been published in Clinical Chemistry and Laboratory Medicine (CCLM) journal. This review reminds the major steps of HbA 1c history, with a special emphasis on the contribution of CCLM in this field.

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“…4,5 However, normal RBC life span has been reported to have a wide range of values regardless of the method used, [6][7][8] and there are also studies suggesting that RBC life span may depend on glycemic control, although evidence for this is conflicting. [9][10][11][12][13] It is also possible that heterogeneity in other features of red cell physiology, such as membrane glucose transport 14 and loss of Hb from older RBCs, 15 may influence the relationship between blood glucose and HbA1c.…”

Section: Introductionmentioning

confidence: 99%

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c

Cohen

Franco²,

Khera

et al. 2008

Blood

390

370

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Although red blood cell (RBC) life span is a known determinant of percentage hemoglobin A1c (HbA1c), its variation has been considered insufficient to affect clinical decisions in hematologically normal persons. However, an unexplained discordance between HbA1c and other measures of glycemic control can be observed that could be, in part, the result of differences in RBC life span. To explore the hypothesis that variation in RBC life span could alter measured HbA1c sufficiently to explain some of this discordance, we determined RBC life span using a biotin label in 6 people with diabetes and 6 nondiabetic controls.

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Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Cited by 168 publications

References 22 publications

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

A history of HbA_1c through Clinical Chemistry and Laboratory Medicine

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c

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Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Cited by 168 publications

References 22 publications

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

Glycated Albumin Is a Better Glycemic Indicator than Glycated Hemoglobin Values in Hemodialysis Patients with Diabetes

A history of HbA1c through Clinical Chemistry and Laboratory Medicine

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c

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Product

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A history of HbA_1c through Clinical Chemistry and Laboratory Medicine