Clinical Utility of Glycosylated Hemoglobins (HbA1)

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In normal subjects and patients with diabetes mellitus (type II), HbA1a+b, HbA1c and HbA0 were fractionated by column chromatographic procedure of Trivelli et al and HbA1 was determined by a commercial kit. Moreover, the total glycosylated hemoglobin (GHbA), glycosylated hemoglobin in HbA0 (GHbA0), glycosylated serum protein (GSP) and urinary glycosylated protein (UGP) were determined the colorimetric method of Gabbay et al, using thiobarbituric acid. Although there was no significant relation between HbA1a+b levels and blood sugar levels, HbA1c levels correlated significantly with the average blood sugar levels for several months proceeding the hemoglobin measurements. A significant correlation existed between HbA1a+b and HbA1c (r=+0.54, p<0.01), and, therefore, a striking correlation was evident in the plots of HbA1a+b+HbA1c against the mean blood sugar levels for 3 months prior to the hemoglobin measurements, which had a correlation coefficient of 0.79 (p<0.001). In addition, HbA1 levels correlated significantly with GHbA (r=+0.89) and with GHbA0(r=+0.94). On the other hand, the correlation coefficient between HbA1 and GSP was only +0.41, although it was statistically significant (p<0.01). In particular, HbA1 levels were not parallel to GSP levels in diabetics complicated with liver diseases. These results suggest that HbA1 (HbA1a+b+c) determinations by a commercial kit are a useful indicator for assessing the long-term blood glucose control in diabetics. In non-diabetics with nephrosis or chronic nephritis, the ratio of UGP to SGP averaged 0.95±0.17. The marked elevation of the ratio (1.95±0.53) was evident in diabetics with nephropathy, showing the elevated UGP levels in these patients. The finding suggest that the glycosylated protein might play a role in pathogenesis of diabetic nephropathy.
Japan Society of Clinical Chemistryの論文

Clinical Utility of Glycosylated Hemoglobins (HbA<SUB>1</SUB>)

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