Rapid changes in chromatographically determined haemoglobin A1c induced by short-term changes in glucose concentration
Open Access
- 1 August 1980
- journal article
- research article
- Published by Springer Science and Business Media LLC in Diabetologia
- Vol. 19 (2), 130-136
- https://doi.org/10.1007/bf00421859
Abstract
Chromatographically determined haemoglobin A1c concentration was measured during short-term (1–24 h) changes in glucose concentration in vitro and in vivo. In vitro at 37 °C the HbA1c concentration increased with glucose concentration and time both in normal and diabetic erythrocytes. In normal erythrocytes incubated in 20–100 mmol/l glucose, the increases in the HbA1c concentration were maximal after 4–6 h and then stable for the next 18–20 h. During the first hour, increases in the HbA1c concentration were linear with time and on average 0.034% HbA1c × h−1 × mmol/l glucose−1. In erythrocytes, after a rapidly produced increase (2h), HbA1c decreased to preincubation concentrations during a further incubation of the erythrocytes in a glucose-free medium at 37 °C for 4–6 h. The mean rate of linear decrease was 0.017% × h−1 × mmol/l glucose−1. After incubation of erythrocytes in 100 mmol/l glucose for 24 h, 1.3% HbA1c remained stable for 6 h in saline. The rapid increase in HbA1c concentration, as determined by chromatography, was not due to stable HbA1c (ketoamine linked glucose) as no increase was found in the HbA1c concentrations determined by the thiobarbiturate method. In juvenile diabetics controlled by an artificial beta-cell, rapid changes of blood glucose concentration (up to 20 mmol/l) resulted in increases in HbA1c concentration of as much as 1.9% within 12 h (mean 1.1%). Rapid in vivo increases in HbA1c concentration were reversible by normalization of the blood glucose concentration. That rapid changes in HbA1c may occur in daily diabetic life was evidenced by differences in HbA1c concentration between blood samples from out-patient diabetics incubated in saline for 16 hours at 4 °C and 37 °C (range of differences 0.2–1.4% HbA1c). The differences correlated to the blood glucose concentration at the time of sampling blood for HbA1c determination. Thus, incubation of blood at a low glucose concentration prior to determination of the glycosylated haemoglobin concentration may overcome interference from rapidly produced HbA1c.Keywords
This publication has 26 references indexed in Scilit:
- Synthesis of Hemoglobin AIc and Related Minor Hemoglobins by ErythrocytesJCI Insight, 1979
- FAST GLYCOSYLATION OF HÆMOGLOBINThe Lancet, 1979
- FAST GLYCOSYLATION OF HÆMOGLOBINThe Lancet, 1979
- FAST GLYCOSYLATION OF HÆMOGLOBINThe Lancet, 1979
- A rapid method for the determination of glycosylated hemoglobins using high pressure liquid chromatographyMetabolism, 1978
- HÆMOGLOBIN A1: AN INDICATOR OF THE METABOLIC CONTROL OF DIABETIC PATIENTSThe Lancet, 1977
- Clinical and biochemical studies on the significance and formation of hemoglobins AIc and AIa+b in diabetes mellitusJournal of Molecular Medicine, 1977
- In vitro synthesis of hemoglobin AIcFEBS Letters, 1976
- The biosynthesis of human hemoglobin A1c. Slow glycosylation of hemoglobin in vivo.JCI Insight, 1976
- Further identification of the nature and linkage of the carbohydrate in hemoglobin A1cBiochemical and Biophysical Research Communications, 1975