Kutter D, Thoma J
Laboratoires réunis L6101 Junglinster, Grand Duchy of Luxembourg.
Clin Lab. 2006;52(9-10):477-81.
Glycated hemoglobin (%HbA1c) has become a well established and reliable long term parameter indicative of the mean glucose load of the preceding 8 -10 weeks. A normal life span of approximately120 days of the red blood cells (RBC) is an essential condition. Hemolytic affections are characterized by a shorter life span, reducing the overall glucose uptake and %HbA1c. Measured %HbA1c is no longer correlated with mean blood glucose of the preceding period, simulating false low values. Underestimation of this kind is demonstrated for several hemolytic conditions, among them hereditary spherocytosis (HS). This latter, often harmless anomaly may lead to serious underestimation of glucose load. Recent investigations show not only a much higher incidence of HS than hitherto admitted (approximately 1 in 250 persons) but also an abnormally high incidence of diabetes in this hemolytic affection. In the presence of hemolysis %HbA1c is to be interpreted with caution. This justifies systematic detection of HS in routine hematology using--if available--the increase of the percentage of hyperchromic RBC.
糖化血红蛋白（%HbA1c）已成为一个公认且可靠的长期指标，可反映前8至10周的平均血糖负荷。红细胞（RBC）约120天的正常寿命是一个必要条件。溶血性疾病的特点是红细胞寿命缩短，从而减少了总体葡萄糖摄取量和%HbA1c。测得的%HbA1c不再与前期的平均血糖相关，会模拟出假的低值。在几种溶血性疾病中都证实了这种低估情况，其中包括遗传性球形红细胞增多症（HS）。这种通常无害的异常情况可能会导致对葡萄糖负荷的严重低估。最近的研究表明，HS的发病率不仅比迄今公认的要高得多（约为250人中1人），而且在这种溶血性疾病中糖尿病的发病率异常高。在存在溶血的情况下，对%HbA1c的解读应谨慎。这证明了在常规血液学检查中使用（如果可用）高色素红细胞百分比的增加来系统检测HS的合理性。
