Research Institute for Children, Children's Hospital, New Orleans, LA 70118, USA; Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA 70118, USA.
Anal Biochem. 2013 Nov 15;442(2):205-12. doi: 10.1016/j.ab.2013.07.016. Epub 2013 Jul 20.
Interindividual and ethnic variation in glycated hemoglobin levels, unrelated to blood glucose variation, complicates the clinical use of glycated hemoglobin assays for the diagnosis and management of diabetes. Assessing the types and amounts of glycated hemoglobins present in erythrocytes could provide insight into the mechanism. Blood samples and self-monitored mean blood glucose (MBG) levels were obtained from 85 pediatric type 1 diabetes patients. Glycated hemoglobin levels were measured using three primary assays (boronate-affinity chromatography, capillary isoelectric focusing (CIEF), and standardized DCA2000+ immunoassay) and a two-dimensional (2D) analytical system consisting of boronate-affinity chromatography followed by CIEF. The 2D system separated hemoglobin into five subfractions, four of which contained glycated hemoglobins. Glycated hemoglobin measurements were compared in patients with low, moderate, or high hemoglobin glycation index (HGI), a measure of glycated hemoglobin controlled for blood glucose variation. MBG was not significantly different between HGI groups. Glycated hemoglobin levels measured by all three primary assays and in all four glycated 2D subfractions were significantly different between HGI groups and highest in high HGI patients. These results show that interindividual variation in glycated hemoglobin levels was evident in diabetes patients with similar blood glucose levels regardless of which glycated hemoglobins were measured.
糖化血红蛋白水平在个体间和种族间存在差异，与血糖变化无关，这使得糖化血红蛋白检测在糖尿病的诊断和管理中的临床应用变得复杂。评估红细胞中存在的糖化血红蛋白的类型和数量可以深入了解其机制。从 85 名儿科 1 型糖尿病患者中采集了血液样本和自我监测的平均血糖（MBG）水平。使用三种主要检测方法（硼酸亲和色谱法、毛细管等电聚焦（CIEF）和标准化 DCA2000+免疫测定法）和二维（2D）分析系统（硼酸亲和色谱法后接 CIEF）来测量糖化血红蛋白水平。2D 系统将血红蛋白分离成五个亚组分，其中四个包含糖化血红蛋白。在血红蛋白糖化指数（HGI）低、中或高的患者中比较糖化血红蛋白测量值，HGI 是衡量糖化血红蛋白控制血糖变化的指标。HGI 组之间的 MBG 没有显著差异。所有三种主要检测方法和所有四种糖化 2D 亚组分测量的糖化血红蛋白水平在 HGI 组之间存在显著差异，在高 HGI 患者中最高。这些结果表明，无论测量哪种糖化血红蛋白，血糖水平相似的糖尿病患者中糖化血红蛋白水平的个体间差异明显。
