Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA; Current affiliation: Siemens Healthineers, Siemens Healthcare Diagnostics, Inc., Tarrytown, NY, USA.
Department of Pathology, Jefferson University Hospitals, Philadelphia, PA, USA.
Clin Chim Acta. 2017 Nov;474:124-129. doi: 10.1016/j.cca.2017.09.011. Epub 2017 Sep 18.
A model for hemoglobin A (HbA) formation was used to predict the relationship between average glucose (AG) and %HbA under conditions of altered red blood cell lifetime (RCL).
Using a kinetic mass balance model for formation of HbA in red blood cells as a function of age (time in circulation), whole blood %HbA vs. glucose was calculated based on the nonlinear distribution of red blood cells as a function of age across RCL.
Model calculations provided a close fit to the standard relationship of estimated average glucose to %HbA for normal RCL (r>0.999). Results for altered RCL were calculated assuming simple time-scale compression or expansion of the distribution of red blood cells as a function of RCL. For a given %HbA, the operative average glucose needed to have achieved a given %HbA was predicted to be altered by RCL according to average glucose×RCL=constant.
Model calculations estimate the extent to which standard reporting of AG vs. HbA underestimates or overestimates AG under conditions of altered RCL. Conditions of altered RCL may often be operative in patients with certain hemoglobin variants.
血红蛋白 A（HbA）形成的模型被用于预测在红细胞寿命（RCL）改变的情况下，平均葡萄糖（AG）与%HbA 之间的关系。
根据 RCL 中红细胞年龄（循环时间）的非线性分布，使用作为红细胞年龄函数的 HbA 形成的动力学质量平衡模型，计算全血%HbA 与葡萄糖的关系。
模型计算结果与正常 RCL 下估计平均葡萄糖与%HbA 的标准关系非常吻合（r>0.999）。对于改变的 RCL，假设红细胞分布随 RCL 简单地按时间尺度压缩或扩展来计算结果。对于给定的%HbA，预计达到给定%HbA 所需的操作平均葡萄糖将根据平均葡萄糖×RCL=常数而被 RCL 改变。
模型计算估计了在改变的 RCL 条件下，AG 与 HbA 的标准报告在多大程度上低估或高估了 AG。在某些血红蛋白变体的患者中，改变的 RCL 条件可能经常存在。
