Prosenz Julian, Öhlinger Thomas, Müllner Ernst W, Marculescu Rodrig, Gerner Christopher, Salzer Ulrich, Kiefer Florian W, Baron David M
Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria.
Transfusion. 2019 Feb;59(2):454-457. doi: 10.1111/trf.14956. Epub 2018 Oct 1.
Few and inconsistent data exist describing the effect of storage duration on glycated hemoglobin (HbA1c) concentrations of red blood cells (RBCs), impeding interpretation of HbA1c values in transfused diabetic patients. Hence the aim of this study was to evaluate to what extent HbA1c concentrations of RBCs change during the maximum allowed storage period of 42 days.
Blood was drawn from 16 volunteers, leukofiltered, and stored under standard blood banking conditions. HbA1c concentrations of RBCs were measured on Days 1 and 42 of storage using three different validated devices (ion-exchange high-performance liquid chromatography Method A1 and A2, turbidimetric immunoassay Method B).
Mean HbA1c concentrations of RBCs on Day 1 were 5.3 ± 0.3% (Method A1), 5.4 ± 0.4% (Method A2), and 5.1 ± 0.4% (Method B). HbA1c concentrations increased to 5.6 ± 0.3% (A1, p < 0.0001), 5.7 ± 0.3% (A2, p = 0.004), and 5.5 ± 0.4% (B, p < 0.0001) on Day 42, respectively, corresponding to a 1.06-fold increase across all methods. Glucose concentrations in the storage solution of RBCs decreased from 495 ± 27 to 225 ± 55 mg/dL (p < 0.0001), confirming that stored RBCs were metabolically active.
These results suggest a significant, albeit minor, and most likely clinically insignificant increase in HbA1c concentrations during storage of RBCs for 42 days.
关于储存时间对红细胞糖化血红蛋白（HbA1c）浓度影响的数据很少且不一致，这妨碍了对输血糖尿病患者HbA1c值的解读。因此，本研究的目的是评估红细胞HbA1c浓度在42天的最大允许储存期内变化的程度。
从16名志愿者身上采集血液，进行白细胞过滤，并在标准血库条件下储存。使用三种经过验证的不同设备（离子交换高效液相色谱法A1和A2、比浊免疫分析法B）在储存的第1天和第42天测量红细胞的HbA1c浓度。
储存第1天红细胞的平均HbA1c浓度分别为5.3±0.3%（方法A1）、5.4±0.4%（方法A2）和5.1±0.4%（方法B）。在第42天，HbA1c浓度分别升至5.6±0.3%（A1，p<0.0001）、5.7±0.3%（A2，p = 0.004）和5.5±0.4%（B，p<0.0001），所有方法的增幅均为1.06倍。红细胞储存溶液中的葡萄糖浓度从495±27降至225±55mg/dL（p<0.0001），证实储存的红细胞具有代谢活性。
这些结果表明，在红细胞储存42天期间，HbA1c浓度有显著升高，尽管升高幅度较小，且很可能在临床上无显著意义。
