Department of Internal Medicine, Hakuhokai Central Hospital, 4-23-1 Higashisonoda-cho, Amagasaki, Hyogo 661-0953, Japan.
Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan.
Clin Biochem. 2019 Nov;73:77-81. doi: 10.1016/j.clinbiochem.2019.08.004. Epub 2019 Aug 3.
HbA1c shows low in patients with hemolysis, whereas glycated albumin (GA) is not affected by hemolysis. Therefore, the GA/HbA1c ratio reflects hemolysis in diabetic patients with hemolysis. Erythrocyte creatine (EC) is an indicator of hemolysis that reflects the mean erythrocyte age. The aim of this study was to examine whether HbA1c adjusted by EC accurately reflected glycemic control in patients with hemolysis.
A total of 238 individuals, consisting of 131 diabetic patients and 107 non-diabetic subjects, and consisting of 42 patients with hemolysis, and 196 subjects without hemolysis were selected for the study. HbA1c expressed in the IFCC units (iA1c) as well as in the NGSP units (A1C) were used. From the fact that EC and the GA/iA1c ratio showed a significant positive correlation, a formula for iA1c adjusted by EC (ECadj-iA1c) was created from a regression equation between EC and the GA/iA1c ratio.
Significant correlations were observed between the GA/iA1c ratio and various hemolytic indicators but not between the GA/ECadj-iA1c ratio and those hemolytic indicators. The GA/iA1c ratio in individuals with hemolysis was significantly higher than in individuals without hemolysis, while no significant differences were observed in the GA/ECadj-iA1c ratio between the groups. Further, iA1c concentrations in non-diabetic patients with hemolysis were significantly lower than in the non-diabetic subjects without hemolysis, whereas ECadj-iA1c and GA concentrations showed no significant difference between the two groups.
These results suggested that ECadj-iA1c accurately reflected glycemic control in patients with hemolysis.
血红蛋白 A1c（HbA1c）在溶血患者中较低，而糖化白蛋白（GA）不受溶血影响。因此，GA/HbA1c 比值反映了溶血糖尿病患者的溶血情况。红细胞肌酸（EC）是反映红细胞平均年龄的溶血指标。本研究旨在探讨 EC 校正的 HbA1c 是否能准确反映溶血患者的血糖控制情况。
共选择了 238 人，包括 131 例糖尿病患者和 107 例非糖尿病患者，其中 42 例患者存在溶血，196 例患者不存在溶血。使用国际临床化学联合会（IFCC）单位（iA1c）和美国国家糖化血红蛋白标准化计划（NGSP）单位（A1C）表示 HbA1c。由于 EC 与 GA/iA1c 比值呈显著正相关，因此从 EC 与 GA/iA1c 比值的回归方程中创建了一个 EC 校正的 iA1c（ECadj-iA1c）公式。
GA/iA1c 比值与各种溶血指标显著相关，但 GA/ECadj-iA1c 比值与这些溶血指标无显著相关性。溶血患者的 GA/iA1c 比值明显高于非溶血患者，而两组间 GA/ECadj-iA1c 比值无显著差异。此外，溶血的非糖尿病患者的 iA1c 浓度明显低于非溶血的非糖尿病患者，而 ECadj-iA1c 和 GA 浓度在两组间无显著差异。
这些结果表明，ECadj-iA1c 能准确反映溶血患者的血糖控制情况。
