Department of Laboratory Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, P.R. China.
Department of Laboratory Medicine, Shenzhen Baoan District Songgang People's Hospital, Shenzhen, Guangdong, P.R. China.
Clin Chem Lab Med. 2021 Jan 14;59(6):1127-1132. doi: 10.1515/cclm-2020-1563. Print 2021 May 26.
Hemoglobin A (HbA) and glycated albumin (GA) are glycemic control status indicators in patients with diabetes mellitus. Hemoglobin H (HbH) disease is a moderately severe form of α-thalassemia. Here we examine the usefulness of HbA and GA in monitoring glycemic control in patients with HbH disease.
HbA, GA, and an oral glucose tolerance test were performed in 85 patients with HbH disease and 130 healthy adults. HbA was measured using five methods, including two systems based on cation-exchange high-performance liquid chromatography (Variant II Turbo 2.0 and Bio-Rad D100), a capillary zone electrophoresis method (Capillarys 3 TERA), a boronate affinity HPLC method (Premier Hb9210), and an immunoassay (Cobas c501).
Significant lower levels of HbA were observed in patients with HbH disease than in healthy adults. In contrast, GA showed no statistically significant differences between participants with and without HbH disease. A considerable number of diabetic patients with HbH disease would be missed if using HbA as a diagnostic criterion for diabetes mellitus.
GA but not HbA is suitable for monitoring glycemic control in patients with HbH disease that can modify the discriminative ability of HbA for diagnosing diabetes.
血红蛋白 A(HbA)和糖化白蛋白(GA)是糖尿病患者血糖控制状况的指标。血红蛋白 H(HbH)病是一种中等严重程度的α-地中海贫血。本研究旨在探讨 HbA 和 GA 在监测 HbH 病患者血糖控制中的作用。
对 85 例 HbH 病患者和 130 例健康成年人进行 HbA、GA 和口服葡萄糖耐量试验。采用 5 种方法检测 HbA,包括基于阳离子交换高效液相色谱法(Variant II Turbo 2.0 和 Bio-Rad D100)的 2 种系统、毛细管区带电泳法(Capillarys 3 TERA)、硼酸亲和高效液相色谱法(Premier Hb9210)和免疫测定法(Cobas c501)。
与健康成年人相比,HbH 病患者的 HbA 水平显著降低。相比之下,GA 在 HbH 病患者和无 HbH 病患者之间无统计学差异。如果将 HbA 作为诊断糖尿病的标准,将漏诊相当数量的 HbH 病合并糖尿病患者。
GA 而非 HbA 适合用于监测 HbH 病患者的血糖控制,可改善 HbA 诊断糖尿病的判别能力。