Nathan D M
Clin Chem. 1981 Jul;27(7):1261-3.
The utility of glycosylated hemoglobin (HbA1) measurement as an index of chronic control in diabetes can be adversely affected by interference from a labile glycosylated fraction that changes rapidly with acute changes in blood glucose concentration. I used a "high-pressure" liquid-chromatographic assay and a newly developed electrophoretic assay to quantitate the contribution of this labile fraction. If erythrocytes are incubated at 22 degrees C in isotonic saline for 12 h before hemolysis, the labile fraction is eliminated. Its contribution is similar as measured by both assays: 2-3.5% of total HbA1 in normal cells and 7-9.5% in diabetic cells. A 3-h incubation of erythrocytes with glucose produces acute changes in apparent HbA1 concentrations by both assays, but such changes can be eliminated by the incubation in saline. Although current methods are time consuming, the labile glycosylated hemoglobin must be removed when the sample is prepared for HbA1 measurement by liquid chromatography and electrophoresis if results are not to be factitiously high.
糖化血红蛋白（HbA1）测量作为糖尿病慢性控制指标的效用可能会受到不稳定糖化部分干扰的不利影响，该部分会随着血糖浓度的急性变化而迅速改变。我使用“高压”液相色谱分析法和新开发的电泳分析法来定量这一不稳定部分的贡献。如果在溶血前将红细胞在22摄氏度的等渗盐水中孵育12小时，不稳定部分就会被消除。通过两种分析方法测得其贡献相似：正常细胞中占总HbA1的2 - 3.5%，糖尿病细胞中占7 - 9.5%。用葡萄糖孵育红细胞3小时会使两种分析方法测得的表观HbA1浓度产生急性变化，但这种变化可通过在盐水中孵育来消除。尽管目前的方法耗时，但如果不想使结果人为偏高，那么在通过液相色谱法和电泳法测量HbA1而制备样品时，必须去除不稳定的糖化血红蛋白。
