Svendsen P A, Christiansen J S, Søegaard U, Welinder B S, Nerup J
Diabetologia. 1980 Aug;19(2):130-6. doi: 10.1007/BF00421859.
Chromatographically determined haemoglobin A1c concentration was measured during short-term (1-24h) changes in glucose concentration in vitro and in vivo. In vitro at 37 degrees C the HbA1c concentration increased with glucose concentration and time both in normal and diabetic erythrocytes. In normal erythrocytes incubated in 20--100 mmol/l glucose, the increases in the HbA1c concentration were maximal after 4--6 h and then stable for the next 18--20 h. During the first hour, increases in the HbA1c concentration were linear with time and on average 0.034% HbA1c x h-1 x mmol/l glucose-1. In erythrocytes, after a rapidly produced increase (2 h), HbA1c decreased to preincubation concentrations during a further incubation of the erythrocytes in a glucose-free medium at 37 degrees C for 4--6 h. The mean rate of linear decrease was 0.017% x h-1 x mmol/l glucose-1. After incubation of erythrocytes in 100 mmol/l glucose for 24 h, 1.3% HbA1c remained stable for 6 h in saline. The rapid increase in HbA1c concentration, as determined by chromatography, was not due to stable HbA1c (ketoamine linked glucose) as no increase was found in the HbA1c concentrations determined by the thiobarbiturate method. In juvenile diabetics controlled by an artificial beta-cell, rapid changes of blood glucose concentration (up to 20 mmol/l) resulted in increases in HbA1c concentration of as much as 1.9% within 12 h (mean 1.1%). Rapid in vivo increases in HbA1c concentration were reversible by normalization of the blood glucose concentration. That rapid changes in HbA1c may occur in daily diabetic life was evidenced by differences in HbA1c concentration between blood samples from out-patient diabetics incubated in saline for 16 hours at 4 degrees C and 37 degrees C (range of differences 0.2--1.4% HbA1c). The differences correlated to the blood glucose concentration at the time of sampling blood for HbA1c determination. Thus, incubation of blood at a low glucose concentration prior to determination of the glycosylated haemoglobin concentration may overcome interference from rapidly produced HbA1c.
在体外和体内葡萄糖浓度短期（1 - 24小时）变化期间，通过色谱法测定血红蛋白A1c浓度。在体外37℃条件下，无论是正常红细胞还是糖尿病红细胞，血红蛋白A1c浓度均随葡萄糖浓度和时间增加。在20 - 100 mmol/l葡萄糖中孵育的正常红细胞，血红蛋白A1c浓度在4 - 6小时后增加最大，然后在接下来的18 - 20小时保持稳定。在第一个小时内，血红蛋白A1c浓度随时间呈线性增加，平均为0.034%血红蛋白A1c×h⁻¹×mmol/l葡萄糖⁻¹。在红细胞中，快速增加（2小时）后，在37℃无葡萄糖培养基中进一步孵育4 - 6小时，血红蛋白A1c降至预孵育浓度。线性下降的平均速率为0.017%×h⁻¹×mmol/l葡萄糖⁻¹。红细胞在100 mmol/l葡萄糖中孵育24小时后，1.3%的血红蛋白A1c在盐水中保持稳定6小时。通过色谱法测定的血红蛋白A1c浓度的快速增加并非由于稳定的血红蛋白A1c（酮胺连接的葡萄糖），因为用硫代巴比妥酸盐法测定的血红蛋白A1c浓度没有增加。在由人工β细胞控制的青少年糖尿病患者中，血糖浓度的快速变化（高达20 mmol/l）导致血红蛋白A1c浓度在12小时内增加高达1.9%（平均1.1%）。体内血红蛋白A1c浓度的快速增加可通过血糖浓度正常化而逆转。门诊糖尿病患者在4℃和37℃盐水中孵育16小时后的血样中血红蛋白A1c浓度的差异证明了糖尿病日常生活中血红蛋白A1c可能发生快速变化（差异范围为0.2 - 1.4%血红蛋白A1c）。这些差异与采集血样用于测定血红蛋白A1c时的血糖浓度相关。因此，在测定糖化血红蛋白浓度之前，将血液在低葡萄糖浓度下孵育可能克服快速产生的血红蛋白A1c的干扰。
