A Rare Case of Variant Hemoglobin (Hb Yahata) Suspected Based on Inconsistent Plasma Glucose and HbA1c Levels

Iizuka, Katsumi; Mizuno, Masami; Niwa, Hiroyuki; Takeda, Jun

doi:10.2169/internalmedicine.54.4017

Cited by 5 publications

(3 citation statements)

References 17 publications

(41 reference statements)

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“…Thus, additional detailed information should be collected in the future to evaluate the effect of menopause on circulating lipid concentrations. Moreover, HbA1c may be affected by anemia, pregnancy, abnormal hemoglobin levels, and steroid treatment [35][36][37]. HbA1c reflects glucose tolerance better than occasional blood glucose measurements at the population level.…”

Section: Discussionmentioning

confidence: 99%

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

Iizuka,

Kobae,

Yanagi

et al. 2024

Healthcare

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The condition of being underweight is a social problem in Japan among women. However, there is a lack of evidence for dietary guidance for underweight women because there has been no comparison of lipids or HbA1c among underweight, normal weight, and overweight women in different age groups. We analyzed the effect of body size and age on the serum lipid and hemoglobin A1c levels in Japanese women in a cross-sectional study. A total of 26,118 women aged >20–65 years underwent physical examinations between 2012 and 2022. Seventeen percent of women aged >20–29 years were underweight, and 8% of those aged 50–65 years were underweight. Total cholesterol and non-HDL-C concentrations increased with age, but the difference between underweight and overweight individuals was lowest among women aged 50–65 years. On the other hand, the differences in HDL-C, TG, and HbA1c levels between underweight and overweight subjects were greatest in the 50–65 age group, but the differences between underweight and normal weight subjects were much smaller. Considering that, unlike HDL-C, TG, and HbA1c, TC and non-HDL-C increase to levels comparable to overweight levels in underweight women in aged 50–65 years, educating people about a diet that lowers non-HDL-C is necessary even in young underweight women.

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Section: Discussionmentioning

confidence: 99%

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

Iizuka,

Kobae,

Yanagi

et al. 2024

Healthcare

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“…There are several methods for measuring HbA1c levels, including ion-exchange high-performance liquid chromatography (HPLC), boronate-affinity HPLC, immunoassays, and enzyme-based assays. Ion-exchange HPLC is the most commonly used method for measuring HbA1c levels because it is fast, accurate, and reliable [2].…”

Section: Introductionmentioning

confidence: 99%

A diabetic patient in whom Hb Weesp was incidentally detected when her HbA1c level was measured

et al. 2019

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The level of glycated hemoglobin A1c (HbA1c) is widely used to monitor long-term glycemic control in patients with diabetes mellitus. There are more than 30 methods for measuring HbA1c levels. In recent times, high-performance liquid chromatography (HPLC) has become the most commonly used method in Japan. However, HPLC-based HbA1c level measurements do not accurately reflect glycemic control in the presence of Hb variants. We report the case of a patient with type 2 diabetes mellitus, who was incidentally found to having an extremely rare Hb variant. A 69-year-old Japanese female visited our clinic and was diagnosed with diabetes mellitus. Her HbA1c level, which was measured using HPLC at our clinic, could not be determined. DNA sequencing revealed a heterozygous mutation in the α1 globin gene (HBA1: c.301C > T, p.Leu101Phe). Hb Weesp was detected. Many Hb variants have been reported; however, to the best of our knowledge, this is only the second report about Hb Weesp in the world and the first from Japan. Clinicians should consider the possibility of Hb variants in cases in which abnormal elution patterns are detected during the measurement of HbA1c using HPLC.

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“…In this case, the patient's plasma GA levels were lower than his HbA1c values. The factors influencing HbA1c values, such as anaemia and haemoglobinopathy, are well known to general physicians,9 but the factors influencing plasma GA levels are rarely taken into consideration. This case reminds us that steroid administration can influence plasma GA levels via increased albumin turnover.…”

Section: Introductionmentioning

confidence: 99%

A discrepancy between plasma glycated albumin and HbA1c levels in a patient with steroid-induced diabetes mellitus

et al. 2016

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A 57-year-old man was admitted for the treatment of steroid-induced diabetes mellitus (DM). He also had interstitial pneumonia and, to treat it, 20 mg prednisolone had been started in April 2014. Although glycated haemoglobin (HbA1c) level was 7.8% (62 mmol/mol), his glycated albumin (GA) level was normal (13.9%) and the ratio of GA to HbA1c (GA:HbA1c) was lower than that of normal participants and patients with type 2 DM. Plasma GA and GA:HbA1c levels became persistently lower. In September 2015, HbA1c levels measured by HPLC and immunoprecipitation methods were almost the same (6.8% (51 mmol/mol) and 6.7% (50 mmol/mol), respectively), but GA (10.2%) and GA:HbA1c (1.6) were much lower. We report the case of a patient with DM where steroid administration may have caused a decrease in plasma GA and GA:HbA1c levels via increased albumin turnover.

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A Rare Case of Variant Hemoglobin (Hb Yahata) Suspected Based on Inconsistent Plasma Glucose and HbA1c Levels

Cited by 5 publications

References 17 publications

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

A diabetic patient in whom Hb Weesp was incidentally detected when her HbA1c level was measured

A discrepancy between plasma glycated albumin and HbA1c levels in a patient with steroid-induced diabetes mellitus

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