A1C but Not Serum Glycated Albumin Is Elevated Because of Iron Deficiency in Late Pregnancy in Diabetic Women

Abstract

OBJECTIVEWe have already reported that A1C is elevated because of iron deficiency in late pregnancy among nondiabetic pregnant women. This report examined whether the same phenomenon is observed in pregnant women with diabetes.RESEARCH DESIGN AND METHODSThis longitudinal study was conducted in 17 pregnant women with diabetes (20–35 weeks of pregnancy). A1C, serum glycated albumin, erythrocyte indexes, and iron metabolism indexes were measured.RESULTSA1C levels were significantly increased in late pregnancy, whereas serum glycated albumin showed no significant changes. Glycated albumin/A1C ratio, mean corpuscular hemoglobin, serum transferrin saturation, and serum ferritin were significantly decreased in late pregnancy. Serum transferrin saturation showed a significant positive correlation with glycated albumin/A1C ratio.CONCLUSIONSA1C levels, but not serum glycated albumin levels, are elevated in late pregnancy because of iron deficiency in diabetic women. Serum glycated albumin may offer an adequate marker for glycemic control during pregnancy.

A newer conversion equation for the correlation between HbA1c and glycated albumin

“…The mean HbA1c was 7.5% ± 0.1% (men) and 7.4% ± 0.2% (women), and the mean GA was 20.9% ± 0.3% (men) and 20.9% ± 0.7% (women). Of the 201 men, 10 individuals had no history need to be considered when interpreting HbA1c or GA values [6][7][8][9][10][11][12][13]. However, past studies included the participants who were suffering from those diseases, the selection errors might be caused.…”

“…During pregnancy, the HbA1c values are higher during the third trimester because of iron deficiency, whereas the GA is not affected. Therefore, GA may be a more suitable marker for monitoring glycemic control during pregnancy [8][9]. In chronic liver diseases, such as chronic hepatitis and liver cirrhosis, hypersplenism lowers the HbA1c values because of the shortened lifespan of the erythrocytes, whereas it raises the GA values because of reduced albumin synthesis and the prolonged half-life of serum albumin [10].…”

Development of Diagnostic Fragment Ion Library for Glycated Peptides of Human Serum Albumin: Targeted Quantification in Prediabetic, Diabetic, and Microalbuminuria Plasma by Parallel Reaction Monitoring, SWATH, and MSE

“…Although HbA1c is considered the "gold standard" marker, reflecting the glycemic status over the period of 8 -10 weeks (1, 10), factors like anemia, blood loss, splenomegaly, and iron deficiency affect HbA1c levels (11). AGE-HSA reflects glycemic status over the preceding 3-4 weeks and has been recommended in gestational diabetes (12). In diabetes, the levels of AGE-HSA increase and were found to be positively correlated with hyperglycemia (13,14).…”

Glycated albumin: a potential biomarker in diabetes

“…On the other hand, GA remained stable through this period, because it did not suffer interference from the physiological changes characteristic of pregnancy (41).…”