Approved IFCC Reference Method for the Measurement of HbA1c in Human Blood

Jeppsson, Jan‐Olof; Kobold, Uwe; Barr, John R.; Finke, Andreas; Hoelzel, Wieland; Hoshino, Takao; Miedema, Kor; Mosca, Andrea; Mauri, Pierluigi; Paroni, Rita; Thienpont, Linda M.; Umemoto, Masao; Weykamp, Cas

doi:10.1515/cclm.2002.016

Cited by 538 publications

(355 citation statements)

References 16 publications

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“…A Federação Internacional de Bioquímica Clínica (IFCC) aprovou recentemente um método de referência para GHb (27). O método é baseado em clivagem da GHb em peptídeos específicos, separação por HPLC de troca iônica e identificação por espectrometria de massa ou por eletroforese capilar.…”

Section: Padronização E Harmonização Dos Resultadosunclassified

“…Nos últimos anos, eles têm sido substituídos por sistemas de HPLC mais robustos e automatizados (35)(36)(37)(38). O método de HPLC por troca iônica foi utilizado pelo DCCT (3) e é recomendado como método de referência interino para a dosagem de GHb até que os órgãos internacionais decidam sobre o método de referência definitivo (27,39).…”

Section: Métodos Para Dosagem Da Ghbunclassified

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Glico-hemoglobina (HbA1c): aspectos clínicos e analíticos

Camargo

Gross

2004

Arq Bras Endocrinol Metab

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RESUMOA glico-hemoglobina (GHb) é um parâmetro importante no controle glicêmico de pacientes com DM. Vários estudos clínicos mostraram claramente que a melhora no controle glicêmico está fortemente associada com a diminuição no desenvolvimento e/ou progressão das complicações em diabetes melito tipos 1 e 2. A medida exata e precisa da GHb é uma questão importante para os laboratórios clínicos. Vários fatores afetam os resultados e podem levar a resultados errôneos. Nesta revisão, discutimos os problemas da padronização da determinação da GHb para monitorar a terapia diabética e também os principais fatores interferentes. Os métodos para GHb podem ser diferentemente afetados pelas interferências. O efeito da interferência pode ser clinicamente mais relevante com o pior controle glicêmico. O laboratório deve estar atento para estes fatores para evitar confusão na interpretação clínica dos resultados, e os clínicos devem contatar o laboratório sempre que houver discrepância entre a impressão clínica e o resultado laboratorial. Glycohemoglobin (GHb) has a key role in the assessment of glycemic control in diabetic patients. Several studies have clearly shown that improved glycemic control is strongly associated with decreased development and/or progression of diabetic complications in both type 1 and 2 diabetes mellitus. Therefore, accurate determination of GHb concentration is an important issue for clinical laboratories. Several factors may affect and lead to erroneous results. We discuss the problems of standardization of GHb measurements for monitoring glycemic control and also consider the potential interfering factors on GHb measurements. Moreover, GHb assays may be affected by interference in different ways. The effect of interference may be more clinically relevant with poor metabolic control. Laboratory staff must be aware of all pitfalls to avoid adding more confusion to the clinical interpretation of HbA 1c values and physicians should contact laboratories if discrepancies between clinical impressions and laboratory data are observed.

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Section: Padronização E Harmonização Dos Resultadosunclassified

Section: Métodos Para Dosagem Da Ghbunclassified

Glico-hemoglobina (HbA1c): aspectos clínicos e analíticos

Camargo

Gross

2004

Arq Bras Endocrinol Metab

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“…HbA 1c was originally named as one of the chromatography peaks in the hemoglobin of healthy people as a trace component, but the IFCC redefined the substance as hemoglobin that is non-enzymatically and stably bound to glucose, a valine on the hemoglobin's b-chain N-terminal being glycosylated to formb-N1-deoxyfructosyl Hb [48][49][50] However, to maintain the precision and stability of the measured values, nationwide surveillance of differences in measured values between facilities and test methods, facility certification, and disclosure of information on assay reagents are necessary. Especially in some Point of Care (POC) devices for simplified HbA 1c measurement, standardization is seen as insufficient and the use of such devices for diagnosis of diabetes mellitus cannot be recommended at this time.…”

Section: Definition Of Hba 1cmentioning

confidence: 99%

Report of the Committee on the classification and diagnostic criteria of diabetes mellitus

Kuzuya

Nakagawa

Satoh

et al. 2002

Diabetes Research and Clinical Practice

612

414

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Concept of Diabetes Mellitus: Diabetes mellitus is a group of diseases associated with various metabolic disorders, the main feature of which is chronic hyperglycemia due to insufficient insulin action. Its pathogenesis involves both genetic and environmental factors. The long-term persistence of metabolic disorders can cause susceptibility to specific complications and also foster arteriosclerosis. Diabetes mellitus is associated with a broad range of clinical presentations, from being asymptomatic to ketoacidosis or coma, depending on the degree of metabolic disorder. Classification (Tables 1 and 2, and Figure 1): The classification of glucose metabolism disorders is principally derived from etiology, and includes staging of pathophysiology based on the degree of deficiency of insulin action. These disorders are classified into four groups: (i) type 1 diabetes mellitus; (ii) type 2 diabetes mellitus; (iii) diabetes mellitus due to other specific mechanisms or diseases; and (iv) gestational diabetes mellitus. Type 1 diabetes is characterized by destruction of pancreatic b-cells. Type 2 diabetes is characterized by combinations of decreased insulin secretion and decreased insulin sensitivity (insulin resistance). Glucose metabolism disorders in category (iii) are divided into two subgroups; subgroup A is diabetes in which a genetic abnormality has been identified, and subgroup B is diabetes associated with other pathologic disorders or clinical conditions. The staging of glucose metabolism includes normal, borderline and diabetic stages depending on the degree of hyperglycemia occurring as a result of the lack of insulin action or clinical condition. The diabetic stage is then subdivided into three substages: non-insulin-requiring, insulin-requiring for glycemic control, and insulin-dependent for survival. The two former conditions are called non-insulin-dependent diabetes and the latter is known as insulin-dependent diabetes. In each individual, these stages may vary according to the deterioration or the improvement of the metabolic state, either spontaneously or by treatment. Diagnosis (Tables 3-7 and Figure 2): Categories of the State of Glycemia: Confirmation of chronic hyperglycemia is essential for the diagnosis of diabetes mellitus. When plasma glucose levels are used to determine the categories of glycemia, patients are classified as having a diabetic type if they meet one of the following criteria: (i) fasting plasma glucose level of ‡126 mg/dL ( ‡7.0 mmol/L); (ii) 2-h value of ‡200 mg/dL ( ‡11.1 mmol/L) in 75 g oral glucose tolerance test (OGTT); or (iii) casual plasma glucose level of ‡200 mg/dL ( ‡11.1 mmol/L). Normal type is defined as fasting plasma glucose level of <110 mg/dL (<6.1 mmol/L) and 2-h value of <140 mg/dL (<7.8 mmol/L) in OGTT. Borderline type (neither diabetic nor normal type) is defined as falling between the diabetic and normal values. According to the current revision, in addition to the earlier listed plasma glucose values, hemoglobin A 1c (HbA 1c ) has been given a more p...

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“…8,9 HbA1c% estimation was done by ion exchange resin method. 10 The SPSS 22.0 statistical package was used for data processing. Results obtained were summarized as mean (± standard deviation).…”

Section: Methodsmentioning

confidence: 99%

Correlation of trace elements (serum zinc and copper) in type 2 diabetic patients with and without complications

2020

IJCBR

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Introduction: Type 2 diabetes mellitus (DM) is supposed to be associated with alteration in the serum levels of trace elements. Conversely, research also suggests that imbalances of specific elements associated with the complications of diabetes mellitus. Copper plays important role in oxidative stress and it's one of the important factor contributes to aetiology of DM. And zinc involved with synthesis & secretion of insulin. So, we have choose copper and zinc to find association in diabetics patients. Materials and Methods:In this cross sectional observational study total of one hundred and twenty (120) subjects were included and categorized into 3 groups. On the basis of screening, 80 patients were divided into two study groups: Group I (40 patients with micro-or macrovascular complications) and Group II (40 diabetic patients without complications). Group III include the 40 age and sex matched non-diabetic healthy control subjects selected for comparison. Serum zinc, copper concentration and HbA1c% (glycated haemoglobin) were estimated in all three study groups. Result: Serum copper concentration and HbA1c% were significantly (p<0.05) higher in diabetic patients (with and without complication) compared to control group. And serum copper shows significant (p<0.01) positive correlation with HbA1c% in both diabetic study groups. Serum zinc concentration was significantly (p<0.05) lower in diabetic patients (with and without complication) compared to healthy control group. And serum zinc shows significant (p<0.01) negative correlation with HbA1c% in both diabetic groups. Conclusion: Alteration in levels of trace elements (like, Zn and Cu) are found to be important influencing factors for diabetic patients for developing complications. From the present study, it may be determined that altered levels of trace elements (like zinc and copper) may have contributory a role in the pathogenesis and progression of type 2 DM.

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Approved IFCC Reference Method for the Measurement of HbA1c in Human Blood

Cited by 538 publications

References 16 publications

Glico-hemoglobina (HbA1c): aspectos clínicos e analíticos

Glico-hemoglobina (HbA1c): aspectos clínicos e analíticos

Report of the Committee on the classification and diagnostic criteria of diabetes mellitus

Correlation of trace elements (serum zinc and copper) in type 2 diabetic patients with and without complications

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