Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients

Soros, Arlette; Chalew, Stuart A.; McCarter, Robert; Shepard, Rachel; Hempe, James M.

doi:10.1111/j.1399-5448.2009.00630.x

Cited by 64 publications

(74 citation statements)

References 29 publications

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“…Individuals with HbA1c values persistently lower or higher than expected relatively to their blood glucose levels have been identified in several studies where blood glucose was estimated based on fasting plasma glucose [22], self- [18,19,31,32], continuous glucose monitoring data [20,33], and classified as high or low glycators. HGI is a measure of the disagreement between the observed value of HbA1c and the one predicted on the basis of blood glucose levels and it is thought to be an indicator of the degree of hemoglobin glycation.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, HbA1c and other measures of glycaemia reflect different aspects of glucose metabolism, the former is an indicator of the non-enzymatic protein glycation which is dependent of glucose concentration into erythrocytes whereas the latter expresses the physiology of glucose in the extracellular compartment. A mathematical method to measure the discordance between HbA1c and the predicted value of HbA1c based on plasma glucose levels has been developed and termed hemoglobin glycation index (HGI) [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

Fiorentino

Marini

Succurro

et al. 2017

Diabetes Research and Clinical Practice

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Hemoglobin glycation indexHepatic steatosis Non-enzymatic protein glycation A B S T R A C TAims: Hemoglobin glycation index (HGI), which is the difference between the observed value of HbA1 and the predicted HbA1c based on plasma glucose levels, represents a measure of the degree of non-enzymatic glycation of hemoglobin and it has been found to be positively associated with diabetic complications. Herein we investigated whether HGI is associated with hepatic steatosis and related biomarkers in subjects without diabetes.Methods: 1120 White individuals without diabetes were stratified in quartiles according to HGI levels. Hepatic steatosis was diagnosed by ultrasonography.Results: As compared with subjects in the lowest quartile of HGI those in the intermediate and high HGI groups displayed an unfavorable cardio-metabolic risk profile having significantly higher values of body mass index (BMI), waist circumference, % fat mass, total cholesterol, triglycerides, inflammatory markers such as high sensitivity C reactive protein, erythrocytes sedimentation rate, complement C3, platelets and white blood cell count, hepatic insulin resistance assessed by the liver IR index and lower concentrations of highdensity lipoprotein. HGI was positively associated with the biomarker of liver damage alanine aminotransferase, and fatty liver index, an indicator of hepatic steatosis. In a logistic regression analysis adjusted for age, gender and BMI individuals in the highest quartile of HGI exhibited a 1.6-fold increased odd of having hepatic steatosis (95% CI: 1.03-2.41; p = 0.03) as compared with subjects in the lowest quartile of HGI.Conclusions: Higher levels of HGI may identify subjects without diabetes at increased risk of having hepatic steatosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

Fiorentino

Marini

Succurro

et al. 2017

Diabetes Research and Clinical Practice

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“…Deviations between mean blood glucose and A1C values with continuous glucose monitoring (CGM) have been shown to be consistent in each individual [39][40][41]. These deviations in mean blood glucose and the A1C value are called the glycohemoglobin index (GHI), and the biological variation of A1C has been examined [3,4,42,43]. The G-gap is also reported to be an indicator with biological variation [5,31], and Nayak et al [6] reported that the G-gap has consistent biological variability in individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have examined glycemic indexes with biological variation [37][38][39][40][41][42][43]. Deviations between mean blood glucose and A1C values with continuous glucose monitoring (CGM) have been shown to be consistent in each individual [39][40][41].…”

Section: Discussionmentioning

confidence: 99%

The ratio of glycated albumin to hemoglobin A1c measured in IFCC units accurately represents the glycation gap

et al. 2015

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“…Glycated hemoglobin levels are often monitored during T1D as an indicator of long-term elevated glucose levels (Soros et al 2010). Several studies have shown elevated glycation of pancreatic b proteins, including insulin, accompanying T1D (McKillop et al 2002).…”

Section: Autoantigens Created By Posttranslational Modifications In Tmentioning

confidence: 99%

Do MHCII-Presented Neoantigens Drive Type 1 Diabetes and Other Autoimmune Diseases?

Marrack

Kappler

2012

Cold Spring Harbor Perspectives in Medicine

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The strong association between particular MHCII alleles and type 1 diabetes is not fully understood. Two ideas that have been considered for many years are that autoimmunity is driven by (1) low-affinity CD4 þ T cells that escape thymic negative selection and respond to certain autoantigen peptides that are particularly well presented by particular MHCII molecules, or (2) CD4 þ T cells responding to neoantigens that are absent in the thymus, but uniquely created in the target tissue in the periphery and presented by particular MHCII alleles. Here we discuss the recent structural data in favor of the second idea. We review studies suggesting that peptide antigens recognized by autoimmune T cells are uniquely proteolytically processed and/or posttranslationally modified in the target tissue, thus allowing these T cells to escape deletion in the thymus during T-cell development. We postulate that an encounter with these tissue-specific neoantigenic peptides presented by the particular susceptible MHCII alleles in the peripheral tissues when accompanied by the appropriate inflammatory milieu activates these T-cell escapees leading to the onset of autoimmune disease.

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Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients

Abstract: Biological variation in A1c is a robust quantitative trait that can be assessed using HGI calculated from routine clinic data. This suggests that HGI could be used clinically for more personalized assessment of complications risk.

Cited by 64 publications

References 29 publications

Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

The ratio of glycated albumin to hemoglobin A1c measured in IFCC units accurately represents the glycation gap

Do MHCII-Presented Neoantigens Drive Type 1 Diabetes and Other Autoimmune Diseases?

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