Interference of carbamylated and acetylated hemoglobins in assays of glycohemoglobin by HPLC, electrophoresis, affinity chromatography, and enzyme immunoassay

Weykamp, Cas; Penders, T. J.; Siebelder, Carla; Muskiet, Frits A. J.; Slik, W. van der

doi:10.1093/clinchem/39.1.138

Cited by 89 publications

(25 citation statements)

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“… 40 Moreover, carbamylated hemoglobin, which is formed under uremic conditions, may interfere with some HbA1c assays and result in an overestimation of HbA1c values. 44 Compared with HbA1c, GA has a strong correlation with AG and provides a more reliable index of glycemic control because it is not affected by red blood cell lifespan or erythropoietin administration. Because advanced CKD is an extreme microvascular complication of diabetic nephropathy, CKD patients with diabetes should be carefully managed to prevent disease progression.…”

Section: Discussionmentioning

confidence: 99%

Glycated Albumin Versus HbA1c in the Evaluation of Glycemic Control in Patients With Diabetes and CKD

Gan

Liu

2018

Kidney International Reports

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IntroductionIt is inaccurate to assess blood glucose with glycated hemoglobin (HbA1c) in patients with diabetes and chronic kidney disease (CKD), and whether glycated albumin (GA) is better than HbA1c in these patients remains unclear.MethodsWe searched PubMed, Embase, Web of Science, Scopus, the Cochrane Library, and MEDLINE to July 2017 for studies that investigated the correlation between GA or HbA1c and the average glucose levels (AG) relevant to this theme. Statistical analysis was performed using RevMan5.3 and Stata12.0. The outcome was the correlation coefficient between GA or HbA1c and AG. For the first time, we made a comparison of GA and HbA1c in different CKD stages.ResultsA total of 24 studies with 3928 patients were included. Early stages of CKD refer to CKD stage 1 to 3. Advanced CKD refer to CKD stage 4 and 5 including patients receiving dialysis. The meta-analysis suggested that in early stages of CKD, the pooled R between GA and AG was 0.61 (95% CI = 0.49−0.73) and 0.71 (95% CI = 0.55−0.87) for HbA1c (P > 0.05). In advanced CKD patients, the pooled R between GA and AG was 0.57 (95% CI = 0.52−0.62), and 0.49 (95% CI = 0.45−0.52) for HbA1c (P = 0.0001).ConclusionGA is superior to HbA1c in assessing blood glucose control in diabetes patients with advanced CKD.

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Section: Discussionmentioning

confidence: 99%

Glycated Albumin Versus HbA1c in the Evaluation of Glycemic Control in Patients With Diabetes and CKD

Gan

Liu

2018

Kidney International Reports

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“…Glycated amino acid may interfere with the test for GA however, the new improved methods employed currently are free of interference by endogenous glycated amino acids and are unaffected by albumin concentration like high performance liquid concentration method and Bromocresol green method etc. [ 49 ]…”

Section: Introductionmentioning

confidence: 99%

Amadori albumin in diabetic nephropathy

Neelofar

Ahmad

2015

Indian J Endocr Metab

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Nonenzymatic glycation of macromolecules in diabetes mellitus (DM) is accelerated due to persistent hyperglycemia. Reducing sugar such as glucose reacts non enzymatically with free €-amino groups of proteins through series of reactions forming Schiff bases. These bases are converted into Amadori product and further into AGEs. Non enzymatic glycation has the potential to alter the biological, structural and functional properties of macromolecules both in vitro and in vivo. Studies have suggested that amadori as well as AGEs are involved in the micro-macro vascular complications in DM, but most studies have focused on the role of AGEs in vascular complications of diabetes. Recently putative AGE-induced patho-physiology has shifted attention from the possible role of amadori-modified proteins, the predominant form of the glycated proteins in the development of the diabetic complications. Human serum albumin (HSA), the most abundant protein in circulation contains 59 lysine and 23 arginine residues that could, in theory be involved in glycation. Albumin has dual nature, first as a marker of intermediate glycation and second as a causative agent of the damage of tissues. Among the blood proteins, hemoglobin and albumin are the most common proteins that are glycated. HSA with a shorter half life than RBC, appears to be an alternative marker of glycemic control as it can indicate blood glucose status over a short period (2-3 weeks) and being unaffected by RBCs life span and variant haemoglobin, anemia etc which however, affect HbA1c. On the other hand, Amadori albumin may accumulate in the body tissues of the diabetic patients and participate in secondary complications. Amadori-albumin has potential role in diabetic glomerulosclerosis due to long term hyperglycaemia and plays an important role in the pathogenesis of diabetic nephropathy. This review is an approach to compile both the nature of glycated albumin as a damaging agent of tissues and as an intermediate diagnostic marker and its potential role in diabetic nephropathy.

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“…In samples obtained from patients with renal failure (before dialysis) a significant difference (Diamat -Unimate = (+) 0.45%) was found using the paired t test (P = 0.009) while in patients without renal failure the difference was negative. These results suggest that the immunoturbidimetic assay is not affected by interference of carbamylated hemoglobin, which has been reported to give falsely high results using HPLC (14). The presence of HbS does not affect the results obtained with Unimate while lower results were obtained by Diamat ( Table 2).…”

Section: Resultsmentioning

confidence: 64%

Immunoturbidimetric assay of glycated hemoglobin

Metus

Ruzzante

Bonvicini

et al. 1999

J. Clin. Lab. Anal.

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We investigated the performances of HbA1c determination by a latex enhanced turbidimetric immunoassay using the specific monoclonal antibodies (Unimate, Roche) against the beta-N-terminal fragments. The coefficients of variation ranges from 1.7 to 3.8% within assay (n = 30) and from 3.9 to 4.9% between assay (n = 20). The assay was linear from 2.5 to 14.9% of HbA1c. No interferences was found from fetal, carbamylated, or variant (S) hemoglobins and from labile Schiff adduct with glucose. The following relationship was derived from fresh sample comparison between HPLC (Diamat-BioRad) (x) and immunoassay (y) method: y = 0.971 x + 0.87%, r=0.98, n = 115. The immunoassay provides a highly precise and specific method for HbA1c.

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Interference of carbamylated and acetylated hemoglobins in assays of glycohemoglobin by HPLC, electrophoresis, affinity chromatography, and enzyme immunoassay

Cited by 89 publications

References 0 publications

Glycated Albumin Versus HbA1c in the Evaluation of Glycemic Control in Patients With Diabetes and CKD

Glycated Albumin Versus HbA1c in the Evaluation of Glycemic Control in Patients With Diabetes and CKD

Amadori albumin in diabetic nephropathy

Immunoturbidimetric assay of glycated hemoglobin

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