Limitations of A1c Interpretation

Shepard, Jessica G; Airee, Anita; Dake, Andrew W.; McFarland, M. Shawn; Vora, Amit N.

doi:10.14423/smj.0000000000000381

Cited by 29 publications

(21 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When using HbA 1c to diagnose DM, it is important to recognize that A 1C is an indirect measure of average blood glucose levels and to take other factors into consideration that may impact hemoglobin glycation independently of glycemia including age, race/ethnicity, erythrocyte lifespan and anemia/hemoglobinopathies. 49 This has not been accounted for in our study.…”

Section: Discussionmentioning

confidence: 86%

Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes

Karanfil¹,

Akdi²,

Özbay³

et al. 2019

Cor Vasa

View full text Add to dashboard Cite

Chronické totální uzávěry koronárních tepen (chronic coronary total occlusion, CTO) jsou většinou spojeny s infarktovou tepnou (infarct-related chronic coronary total occlusion, IRA CTO); ne všechny CTO však musejí vždy vést k rozvoji STEMI nebo být STEMI vyvolány. Klinický profi l pacientů s neinfarktovou CTO (non-IRA CTO) by mohl představovat endogenní kardioprotektivní mechanismus aktivovaný v odpověď na ischemii myokardu vyvolanou rozvojem aterosklerózy. Cíl: Naším cílem bylo posoudit klinický profi l pacientů s non-IRA CTO z hlediska přítomných faktorů kardiovaskulárního rizika. Metody: Prohlédli jsme naši databázi invazivních kardiologických výkonů, přičemž jsme pátrali po non-IRA CTO jakékoli významnější koronární tepny a snažili jsme se zjistit, zda byl v anamnéze pacienta uveden infarkt myokardu nebo zda byl nalezen elektrokardiografi cký (kmity Q, vymizení kmitu R), echokardiografi cký nebo ventrikulografi cký důkaz v tomto směru (abnormální kinetika segmentu stěny levé komory). Následně jsme porovnali incidenci non-IRA CTO u pacientů s diabetem, prediabetem a u kontrolních skupin jedinců bez diabetu nebo prediabetu. Výsledky: Popisujeme průřezovou studii s 2 180 pacienty, u nichž byla v období mezi lednem a dubnem 2018 v nemocnici terciární péče provedena koronarografi e pro zhodnocení stabilní ischemické choroby srdeční. Nalezli jsme 41 po sobě následujících pacientů s non-IRA CTO (1,9 %) s nízkou prevalencí kuřáctví (7 %). Většina jedinců s uvedeným nálezem (93 %) měla buď diabetes (61 %), nebo prediabetes (32 %); v tomto ohledu se statisticky významně lišili od jedinců bez diabetu nebo prediabetu (p < 0,001). Závěr: Nalezli jsme vztah mezi non-IRA CTO a prediabetem a diabetem. Zatímco diabetes a prediabetes agresivně vyvolávají aterosklerózu, mohou aktivovat i endogenní kardioprotektivní mechanismy chránící kontraktilní funkci levé komory.

show abstract

Section: Discussionmentioning

confidence: 86%

Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes

Karanfil¹,

Akdi²,

Özbay³

et al. 2019

Cor Vasa

View full text Add to dashboard Cite

show abstract

“…Additionally, serum levels of glycated albumin (a product of non-enzymic glycation that is also used as a glycaemic indicator) apparently decreased in all subjects in the 2 mg/d group with the G/G genotype. Although an accurate HbA1c measurement is limited by various conditions, including erythrocyte lifespan, normal ageing and other factors ( 26 ) , the decline in both HbA1c and glycated albumin levels suggests that Fx may aid in glucose metabolism. Taken together, our findings indicate a novel role for Fx: UCP1 genotype-dependent reduction of HbA1c levels in humans, although the mechanism by which Fx exerts this effect remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Reduction of HbA1c levels by fucoxanthin-enriched akamoku oil possibly involves the thrifty allele of uncoupling protein 1 (UCP1): a randomised controlled trial in normal-weight and obese Japanese adults

et al. 2017

View full text Add to dashboard Cite

Lifestyle-related problems are becoming a major health threat in East Asian countries. Therefore, finding an efficacious nutraceutical for this population is important. One candidate is fucoxanthin (Fx), a carotenoid abundantly found in edible brown seaweed that has been associated with a number of valuable health-promoting benefits. Unfortunately, clinical studies of Fx are limited. In the present study, we aimed to evaluate the effects of Fx on obesity-related parameters in Japanese subjects harbouring an SNP associated with lifestyle-related problems. In all, sixty normal-weight and obese Japanese adults with BMI over 22 kg/m2 were single-blinded and randomly assigned to three Fx-dose cohorts and administered Fx-enriched akamoku oil containing Fx at 0, 1 or 2 mg/d for 8 weeks (n 20 per group). Parameters relating to obesity and serum Fx metabolites were measured before and after intervention, but no significant differences were observed between and within the groups. Despite no changes in visceral fat areas and resting energy expenditures after intervention, we observed a significant decline in HbA1c levels in the 2 mg/d Fx group compared with that in the 0 mg/d group (P < 0·05), which was correlated with an increase in serum fucoxanthinol (Fx metabolite) levels. In addition, HbA1c levels declined more significantly in subjects with G/G alleles of the uncoupling protein 1 (UCP1) gene than in those with the A/A and A/G alleles (P < 0·05). We conclude that although Fx supplementation does not affect visceral fat areas, it may reduce HbA1c levels in those harbouring the thrifty allele of UCP1-3826A/G.

show abstract

“…It was also reported as a sensitive risk biomarker for the microvascular complications of diabetes mellitus. Despite the obvious advantages, glycated hemoglobin has its limitations since several factors independent on glycemic status have been reported to influence the glycated hemoglobin levels, such as genetic influence, patient ethnicity, hematological diseases with rapid turnover of the red blood cells (anemia, hemolysis, hemoglobin pathologies and transfusions), individual variability of erythrocyte life span, age, pregnancy, vitamin C and E consumption and other medical conditions (malignancies, chronic liver disease, hemodialysis, uremia) 10,11 .…”

Section: Non-enzymatic Protein Glycationmentioning

confidence: 99%

Erythrocyte membrane in type 2 diabetes mellitus

Gabreanu

Angelescu

2016

Discoveries (Craiova)

View full text Add to dashboard Cite

Type 2 diabetes mellitus represents a major public health challenge, due to the continuously growing prevalence and the complexity of the diabetic complications. Hyperglycemia seems to be the main mechanism for the disease progression. During erythrocyte's long life span, erythrocyte membranes are affected by the chronic exposure to glucose, which triggers several biochemical modifications that lead to both structural and functional disruption, which are further involved in the physiopathology of diabetes and its complications. Non-enzymatic protein glycation of red blood cell membrane proteins occur in two phases: early glycation, characterized by Schiff bases and Amadouri compounds formation, and advanced glycation, characterized by advanced glycation end products (AGEs). These products could be valuable tools for early diagnosis or biomarkers for disease progression, depending on how advanced they are in the glycation process. Advanced glycated end products were linked with diabetic complications. Also, lipid peroxidation and decreased activity of the enzyme pumps occur in the erythrocyte membrane of the diabetic patients. The investigation of lipid rafts and erythrocyte membrane fatty acids are a valuable tool for longterm monitoring of metabolic status. Further investigation of the erythrocyte membrane could provide novel biomarkers for monitoring of diabetes and its complications.

show abstract

Limitations of A1c Interpretation

Cited by 29 publications

References 32 publications

Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes

Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes

Reduction of HbA1c levels by fucoxanthin-enriched akamoku oil possibly involves the thrifty allele of uncoupling protein 1 (UCP1): a randomised controlled trial in normal-weight and obese Japanese adults

Erythrocyte membrane in type 2 diabetes mellitus

Contact Info

Product

Resources

About