Pitfalls in Hemoglobin A1c Measurement: When Results may be Misleading

Radin, Michael

doi:10.1007/s11606-013-2595-x

Cited by 242 publications

(244 citation statements)

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“…Apart from its role in pathogenesis, AGE-modified HSA (AGE-HSA) has been suggested as an alternative diagnostic marker to glycated hemoglobin (HbA1c) for monitoring glycemic status in diabetes (10). 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).…”

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confidence: 99%

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

Korwar

Vannuruswamy

Jagadeeshaprasad

et al. 2015

Molecular & Cellular Proteomics

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Human serum albumin is one of the most abundant plasma proteins that readily undergoes glycation, thus glycated albumin has been suggested as an additional marker for monitoring glycemic status. Hitherto, only Amadori-modified peptides of albumin were quantified. In this study, we report the construction of fragment ion library for Amadori-modified lysine (AML), N()-(carboxymethyl)lysine (CML)-, and N()-(carboxyethyl)lysine (CEL)-modified peptides of the corresponding synthetically modified albumin using high resolution accurate mass spectrometry (HR/AM). The glycated peptides were manually inspected and validated for their modification. Further, the fragment ion library was used for quantification of glycated peptides of albumin in the context of diabetes. Targeted Sequential Window Acquisition of all THeoretical Mass Spectra (SWATH) analysis in pooled plasma samples of control, prediabetes, diabetes, and microalbuminuria, has led to identification and quantification of 13 glycated peptides comprised of four AML, seven CML, and two CEL modifications, representing nine lysine sites of albumin. Five lysine sites namely K549, K438, K490, K88, and K375, were observed to be highly sensitive for glycation modification as their respective m/z showed maximum fold change and had both AML and CML modifications. Thus, peptides involving these lysine sites could be potential novel markers to assess the degree of glycation in diabetes. Molecular & Cellular Proteomics

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confidence: 99%

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

Korwar

Vannuruswamy

Jagadeeshaprasad

et al. 2015

Molecular & Cellular Proteomics

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“…Taken together, these results suggest that environmental exposures may acutely influence the inflammatory milieu in the airways and longer-lived biomarkers may more accurately reflect the complex inflammatory states of a given asthma patient (Figure 1). To enable better long-term treatment decisions for asthma patients, future studies should aim to identify biomarkers that integrate activity of these pathways over time, akin to hemoglobin A1C levels in diabetes patients (22). Analyses of both immediate and longitudinal gene expression and inflammatory profiles in the lung should provide a more comprehensive picture of the interplay between these pathways over time, and our data suggest that subtle shifts in environmental exposures may induce switching between inflammatory pathways.…”

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confidence: 93%

Accurately measuring and modeling Th2 and Th17 endotypes in severe asthma

Hart

Choy²,

Bradding

et al. 2017

Ann. Transl. Med.

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“…Besides, it should be noted that there will be certain caveats to the use of this test that must be understood by clinicians [33][34][35][36]. The aim of this study was to correlate the A1C values with the OGTT in Brazilian individuals without diabetes but with impaired fasting glucose (IFG) and other risk factors for type 2 diabetes.…”

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confidence: 99%

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2017

EMIJ

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Aim: The aim of this study is to correlate the A1C values with the OGTT in individuals without type 2 Diabetes (DM) but with impaired fasting glucose (IFG) (FPG: 5.6-6.9mmol/l). Methods:We investigated 119 subjects with IFG divided according to A1C levels (<5.7%; 5.7-6.4%, ≥6.5%) and analyzed the correlation among A1C, FPG and 2-hPG by Pearson's coefficient. Kappa coefficient was used to test agreement between A1C and 2-hPG for the diagnosis of DM. Results:The average age of the subjects was 54.2 ± 14.6 years, the average BMI was 30.2 ±5.5 and 70.5% were women. While levels of A1C ≥6.5% were associated to alterations in the 2-hPG in 86.7%, only 28.6% of these patients had 2-hPG >11.1mmol/l. Furthermore, 31.6% of the patients with DM diagnosed by the OGTT had A1C levels ≥6.5% and 64.3% of the patients with A1C < 5.7% had a normal OGTT. The Kappa coefficient of reliability between A1C and 2-hPG to diagnose DM was 0.71. Conclusion:A1C is a useful tool in evaluating IFG patients and correlates better to 2-hPG than to FPG. Yet, the agreement between A1C and OGTT to diagnose DM in this group was moderate (71%). It may be too soon to consider A1C as a substitute exam for OGTT.

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Pitfalls in Hemoglobin A1c Measurement: When Results may be Misleading

Cited by 242 publications

References 50 publications

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

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

Accurately measuring and modeling Th2 and Th17 endotypes in severe asthma

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