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Evaluation of glycated hemoglobin and fetal hemoglobin-adjusted HbA1c measurements in infants

Authors


Corresponding author: Shigeru Suzuki,

Department of Pediatrics,

Asahikawa Medical University,

2-1-1-1 Midorigaoka Higashi, Asahikawa 078–8510,

Japan.

Tel: 81-166-68-2481;

fax: 81-166-68-2489;

e-mail: shige5p@asahikawa-med.ac.jp

Abstract

Background

As the presence of fetal hemoglobin (HbF) affects the accuracy of hemoglobin A1c (HbA1c) analysis methods, HbA1c measurement may not be a good indicator for patients with neonatal diabetes mellitus, whereas glycated albumin (GA) may be a good indicator.

Objective

To investigate whether total glycated hemoglobin (GHb) or HbF-adjusted HbA1c (adj-HbA1c) can act as a glycemic control marker in infants.

Subjects and Methods

Plasma glucose (PG), GA, HbF, GHb measured using the affinity method, and HbA1c measured using the latex-immunoturbidimetry (LA) or the high-performance liquid chromatography (HPLC) methods were determined in 26 full-term newborn infants aged 4–234 d. Adj-HbA1c was calculated as HbA1c/(total Hb − HbF).

Results

GHb, adj-HbA1c measured using the LA and the HPLC methods were 4.8 ± 0.5%, 4.5 ± 0.5%, and 4.7 ± 0.6%, respectively. GA was most positively correlated with PG (r = 0.696, p < 0.0001). GHb was positively correlated with both PG (r = 0.479, p = 0.013) and GA (r = 0.727, p < 0.0001). Adj-HbA1c measured using the LA method was positively correlated with GA (r = 0.465, p = 0.017), but not PG (r = 0.304, p = 0.132). Adj-HbA1c measured using the HPLC method was correlated with neither PG (r = −0.077, p = 0.710) nor GA (r = 0.360, p = 0.071).

Conclusions

GHb measured using the affinity method may be a useful glycemic control marker in infants. Although adj-HbA1c measured using the LA method was correlated with GA, it may not be a practical measure because it was not correlated with PG and determining HbF levels using HPLC method can be troublesome. Adj-HbA1c measured using the HPLC method should not be used as a glycemic marker in infants.

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