An analysis of the importance of the "labile" fraction of glycosylated hemoglobin as determined by a minicolumn method.
The authors have studied the contribution of the labile fraction of glycosylated hemoglobin to the total glycosylated hemoglobin (GH) in hospitalized, poorly controlled diabetic patients, and in a large group of outpatient diabetics using a conventional minicolumn method. A 5-hour saline incubation of erythrocytes or extensive dialysis of hemoglobin against a glucose-free buffer were used to remove the labile glycohemoglobin fraction. Equivalent results were obtained with either method. The change in GH after dialysis in a group of poorly controlled diabetics averaged 1.1%, but only 0.2% in a group of outpatients whose glycohemoglobin levels were being determined on a routine basis. In both groups, the size of the dialyzable fraction increased in proportion to the total GH level, and outpatients with a dialyzable fraction greater than or equal to 2.0% always had GH levels greater than or equal to 12.0%. In most cases where the total glycohemoglobin was less than 12%, the size of the dialyzable fraction approached the limits of the analytical variability of the minicolumn method (SD = approximately 0.3). The authors conclude that while saline incubation of erythrocytes is a practical procedure for removal of labile glycohemoglobin in a routine clinical laboratory, the use of this procedure is probably only necessary for patients with a high level of total glycosylated hemoglobin.
D003920:Diabetes Mellitus / Q000378:metabolism; D004356:Drug Storage; D005069:Evaluation Studies as Topic; D006442:Glycated Hemoglobin / Q000032:analysis*; D006760:Hospitalization; D006801:Humans; D010045:Outpatients; D013696:Temperature
D006442:Glycated Hemoglobin