Determination of glycated hemoglobin in patients with advanced liver disease.
OBJECTIVE
To evaluate the glycated hemoglobin (HbA(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis, compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin.


METHODS
HbA(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium.


RESULTS
Forty percent of patients with liver cirrhosis had HbA(1c) results below the non-diabetic reference range by at least one HbA(1c) method, while fructosamine results were either within the reference range or elevated. Twenty percent of patients with chronic hepatitis (hepatic fibrosis) had HbA(1c) results below the non-diabetic reference range by at least one HbA(1c) method. In patients with chronic hepatitis treated with ribavirin, 50% of HbA(1c) results were below the non-diabetic reference using at least one of the HbA(1c) methods.


CONCLUSIONS
Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes, HbA(1c) results should be used in patients with advanced liver disease. HbA(1c) and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and ribavirin treatment.
Lahousen
Theresa
T
Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.
Hegenbarth
Karin
K
Ille
Rottraut
R
Lipp
Rainer-W
RW
Krause
Robert
R
Little
Randie-R
RR
Schnedl
Wolfgang-J
WJ
D000998:Antiviral Agents / Q000627:therapeutic use; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy; D006521:Hepatitis, Chronic / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D012254:Ribavirin / Q000627:therapeutic use
D000998:Antiviral Agents; D019270:Fructosamine; D006442:Glycated Hemoglobin; D012254:Ribavirin