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


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.
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan. shige5p@asahikawa-med.ac.jp
Shigeru
S
Suzuki
Masafumi
M
Koga
Noriyasu
N
Niizeki
Akiko
A
Furuya
Kumihiro
K
Matsuo
Yusuke
Y
Tanahashi
Etsushi
E
Tsuchida
Fumikatsu
F
Nohara
Toshio
T
Okamoto
Ken
K
Nagaya
Hiroshi
H
Azuma
D001786:Blood Glucose / Q000032:analysis*; D005319:Fetal Hemoglobin / Q000032:analysis*; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006031:Glycosylation; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn / Q000097:blood*; D012709:Serum Albumin / Q000032:analysis*; D000093423:Glycated Serum Albumin
D001786:Blood Glucose; D005319:Fetal Hemoglobin; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D006454:Hemoglobins; D012709:Serum Albumin; D000093423:Glycated Serum Albumin