title: Two-dimensional analysis of glycated hemoglobin heterogeneity in pediatric type 1 diabetes patients.
abstract: Interindividual and ethnic variation in glycated hemoglobin levels, unrelated to blood glucose variation, complicates the clinical use of glycated hemoglobin assays for the diagnosis and management of diabetes. Assessing the types and amounts of glycated hemoglobins present in erythrocytes could provide insight into the mechanism. Blood samples and self-monitored mean blood glucose (MBG) levels were obtained from 85 pediatric type 1 diabetes patients. Glycated hemoglobin levels were measured using three primary assays (boronate-affinity chromatography, capillary isoelectric focusing (CIEF), and standardized DCA2000+ immunoassay) and a two-dimensional (2D) analytical system consisting of boronate-affinity chromatography followed by CIEF. The 2D system separated hemoglobin into five subfractions, four of which contained glycated hemoglobins. Glycated hemoglobin measurements were compared in patients with low, moderate, or high hemoglobin glycation index (HGI), a measure of glycated hemoglobin controlled for blood glucose variation. MBG was not significantly different between HGI groups. Glycated hemoglobin levels measured by all three primary assays and in all four glycated 2D subfractions were significantly different between HGI groups and highest in high HGI patients. These results show that interindividual variation in glycated hemoglobin levels was evident in diabetes patients with similar blood glucose levels regardless of which glycated hemoglobins were measured.
authors.affiliation: Research Institute for Children, Children's Hospital, New Orleans, LA 70118, USA; Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA 70118, USA. Electronic address: jhempe@chnola-research.org.
authors.forename: James M
authors.initials: JM
authors.lastname: Hempe
authors.forename: Amanda M
authors.initials: AM
authors.lastname: McGehee
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Chalew
mesh_terms: D000293:Adolescent; D001774:Blood Chemical Analysis / Q000379:methods*; D001897:Boronic Acids / Q000737:chemistry; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000737:chemistry / Q000302:isolation & purification; D006801:Humans; D008297:Male
chemical_list: D001897:Boronic Acids; D006442:Glycated Hemoglobin
keywords: Diabetes; Glucose; Glycated hemoglobin; Hemoglobin A1c; Multidimensional analysis