title: HbA1c method evaluation for postmortem samples.
abstract: Glycated hemoglobin (HbA1c) is used for diagnosis of diabetes and evaluation of the glycemic control of diabetics in clinical medicine. It is also a useful biomarker for analyzing postmortem samples, since it is relatively stable and correlates well with clinical samples. We wanted to evaluate the information provided by HbA1c analysis of postmortem blood samples using a HPLC based, fully automated analyzer. Autopsy data from 55 cases, in which glucose, lactate, ketone bodies, and HbA1c were analyzed as a part of cause of death investigation, were selected for the study. Another set of 71 samples were analyzed in parallel with Mono S HPLC and automated BioRad D-10 HPLC. The results of 64 samples attained using both methods were compared using a Bland-Altman plot. We conclude that HbA1c can be analyzed reliably and cost-effectively from postmortem samples using a fully automated HPLC based analyzer. It is necessary, particularly in ketoacidotic cases, to determine the HbA1c level to help distinguish diabetic ketoacidosis from other causes.
authors.affiliation: Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, 00300, Helsinki, Finland, terhi.keltanen@helsinki.fi.
authors.forename: Terhi
authors.initials: T
authors.lastname: Keltanen
authors.forename: Antti
authors.initials: A
authors.lastname: Sajantila
authors.forename: Tiina
authors.initials: T
authors.lastname: Valonen
authors.forename: Teija
authors.initials: T
authors.lastname: Partanen
authors.forename: Katarina
authors.initials: K
authors.lastname: Lindroos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057205:Automation, Laboratory; D001344:Autopsy; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002423:Cause of Death; D002851:Chromatography, High Pressure Liquid / Q000295:instrumentation; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D044707:Forensic Sciences / Q000295:instrumentation / Q000379:methods*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007657:Ketone Bodies / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007657:Ketone Bodies; C517652:hemoglobin A1c protein, human