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Electrospray Mass Spectrometry for Measurement of Glycohemoglobin

Department of Clinical Chemistry, Ziekenhuis De Weezenlanden, Groot Wezenland 20., 8011 JW Zwolle, The Netherlands, Fax +31 38 4299676, E-mail labcenter.zwolle@net.HCC.nl

With the publication of the results of the landmark 9-year Diabetes Control and Complications Trial (DCCT), the importance of Hb A_1c/glycohemoglobin testing in diabetes was firmly established. The DCCT showed, at least in patients with insulin-dependent diabetes mellitus, that the risk for development and progression of the chronic complications of diabetes is closely related to the degree of metabolic control as measured by glycohemoglobin determinations (1). Generally, the same is believed to be true for patients with non-insulin-dependent diabetes mellitus, although the results of the UK Prospective Study must be awaited (2)(3).

The DCCT has confirmed that measuring glycohemoglobin in blood is an excellent tool for the long-term control of the glycemic state. Considering the high prevalence of diabetes mellitus, glycohemoglobin is one of the most important analytes in laboratory medicine today (4). A major task of clinical chemistry should be to optimize conditions for its determination. The development of new methodologies and international standardization is an essential part of such efforts.

Despite the ongoing efforts for standardization of Hb A_1c/glycohemoglobin (5), many glycohemoglobin assays are not standardized among clinical laboratories; values reported by one laboratory may not agree with those from another, and possibly neither would agree with those from the DCCT (6).

Glycohemoglobins are the products of a nonenzymatic reaction between the free aldehyde group of glucose (Hb A_1c) or other sugars and the unprotonated form of free amino groups of hemoglobin. The percentage of glycohemoglobin in human blood depends on the concentration of glucose, the duration of glucose exposure to hemoglobin, and the turnover of erythrocytes. The higher the glucose concentration and the longer the exposure time, the higher the percentage of Hb A_1c.

The potential glycation sites of the hemoglobin . . . [Full Text of this Article]

References

The following articles in journals at HighWire Press have cited this article:

				J L Camargo and J L Gross Conditions associated with very low values of glycohaemoglobin measured by an HPLC method J. Clin. Pathol., April 1, 2004; 57(4): 346 - 349. [Abstract] [Full Text] [PDF]

				D. B. Sacks Hemoglobin Variants and Hemoglobin A1c Analysis: Problem Solved? Clin. Chem., August 1, 2003; 49(8): 1245 - 1247. [Full Text] [PDF]

				D. B. Sacks, D. E. Bruns, D. E. Goldstein, N. K. Maclaren, J. M. McDonald, and M. Parrott Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus Clin. Chem., March 1, 2002; 48(3): 436 - 472. [Abstract] [Full Text] [PDF]

				L. Bry, P. C. Chen, and D. B. Sacks Effects of Hemoglobin Variants and Chemically Modified Derivatives on Assays for Glycohemoglobin Clin. Chem., February 1, 2001; 47(2): 153 - 163. [Abstract] [Full Text] [PDF]

				N. B. Roberts, A. B. Amara, M. Morris, and B. N. Green Long-Term Evaluation of Electrospray Ionization Mass Spectrometric Analysis of Glycated Hemoglobin Clin. Chem., February 1, 2001; 47(2): 316 - 321. [Abstract] [Full Text] [PDF]

				A. Lapolla, D. Fedele, M. Plebani, R. Aronica, M. Garbeglio, R. Seraglia, M. D'Alpaos, and P. Traldi Evaluation of Glycated Globins by Matrix-assisted Laser Desorption/Ionization Mass Spectrometry Clin. Chem., February 1, 1999; 45(2): 288 - 290. [Full Text] [PDF]

				K. P. Peterson, J. G. Pavlovich, D. Goldstein, R. Little, J. England, and C. M. Peterson What is hemoglobin A1c? An analysis of glycated hemoglobins by electrospray ionization mass spectrometry Clin. Chem., September 1, 1998; 44(9): 1951 - 1958. [Abstract] [Full Text] [PDF]

				A. Mosca, R. Paleari, A. Made, C. Ferrero, M. Locatelli, and F. Ceriotti Commutability of control materials in glycohemoglobin determinations Clin. Chem., March 1, 1998; 44(3): 632 - 638. [Abstract] [Full Text] [PDF]

				G. Ellis, L. Chang, B. Cogionis, D. Daneman, S. R. Binder, G. Ellis, L. Chang, B. Cogionis, and D. Daneman Incomplete Removal of Labile Fraction When Measuring Hemoglobin A1c with Bio-Rad Variant® Analyzer • A representative of Bio-Rad Labs. replies: • The authors of the Letter respond: Clin. Chem., December 1, 1997; 43(12): 2437 - 2439. [Full Text]

				J. H. Eckfeldt and D. E. Bruns Another Step Toward Standardization of Methods for Measuring Hemoglobin A1c Clin. Chem., October 1, 1997; 43(10): 1811 - 1813. [Full Text] [PDF]