The Journal of Pediatrics
Volume 153, Issue 1 , Pages 7-9 , July 2008

Discordant HbA1c Results: The Hoofbeats Increase

  • Robert M. Cohen, MD

      Affiliations

    • Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
    • Corresponding Author InformationReprint requests: Robert M. Cohen, MD, Division of Endocrinology, Diabetes & Metabolism, PO Box 670547, Vontz Center for Molecular Studies, 3125 Eden Avenue, University of Cincinnati Medical Center, Cincinnati, OH 45267-0547.
    • ,
  • Clinton H. Joiner, MD, PhD

      Affiliations

    • Sickle Cell Center, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
    • ,
  • Robert S. Franco, PhD

      Affiliations

    • Division of Hematology-Oncology, Department of Medicine, Sickle Cell Center, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio

References 

  1. Felner EI, McGrath M. Inaccurate HbA1c levels in patients with type 1 diabetes and hereditary persistence of hemoglobin F. J Pediatr. 2008;153:137–139
  2. Cohen MP. Diabetes and Protein Glycosylation: Measurement and Biological Relevance. New York: Springer-Verlag; 1986;
  3. Jeha GS, Haymond M. Understanding and interpreting laboratory test results in the clinical management of diabetes mellitus. Pediatr Endocrinol Rev. 2007;5(Suppl 1):608–628
  4. Cohen RM, Holmes YR, Chenier TC, Joiner CH. Discordance between hemoglobin A1c and fructosamine: evidence for a glycosylation gap and its relation to nephropathy in long-standing type 1 diabetes. Diabetes Care. 2003;26:163–167
  5. Cohen RM. A1C: does one size fit all?. Diabetes Care. 2007;30:2756–2758
  6. Gould BJ, Davie SJ, Yudkin JS. Investigation of the mechanism underlying the variability of glycated haemoglobin in non-diabetic subjects not related to glycaemia. Clin Chim Acta. 1997;260:49–64
  7. McCarter RJ, Hempe JM, Gomez R, Chalew SA. Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes. Diabetes Care. 2004;27:1259–1264
  8. Wilson D, Fiallo-Scharer R, Xing D, Wysocki T, Block J, Weinzimer S, et al. Diabetes Research in Children Network (Reliability of two indices of the biologic variabiity in glycosylation among children and adolescents with T1DM). [abstract] Diabetes. 2005;54(Suppl 1):A454
  9. Kim J-I, Stevens RJ, Holman RR. The haemoglobin glycation index is an independent risk factor for microvascular complications in UKPDS patients with newly diagnosed type 2 diabetes. [abstract] Diabetes. 2005;54(Suppl 1):A244
  10. Lindsell CJ, Franco RS, Smith EP, Joiner CH, Cohen RM. A method for the continuous calculation of the age of labeled red blood cells. Am J Hematol. 2008;in press
  11. Cohen RM, Ciraolo P, Palascak MB, Lindsell CJ, Khera PK, Smith EP, et al. Red blood cell (RBC) survival differences among hematologically normal people with diabetes (DM) make a clinically important difference in HbA1c. [abstract] Diabetes. 2007;56(Suppl 1):A116
  12. Cohen RM, Lecaire TJ, Lindsell CJ, Smith EP, D'Alessio DJ. Relationship of prospective GHb to glycated serum proteins in incident diabetic retinopathy: implications of the glycation gap for mechanism of risk prediction. Diabetes Care. 2008;31:151–153
  13. Genuth S, Lachin JM, Nathan DM. Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes: response to McCarter et al. Diabetes Care. 2005;28:233–235
  14. Chalew SA, Hempe JM, McCarter RJ. Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes: response to Genuth, Lachin, and Nathan. Diabetes Care. 2005;28:234–235
  15. Lachin JM, Genuth S, Nathan DM, Rutledge BN. The hemoglobin glycation index is not an independent predictor of the risk of microvascular complications in the Diabetes Control and Complications Trial. Diabetes. 2007;56:1913–1921
  16. Khera PK, Joiner CH, Holmes YR, Cohen RM. Evidence for a steady-state glucose gradient across the erythrocyte membrane at 37°C: a potential source of variation in hemoglobin A1c. [abstract] Diabetes. 2001;50(Suppl 2):A176
  17. Snieder H, Sawtell PA, Ross L, Walker J, Spector TD, Leslie RD. HbA(1c) levels are genetically determined even in type 1 diabetes: evidence from healthy and diabetic twins. Diabetes. 2001;50:2858–2863
  18. Cohen RM, Snieder H, Lindsell CJ, Beyan H, Hawa M, Blincko S, et al. Evidence for independent heritability of the glycation gap (glycosylation gap) fraction of HbA1c in non-diabetic twins. Diabetes Care. 2006;29:1739–1743
  19. Herman WH, Ma Y, Uwaifo G, Haffner S, Kahn SE, Horton ES, et al. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care. 2007;30:2453–2457

PII: S0022-3476(08)00219-9

doi: 10.1016/j.jpeds.2008.03.026

The Journal of Pediatrics
Volume 153, Issue 1 , Pages 7-9 , July 2008

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