HbA1c As Diabetes Mellitus Biomarker and Its Methods Evolution

Authors

  • Liong Boy Kurniawan Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Wahidin Sudirohusodo Hospital, Makassar

DOI:

https://doi.org/10.24293/ijcpml.v30i2.2191

Keywords:

HbA1c, diabetes mellitus, biomarker, methods

Abstract

This literature aims to review various aspects of HbA1c as a Diabetes Mellitus (DM) biomarker and various HbA1c examination methods and their respective advantages and limitations. Diabetes mellitus is a condition characterized by chronic hyperglycemia and can lead to microvascular and macrovascular complications in the future. HbA1c has been used extensively over the last few decades to monitor glycemic control and assess microvascular and macrovascular risk. It has also been used as one of the diagnostic criteria for DM. HbA1c is hemoglobin A, which is glycated at the N terminal of its valine beta-globin chain and provides an overview of glycemic control over the past three months. HbA1c is often reported using % or mmol/mol units and can be adjusted to assess the average blood glucose level over the past three months. Various methods developed for HbA1c examination include immunoassay, boronate affinity, enzymatic, capillary electrophoresis, and Ion-Exchange High-Performance Liquid Chromatography (IE-HPLC), and each has its advantages and limitations. In addition to their advantages in detecting HbA1c, the capillary electrophoresis and IE-HPLC methods can also detect other types of hemoglobin and the presence of hemoglobin variants.

Downloads

Download data is not yet available.

References

Punthakee Z, Goldenberg R, Katz P. Definition, classification, and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes, 2018; 42: S10-15.

American Diabetes Association. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care, 2023; 46(suppl 1): S19-S40.

Leow MKS. Glycated hemoglobin (HbA1c): Clinical applications of a mathematical concept. Acta Inform Med, 2016; 24(4): 233-238.

Little RR, Rohlfing C, Sacks DB. The national glycohemoglobin standardization program: Over 20 years of improving Hemoglobin A1c measurement. Clinical Chemistry, 2019; 65(7): 839-848.

Chen Z, Shao L, Jiang M, Ba X, Ma B, Zhou T. Interpretation of HbA1c lies at the intersection of analytical methodology, clinical biochemistry, and hematology (review). Experimental and Therapeutic Medicine, 2022; 24: 707.

Fayyaz B, Rehman HJ, Minn H. Interpretation of hemoglobin A1c in primary care setting. Journal of Community Hospital Internal Medicine Perspectives, 2019; 9(1): 18-21.

Kaiafa G, Veneti S, Polychronopoulos G, Pilalas D, Daios S, et al. Is HbA1c an ideal biomarker of well-controlled diabetes?. Postgrad Med J, 2021; 97: 380-383.

Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomarker Insights, 2016; 11: 95-104.

Gupta S, Jain U, Chauhan N. Laboratory diagnosis of HbA1c: A review. J Nanomed Res, 2017; 5(4): 00120.

Gillery P. HbA1c and biomarkers of diabetes mellitus in clinical chemistry and laboratory medicine: Ten years after. Clin Chem Lab Med, 2023; 61(5): 861-872.

National Glycohemoglobin Standardization Program. International Federation of Clinical Chemistry (IFCC) standardization of HbA1c. Available at https://ngsp.org/docs/IFCCstd.pdf (accessed May 30, 2023).

American Diabetes Association. Glycemic targets: standards of care in diabetes-2023. Diabetes Care, 2023; 46(suppl 1): S97-S110.

Yaprak B, Keskin L. Evaluation of microvascular complications in patients with new diagnosis type 2 diabetes. European Review for Medical and Pharmacological Sciences, 2023; 27: 1601-1608.

Su JB, Zhao LH, Zhang XL, Cai HL, Huang HY, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol, 2018; 17: 47.

Kim KJ, Choi J, Bae JH, Kim KJ, Yoo HJ, et al. Time to reach target glycosylated hemoglobin is associated with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus: A 6-year observational study. Diabetes Metab J, 2021; 45: 368-38.

Boye KS, Thieu VT, Lage MJ, Miller H, Paczkowski R. The association between sustained HbA1c control and long-term complications among individuals with type 2 diabetes: a retrospective study. Adv Ther, 2022; 39: 2208-2221.

Tan JK, Lim GH, Salim NNM, Chia SY, Thumboo J, Bee YM. Association between mean HbA1c, HbA1c variability, and both mortality and macrovascular complications in patients with diabetes mellitus: A registry-based cohort study. Clinical Epidemiology, 2023; 15: 137-149.

Lind M, Imberg H, Coleman RL, Nerman O, Holman RR. Historical HbA1c values may explain the type 2 diabetes legacy effect: UKPDS 88. Diabetes Care, 2021; 44: 2231-2237.

Campbell MR, Shokrani M. Comparison of HbA1c and glycated protein methodologies. Clin Lab Sci, 2016; 29(2): 114-121.

Li Q, Xiao Y, Shah AD, Li S. Visual inspection of chromatograms assists interpretation of HbA1c: A case report. Diabetes Care, 2018; 41: 1829-1830.

Mukherjee B, Hooda C, Singh V, Sahu R, Singh MU. Comparison of NGSP-certified methods and their cost analysis for estimation of HbA1c- a cross-sectional study. Journal of Clinical and Diagnostic Research, 2023; 17(2): BC01-BC04.

Maradi R, Shetty D. Comparison of HbA1c values by immunoturbidimetric and HPLC methods. International Journal of Biochemistry, 2019; 12(2): 62-65.

Rollborn N, Nordin G, Mandic-Havelka A, Lohmander M, Elmgren A, et al. Good agreement between HbA1c analyzed using capillary electrophoresis, HPLC, immunological and enzymatic methods. Journal of Diabetes, Metabolism and Its Complications, 2019. Available from: https://www.sciencerepository.org/good-agreement-between-hba1c-analyzed-using-capillary-electrophoresis-hplc-immunological-and-enzymatic-methods_JDMC-2019-1-(accessed May 1, 2023).

Downloads

Submitted

2023-06-07

Accepted

2023-08-08

Published

2024-02-16

How to Cite

[1]
Kurniawan, L.B. 2024. HbA1c As Diabetes Mellitus Biomarker and Its Methods Evolution. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 30, 2 (Feb. 2024), 191–196. DOI:https://doi.org/10.24293/ijcpml.v30i2.2191.

Issue

Section

Literature Review