Minor Hemoglobin Components in Diabetic and Uremic Patients

Summary

Hemoglobins A_1c and A_1a+b were measured by an automated chromatographic method in 11 control subjects, 100 diabetics and 30 subjects with renal failure not induced by diabetes. Hb A_1c was higher in diabetics than in controls (8.26 ± 0.31 versus 5.24 ± 0.28, p < 0.01) and strongly correlated with blood glucose values for the preceding 4 months. In poorly controlled diabetics, submitted to an intensive therapeutic program, Hb A_1c decreased rapidly. Hb A_1c was slightly but significantly elevated in the uremic, non-diabetic patients who were not submitted to periodic hemodialysis: 6.42 ± 0.32, p < 0.05. It returned, in hemodialyzed patients, to a level not significantly different from the control value.

Hb A_1a+b was elevated in diabetic subjects (2.43 ± 0.04 vs. 1.55 ± 0.01 in controls, p < 0.001). It was also higher in the uremic patients (2.71 ± 0.14, p < 0.001). No decrease occurred in the hemodialyzed patients (3.27 ± 0.31). Glycosylated hemoglobin values, as routinely estimated and expressed under the name of “Hb A¹”, should be interpreted with caution in patients with renal failure.

Methods discriminating Hb A_1a+b have to be used.

Key-Words:

Hemoglobin A _1c - Hemoglobin A _1a+b - Diabetes Mellitus - Uremia - Minor Hemoglobin Fractions