![]() ![]() (Methods of obtaining glycated hemoglobin values are expressed in detail in Table 1.) The affinity support binds a greater range of glycated species, leading to the conclusion that affinity methods may more accurately represent the levels of glycosylation. 7 The authors reported that, although the methods correlated well, they observed that the affinity technique showed higher percentages of glycated hemoglobins than would be obtained by using ion-change chromatography. A comparison of the determination of glycosolated hemoglobin by affinity chromatography to ion-exchange methods has been published. ![]() Initially high-performance liquid chromatographie (HPLC) ion exchange and affinity chromatography mini-columns were primarily employed in most clinical laboratories as methodologies for measuring A1c. Glycated hemoglobin: strengths and limitations Thus HbA1c levels should provide an integrated assessment of blood glucose levels over the preceding 90 to 120 days. HbA1c is formed slowly and continuously throughout the life of the red cell. In diabetic patients these glucose adducts are increased in parallel with HbA1c. Glucose is also linked in the same way to other sites of the hemoglobin molecule such as the N-terminus of the a-chain and certain lysine residues. The term, “A1c” should be reserved for HbA, which has glucose attached to the N-terminus of the b-chain by a ketoamine linkage. 1-6 Hemoglobin A1c (HbA1c) is the most abundant minor hemoglobin in normal red cells and is elevated as much as threefold in people with diabetes. The utility of glycosylated hemoglobin measurements in the management of patients with diabetes has been established for almost 40 years. ![]()
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