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Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates

Journal of Perinatology volume 31, page 808 (2011)Cite this article

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Dupont et al.1 measured glycated hemoglobin (GHb) in cord blood by electrospray ionization mass spectrometry (EI-MS). They suggested that GHb levels determined by EI-MS could be used as an indicator of glycemic control in neonatal diabetes mellitus. The EI-MS method measuring GHb in β-chain (HbA1c) has been reported to be a reliable method and chosen as the gold standard method for international standardization. Although discrepancy exists between GHb levels determined by conventional method and glycemic control state in patients with variant hemoglobin, GHb in β-chain determined by EI-MS method reflect more accurately glycemic control state.2 Dupont et al. proposed the usefulness of glycated hemoglobin α-chain and γ-chain by EI-MS as glycemic control marker in neonatal diabetes mellitus. However, their results showed that GHb levels in α-chain and those in γ-chain were lower than those of β-chain (HbA1c). Therefore, glycation levels in α-chain and those in γ-chain might be lower compared with those in β-chain. Furthermore, in the neonatal period switching from HbF to HbA prolongs the lifespan of erythrocytes containing HbF, which influences GHb levels in γ-chain. In addition, EI-MS method is used only by specific laboratories, and thus is not widely spread for clinical use. Taken all together, measurement of GHb in α-chain or γ-chain by EI-MS might not be an appropriate indicator of glycemic control in neonatal diabetes mellitus. Our proposal that glycated albumin is an appropriate indicator of glycemic control in neonatal diabetes mellitus is based on that glycated albumin levels are not influenced by the presence of any subtypes of hemoglobin, and can be measured by convenient enzymatic method.3

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References

  1. Dupont FO, Gagnon R, Menard J, Auray-Blais C, Ardilouze JL . Evaluation of the glycemic control in neonates: a novel technical approach for measuring fetal glycated hemoglobin. J Perinatol (in press).

  2. Nakanishi T, Miyazaki A, Shimizu A, Yamaguchi A, Nishimura S . Assessment of the effect of hemoglobin variants on routine HbA1c measurements by electrospray ionization mass spectrometry. Clin Chim Acta 2002; 323: 89–101.

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  3. Koga M, Murai J, Saito H, Yamada Y, Mori T, Suno S et al. Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates. J Perinatol 2011; doi:10.1038/jp.2010.144.

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Authors and Affiliations

  1. Department of Internal Medicine, Kinki Central Hospital, Itami, Hyogo, Japan

    M Koga

  2. Department of Medicine, Nissay Hospital, Osaka, Japan

    S Kasayama

  3. Department of Clinical and Laboratory Medicine, Osaka Medical College, Takatsuki, Osaka, Japan

    A Miyazaki

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  1. M Koga
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  2. S Kasayama
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  3. A Miyazaki
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Correspondence to M Koga.

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Koga, M., Kasayama, S. & Miyazaki, A. Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates. J Perinatol 31, 808 (2011). https://doi.org/10.1038/jp.2011.71

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