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. 2004 Apr;57(4):346-9.
doi: 10.1136/jcp.2002.007088.

Conditions associated with very low values of glycohaemoglobin measured by an HPLC method

J L Camargo  1 , J L Gross
Affiliations

Conditions associated with very low values of glycohaemoglobin measured by an HPLC method

J L Camargo et al. J Clin Pathol. 2004 Apr.

Abstract

Aims: To identify the causes of very low glycohaemoglobin (GHb) values in a sample of patients with diabetes in southern Brazil using high performance liquid chromatography.

Methods: Between August 1996 and December 2001 all samples from patients with diabetes at a university hospital with GHb values below the reference range (4.7-6.0% HbA(1c)) were submitted to cellulose acetate electrophoresis. Medical records were reviewed to identify conditions that might be associated with these low values.

Results: Among 29 657 samples analysed, 130 patients had GHb < 4.7%. Seventy three patients (56%) were heterozygous for HbS, HbC, or HbD (19 black, two mulatto, and 52 white patients). The other 57 patients (44%) without Hb variants had low haematocrit and haemoglobin values (42 patients) or other conditions such as pregnancy, lipaemia, malignancy, cirrhosis, acetylsalicylic acid use, and absence of diabetes (15 patients).

Conclusions: The presence of an Hb variant may falsely lower GHb measurements. However, anaemia is also a source of negative interference. The haematological status should be considered for the correct interpretation of GHb results.

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Figures

Figure 1
Figure 1
Flow diagram of research protocol used to identify conditions associated with very low glycohaemoglobin (GHb) values.
Figure 2
Figure 2
Summary of conditions associated with very low glycohaemoglobin (GHb) values in a group of patients with diabetes in southern Brazil. AAS, acetylsalicylic acid; HbA1c, glycated haemoglobin; HCV, hepatitis C virus; HIV, human immunodeficiency virus.
Figure 3
Figure 3
Glycohaemoglobin (GHb), haemoglobin (Hb), and haematocrit (Ht) values in a patient with very low GHb values. The estimated value for GHb, calculated by mean plasma glucose in the period, is shown for three month intervals. After the correction of anaemia, GHb values increased, reaching the estimated value.
See this image and copyright information in PMC

Comment in

  • HbA1c measurement.
    Kilpatrick ES. Kilpatrick ES. J Clin Pathol. 2004 Apr;57(4):344-5. doi: 10.1136/jcp.2003.010918. J Clin Pathol. 2004. PMID: 15047732 Free PMC article. No abstract available.

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