Average glucose from hemoglobin A(1c) for altered red blood cell lifetimes: Predictions based on a model for hemoglobin A1c formation

作者：Molinaro Ross; Herman Jay H; Stickle Douglas F^*

来源：Clinica Chimica Acta, 2017, 474: 124-129.

DOI：10.1016/j.cca.2017.09.011

• Hemoglobin A(1c)
• Glycation rate
• Erythrocytes
• Mathematical modeling
• Estimated average glucose
• Hemoglobin variants

Background: A model for hemoglobin A(1c) (HbA(1c)) formation was used to predict the relationship between average glucose (AG) and %HbA(1c) under conditions of altered red blood cell lifetime (RCL).
Methods: Using a kinetic mass balance model for formation of HbA(1c) in red blood cells as a function of age (time in circulation), whole blood %HbA(1c) vs. glucose was calculated based on the nonlinear distribution of red blood cells as a function of age across RCL.
Results: Model calculations provided a close fit to the standard relationship of estimated average glucose to % HbA(1c) for normal RCL (r > 0.999). Results for altered RCL were calculated assuming simple time-scale compression or expansion of the distribution of red blood cells as a function of RCL. For a given %HbA(1c), the operative average glucose needed to have achieved a given %HbA(1c) was predicted to be altered by RCL according to average glucose x RCL = constant.
Conclusions: Model calculations estimate the extent to which standard reporting of AG vs. HbA(1c) underestimates or overestimates AG under conditions of altered RCL. Conditions of altered RCL may often be operative in patients with certain hemoglobin variants.

• 出版日期2017-11