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HbA1c

 

HbA₁c variations

  • http://pmj.bmj.com/content/79/933/421.1.full.pdf (PGM 2003)
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1569985/pdf/bmj33300586.pdf (BMJ 2006)
  • ↑ High HbA₁c
    • New/uncontrolled Diabetes mellitus
      • non-diabetic hyperglycaemia (secondary diabetes: acromegaly, phaeochromocytoma, thyrotoxicosis, Cushing's syndrome)
    • Splenectomy
    • Some Hb variants (but see also below) [eg due to test interference]: HbF, HbE, HbD, HbJ Capetown, Hb Raleigh, carbamylated Hb (uraemia)
    • Alcoholism
  • ↓ Low HbA₁c
    • Haemolytic anaemia (congenital: eg spherocytosis, elliptocytosis | acquired: eg drug-induced)
    • Haemoglobinopathies
    • Myelodysplastic disease
    • Some Hb variants (but see also above): HbS, HbC, HbJ, HbG, Hb Ramadan
    • Chronic blood loss
    • Chronic renal failure (variable)

A1c vs Glu; CVD; Metabolic syndrome

A1c MBG* CVD Prev: MS=3:
5% 5 BP<130/80 BP≥130/85
6% 7 TC<4 TG≥1.7
7% 9 LDL-C<2 HDL≥1.3f|1.0m
8% 11 HbA1c<6.5% IFG≥6.1
9% 13
 
 Waist>102m|88f
* MBG=mean(3pre+3post) = 1.91 x HbA(1c) - 4.36 [~ 2*A1c-5 for A1c=5:10]
5%=5.2, 6%=7.1, 7%=9.0, 8%=10.9, 9%=12.8, 10%=14.7
approx: 5%=5; 6%=7; 7%=9; 7.5%=10; 8%=11; 9%=13; 10%=15
or: MBG=5+2*(A1c-5)

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