Determination of glycated hemoglobin in patients with advanced liver disease

doi:10.3748/wjg.v10.i15.2284

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Aug 1, 2004; 10(15): 2284-2286
Published online Aug 1, 2004. doi: 10.3748/wjg.v10.i15.2284

Determination of glycated hemoglobin in patients with advanced liver disease

Theresa Lahousen, Karin Hegenbarth, Rottraut Ille, Rainer W. Lipp, Robert Krause, Randie R. Little, Wolfgang J. Schnedl

Karin Hegenbarth, Rainer W. Lipp, Robert Krause, Wolfgang J. Schnedl, Department of Internal Medicine, School of Medicine, Medical University Graz, Auenbruggerplatz 15, A-8063 Graz, Austria

Theresa Lahousen, Rottraut Ille, Department of Psychiatry, School of Medicine, Medical University Graz, Auenbruggerplatz 31, A-8063 Graz, Austria

Randie R. Little, University of Missouri School of Medicine, Department of Pathology and Child Health, One Hospital Drive, Columbia, MO 65212, USA

Author contributions: All authors contributed equally to the work.

Correspondence to: Dr. Wolfgang J. Schnedl, Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria. wolfgang.schnedl@meduni-graz.at

Telephone: +43-316-385-81801 Fax: +43-316-385-3062

Received: February 23, 2004
Revised: April 3, 2004
Accepted: April 9, 2004
Published online: August 1, 2004

Abstract

AIM: To evaluate the glycated hemoglobin (HbA 1c) determination methods and to determine fructosamine in patients with chronic hepatitis, compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin.

METHODS: HbA_1c values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium.

RESULTS: Forty percent of patients with liver cirrhosis had HbA1c results below the non-diabetic reference range by at least one HbA_1c method, while fructosamine results were either within the reference range or elevated. Twenty percent of patients with chronic hepatitis (hepatic fibrosis) had HbA_1c results below the non -diabetic reference range by at least one HbA_1c method. In patients with chronic hepatitis treated with ribavirin, 50% of HbA1c results were below the non-diabetic reference using at least one of the HbA_1c methods.

CONCLUSION: Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes, HbA 1c results should be used in patients with advanced liver disease. HbA _1c and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and ribavirin treatment.

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