Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults.
<h4>Background</h4>The establishment of Reference Intervals (RIs) for Hemoglobin A1C and other hemoglobin subfractions (A1A, A1B, F, LA1C, A0) is of utmost importance in screening, diagnosing, and monitoring diabetes and other hemoglobin abnormalities through the application of high-pres...
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| Format: | Article |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0300028&type=printable |
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| author | Anwar Borai Kiyoshi Ichihara Suhad Bahijri Abeer Alsofyani Mohieldin Elsayid Haitham Husain Sultanah Boraie Naif Sannan Ziad Kalantan Majdi Jan Maha Gassas Mohammed Harbi Norah Alrowaili Mohammed Almohammadi Hawazen Zarif Mansour Qurashi |
| author_facet | Anwar Borai Kiyoshi Ichihara Suhad Bahijri Abeer Alsofyani Mohieldin Elsayid Haitham Husain Sultanah Boraie Naif Sannan Ziad Kalantan Majdi Jan Maha Gassas Mohammed Harbi Norah Alrowaili Mohammed Almohammadi Hawazen Zarif Mansour Qurashi |
| author_sort | Anwar Borai |
| collection | DOAJ |
| description | <h4>Background</h4>The establishment of Reference Intervals (RIs) for Hemoglobin A1C and other hemoglobin subfractions (A1A, A1B, F, LA1C, A0) is of utmost importance in screening, diagnosing, and monitoring diabetes and other hemoglobin abnormalities through the application of high-pressure liquid chromatography (HPLC) technique. Because there are no locally established RIs for these parameters, it is essential to establish RIs specific to the Saudi population to accurately diagnose and monitor diabetic individuals and identify abnormal levels in hemoglobin subfractions.<h4>Methods</h4>As part of the IFCC global multicenter study of laboratory reference values, a cross-sectional study was conducted in Saudi Arabia. The study involved recruiting a total of 381 healthy adult subjects (>18 years, BMI 28.3 ± 6 kg/m2). Blood samples were analyzed for A1C, biochemical and other immunoassay parameters. The need for RIs based on sex, age, and BMI was determined using the standard deviation ratio (SDR) through a 3-level nested ANOVA.<h4>Results</h4>Based on the threshold of SDR≥0.4, RIs for A1C and other Hb subfractions were not partitioned by sex or BMI, but partitioned by age (<45 & ≥45 years) for A1C, LA1C, A0 and F. Spearman's correlation between glucose, insulin, and C-peptide showed a positive association with different hemoglobin subtractions of A1B, F, A1C, and LA1C. The RIs were obtained by using the parametric method and the latent abnormal values exclusion (LAVE) principle was applied on A1C.<h4>Conclusion</h4>This study established RIs for A1C and other Hb subfractions for healthy adult Saudis. Age was found to be an important source of variation for most of the parameters including A1C. These findings will enhance the understanding and clinical decision-making concerning A1C and other hemoglobin subfractions. The elevated upper limit of RIs for A1C reflects the high prevalence of diabetes in the Saudi population specially in those with increased age. |
| first_indexed | 2024-04-24T16:50:36Z |
| format | Article |
| id | doaj.art-5f20aa91af8146b2809e6d6876f6edfe |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-24T16:50:36Z |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5f20aa91af8146b2809e6d6876f6edfe2024-03-29T05:32:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01193e030002810.1371/journal.pone.0300028Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults.Anwar BoraiKiyoshi IchiharaSuhad BahijriAbeer AlsofyaniMohieldin ElsayidHaitham HusainSultanah BoraieNaif SannanZiad KalantanMajdi JanMaha GassasMohammed HarbiNorah AlrowailiMohammed AlmohammadiHawazen ZarifMansour Qurashi<h4>Background</h4>The establishment of Reference Intervals (RIs) for Hemoglobin A1C and other hemoglobin subfractions (A1A, A1B, F, LA1C, A0) is of utmost importance in screening, diagnosing, and monitoring diabetes and other hemoglobin abnormalities through the application of high-pressure liquid chromatography (HPLC) technique. Because there are no locally established RIs for these parameters, it is essential to establish RIs specific to the Saudi population to accurately diagnose and monitor diabetic individuals and identify abnormal levels in hemoglobin subfractions.<h4>Methods</h4>As part of the IFCC global multicenter study of laboratory reference values, a cross-sectional study was conducted in Saudi Arabia. The study involved recruiting a total of 381 healthy adult subjects (>18 years, BMI 28.3 ± 6 kg/m2). Blood samples were analyzed for A1C, biochemical and other immunoassay parameters. The need for RIs based on sex, age, and BMI was determined using the standard deviation ratio (SDR) through a 3-level nested ANOVA.<h4>Results</h4>Based on the threshold of SDR≥0.4, RIs for A1C and other Hb subfractions were not partitioned by sex or BMI, but partitioned by age (<45 & ≥45 years) for A1C, LA1C, A0 and F. Spearman's correlation between glucose, insulin, and C-peptide showed a positive association with different hemoglobin subtractions of A1B, F, A1C, and LA1C. The RIs were obtained by using the parametric method and the latent abnormal values exclusion (LAVE) principle was applied on A1C.<h4>Conclusion</h4>This study established RIs for A1C and other Hb subfractions for healthy adult Saudis. Age was found to be an important source of variation for most of the parameters including A1C. These findings will enhance the understanding and clinical decision-making concerning A1C and other hemoglobin subfractions. The elevated upper limit of RIs for A1C reflects the high prevalence of diabetes in the Saudi population specially in those with increased age.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0300028&type=printable |
| spellingShingle | Anwar Borai Kiyoshi Ichihara Suhad Bahijri Abeer Alsofyani Mohieldin Elsayid Haitham Husain Sultanah Boraie Naif Sannan Ziad Kalantan Majdi Jan Maha Gassas Mohammed Harbi Norah Alrowaili Mohammed Almohammadi Hawazen Zarif Mansour Qurashi Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. PLoS ONE |
| title | Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. |
| title_full | Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. |
| title_fullStr | Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. |
| title_full_unstemmed | Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. |
| title_short | Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. |
| title_sort | establishment of reference interval for hemoglobin a1c and other hemoglobin subfractions for healthy saudi adults |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0300028&type=printable |
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