In the presence of glucose in the blood, hemoglobin may undergo a glycation process and turned into glycated hemoglobin. HbA1c is one form of glycated hemoglobin. Measured HbA1c represents how much glucose in the blood for the last 120 days (the age of erythrocytes).
In hemolysis and blood loss, measurement of HbA1c will yield falsely low result, giving us a false idea that blood glucose in the last 120 days has been low while it actually has not. Is this phenomenon caused by a reduction in the amount of hemoglobin?
The answer is no. HbA1c is measured in percentage against total hemoglobin, so a whole reduction of hemoglobin will cause a decrease in both the amount of HbA1c and the amount of total hemoglobin. In such a condition, Hba1c percentage measured will roughly be the same.
Still, in hemolysis and blood loss, HbA1c does go lower. So how can it be? This is because in hemolysis and blood loss, erythrocyte population is filled with a larger amount of young erythrocytes, resulting from the body’s effort to compensate for hemoglobin reduction. Young erythrocytes have less exposure time to blood glucose, and thus, have less amount of HbA1c. This is why HbA1c measurement in hemolysis and blood loss will generate lower result than it should be.
In hemolysis and blood loss, measurement of HbA1c will yield falsely low result, giving us a false idea that blood glucose in the last 120 days has been low while it actually has not. Is this phenomenon caused by a reduction in the amount of hemoglobin?
The answer is no. HbA1c is measured in percentage against total hemoglobin, so a whole reduction of hemoglobin will cause a decrease in both the amount of HbA1c and the amount of total hemoglobin. In such a condition, Hba1c percentage measured will roughly be the same.
Still, in hemolysis and blood loss, HbA1c does go lower. So how can it be? This is because in hemolysis and blood loss, erythrocyte population is filled with a larger amount of young erythrocytes, resulting from the body’s effort to compensate for hemoglobin reduction. Young erythrocytes have less exposure time to blood glucose, and thus, have less amount of HbA1c. This is why HbA1c measurement in hemolysis and blood loss will generate lower result than it should be.
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