Does the absolute HbA1c improve the genotype-phenotype association in Type 2 Diabetes?

Authors: Alexandra Fiott, Pace N, R. Galdies, J. Vassallo, A.E. Felice

Corresponding: Alexandra Fiott (lexi.

Keywords: HbA1c, Hb variants, HPLC, diabetes, SNPs, genetics


Issue: Xjenza Online Vol. 2 Iss. 1 - March 2014

HbA1c is a measure of the mean blood glucose levels for the prior 90 - 120 days, the mean life- time of red blood cells. However, factors that in uence the erythrocyte turnover or the biochemical structure of haemoglobin (Hb) might complicate the interpretation of results. With a frequency of haemoglobinopathies of around 5% in the Maltese population, an alternative biomarker should be considered. The aim of this study was to determine whether the absolute HbA1c could improve the genotype-phenotype association in Type 2 Diabetes Mellitus (T2DM) and whether it could thus be an alternative measure. Ion-exchange high performance liquid chromatogra- phy (HPLC) and polymerase chain reaction (PCR) were used to genotype and phenotype ve different groups of subjects: haematologically normal adult con- trols, anaemics (Hb<10g/dL), B-thalassaemics, normal pregnant women and type 2 diabetics (controlling their diabetes either by diet alone, or using metformin for up to six months). The single nucleotide polymorphisms (SNPs) selected were in the ADRB2, LEP, FABP2, TCF7L2, MIF, IL6 and UCP1 genes. Statistical analysis showed that the absolute HbA1c did not improve the genotype-phenotype association, as it showed the same trends as the relative HbA1c. The difference between the HbF and HbA1c is due to the homogenous distribution of HbA1c among erythrocytes, unlike HbF. In vitro glycation showed that Hb Beta- Valletta, found in 1.8% of Maltese adults, does not in uence glycation and thus the HbA1c is not in uenced by this variant in heterozygotes/ homozygotes.

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