Association of hemoglobin H (HbH) disease with hemoglobin A_1c and glycated albumin in diabetic and non-diabetic patients

Objectives: Hemoglobin A_1c (HbA_1c) and glycated albumin (GA) are glycemic control status indicators in patients with diabetes mellitus. Hemoglobin H (HbH) disease is a moderately severe form of α-thalassemia. Here we examine the usefulness of HbA_1c and GA in monitoring glycemic control in patients with HbH disease.

Methods: HbA_1c, GA, and an oral glucose tolerance test were performed in 85 patients with HbH disease and 130 healthy adults. HbA_1c was measured using five methods, including two systems based on cation-exchange high-performance liquid chromatography (Variant II Turbo 2.0 and Bio-Rad D100), a capillary zone electrophoresis method (Capillarys 3 TERA), a boronate affinity HPLC method (Premier Hb9210), and an immunoassay (Cobas c501).

Results: Significant lower levels of HbA_1c were observed in patients with HbH disease than in healthy adults. In contrast, GA showed no statistically significant differences between participants with and without HbH disease. A considerable number of diabetic patients with HbH disease would be missed if using HbA_1c as a diagnostic criterion for diabetes mellitus.

Conclusions: GA but not HbA_1c is suitable for monitoring glycemic control in patients with HbH disease that can modify the discriminative ability of HbA_1c for diagnosing diabetes.