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Hemoglobin A1c determination in the A1C-Derived Average Glucose (ADAG) study

  • Erna Lenters-Westra and Robbert J. Slingerland
Published/Copyright: November 1, 2008
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 46 Issue 11

Abstract

Background: The A1C-Derived Average Glucose (ADAG) study was commenced to gain a better understanding of the relationship between HbA1c and average blood glucose and to investigate if HbA1c could be expressed in the same units as day-to-day glucose monitoring. Owing to the impact of the outcome of this study it was very important to determine HbA1c values with a minimum of uncertainty and as close as possible to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) primary reference method, which is the only valid anchor of HbA1c standardization.

Methods: Approximately 2300 samples were analyzed with four IFCC secondary reference methods. Additional off-line calibration with IFCC secondary reference material with assigned IFCC values was performed to improve the uncertainty in the HbA1c value determination.

Results: Additional off-line calibration improved the 95% confidence interval between the four different HbA1c methods at HbA1c of 6.00% from ±0.28% (5.72%–6.28%) to ±0.20% (5.80%–6.20%) and at HbA1c of 9.00% from ±0.43% (8.57%–9.43%) to ±0.24% (8.76%–9.24%).

Conclusions: The HbA1c results used in the ADAG study were determined with the lowest uncertainty technically feasible by using four certified IFCC secondary reference methods and additional off-line calibration with IFCC secondary reference material.

Clin Chem Lab Med 2008;46:1617–23.

Keywords: glycohemoglobin; HbA1c; International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) primary reference method; IFCC reference system; secondary reference material
Corresponding author: Erna Lenters-Westra, Isala klinieken, Department of Clinical Chemistry, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands Phone: +31-38-4242-476, Fax: +31-38-4242-676,
Received: 2008-5-26
Accepted: 2008-8-1
Published Online: 2008-11-01
Published in Print: 2008-11-01

©2008 by Walter de Gruyter Berlin New York

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https://doi.org/10.1515/CCLM.2008.322
Keywords for this article
glycohemoglobin; HbA1c; International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) primary reference method; IFCC reference system; secondary reference material

Articles in the same Issue

  1. Editorial
  2. Biochemical markers in clinical cardiology: perspectives from present to future. 1st IFCC-Ortho Clinical Diagnostics Conference on Clinical Diagnosis and the Clinical Laboratory
  3. Highlight: Cardiovascular Biomarkers
  4. Reviews
  5. The clinical impact of the universal diagnosis of myocardial infarction
  6. Troponin revisited 2008: assay performance
  7. Standardization of troponin I measurements: an update
  8. Biochemistry of B-type natriuretic peptide – where are we now?
  9. Clinical relevance of non-cardiac determinants of natriuretic peptide levels
  10. What is the value of B-type natriuretic peptide testing for diagnosis, prognosis or monitoring of critically ill adult patients in intensive care?
  11. Natriuretic peptide testing in primary care patients
  12. Natriuretic peptide testing in emergency settings
  13. Minireviews
  14. Oxidative stress, free radicals and bone remodeling
  15. Plasma homocysteine and vascular disease in elderly patients with mental illness
  16. Opinion Papers
  17. Fate of abstracts presented at the 2002 IFCC meeting
  18. Transition from congress abstract to full paper: the case of a national Argentinean congress in clinical laboratory
  19. Genetics and Molecular Diagnostics
  20. Association of endothelin-1 gene polymorphisms with variant angina in Korean patients
  21. Single nucleotide polymorphisms in ABCG5 and ABCG8 genes in Chilean subjects with polygenic hypercholesterolemia and controls
  22. Paternal exclusion: allele sharing in microsatellite testing
  23. General Clinical Chemistry
  24. Rapid sample preparation and simultaneous quantitation of prostaglandins and lipoxygenase derived fatty acid metabolites by liquid chromatography-mass spectrometry from small sample volumes
  25. Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy
  26. Aggregation of lipoprotein and inflammatory parameters in families with a history of premature myocardial infarction: the Tallinn Myocardial Infarction Study
  27. Significant elevation of a Th2 cytokine, interleukin-10, in pelvic inflammatory disease
  28. Hemoglobin A1c determination in the A1C-Derived Average Glucose (ADAG) study
  29. The effect of the mode of delivery on maternal-neonatal interleukin-6, biogenic amine and their precursor amino acid concentrations
  30. A rapid liquid chromatography-tandem mass spectrometry analysis of whole blood sirolimus using turbulent flow technology for online extraction
  31. Validation and Outcome Studies
  32. Benefits of the iQ200 automated urine microscopy analyser in routine urinalysis
  33. Electrochemical detection of blood alcohol concentration using a disposable biosensor based on screen-printed electrode modified with Nafion and gold nanoparticles
  34. About the z-multiplier in total error calculations
  35. Letters to the Editor
  36. A hypothyroid patient with increased free thyroid hormones
  37. Evaluation of blood collection tubes specific for homocysteine measurement
  38. Influence of assay-dependent variability of serum insulin levels on insulin sensitivity indices
  39. Frequency and type of preanalytical errors in a laboratory medicine department in India
  40. Sample dilution causes a positive bias on C-reactive protein using VITROS reagents, diluents and instruments – clinical implications?
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