PLoS ONE (Jan 2024)

Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults.

  • 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

DOI
https://doi.org/10.1371/journal.pone.0300028
Journal volume & issue
Vol. 19, no. 3
p. e0300028

Abstract

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BackgroundThe 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.MethodsAs 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.ResultsBased 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 (ConclusionThis 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.