Measurment of stable Glycosylated Hemoglobin (Hb A1) and Its unstable type (pre- Hb A1c) with the lon- exchange Chromatography in Diabetic patients

SUMMARY: At present, measurment of glycosylated hemoglobin, especially the stable fraction of hemoglobin (HbA1c) is one of the ways to control diabetes because this measurment can demonstrate total glycemia during last 1.2.3 months. Glycosylated hemoglobin is seen in 3 forms: Ala Alb A1c. Among these hemoglobin Alc is quantitively more than other 2 forms and its difference with other hemoglobins in terms of chemical structure is the linkage of a molecule of glucose in N-terminal of β chain on the aminoacid of Valine without intervention of enzyme. Glycogenesis of this protein (Hb A1c)occurs very slowly and this process continues in the all life-time of red globules. Formation of Hb A1c takes place in 2 different phases: First phase: Appearance of the unstable form called aldimine or pre HbA1c which is reversible and its formation is very faster than the second phase. Second phase: Formation of Ketoamine or stable form of glycosylated hemoglobin. The main goal in this article is to make a comparison between the rate of unstable glycosylated hemoglobin and its stable fraction with glycemia. The results obtained indicate that there is a close correlation between total glycosylated hemoglobin and its unstable fraction. The rate of unstable glycosylated hemoglobin enhances with the increase of hemoglobin. Correlation between glycosylated hemoglobin and glycemia in the state of fast which has been experimented on the same blood sample, is direct and meaningful. A Comparison between the linkage of stable and unstable glycosylated hemoglobins with glycemia rate divided into 4 different (1g/L, 1-2g/L, 2-3g/L, 3-4g/L), indicates that the contents of stable and unstable hemoglobins have a direct relation with glycemia, i.e, the more the content of glycemia, the more will be the contents of stable and unstable hemoglobins, and the linkage of stable fraction with glycemia is always better than the unstable fraction In addition, the close linkage between the fractions of stable and unstable glycosylated hemoglobin reflects that diabetic patients who are not under complete control, the content of pre-Hb A1c, a marker of glycemia changes in the short-term, and stable glycosylated hemoglobins, a marker of glycemia changes in the long-term, will increase simultaneously.