Monitoring novel modified hemoglobin using mass spectrometry contributes to accurate blood glucose management of the Han Chinese population

Background: The goal of this study was to detect novel modified forms of hemoglobin using mass spectrometry (MS) and to investigate the effect of modified hemoglobin on HbA1c and fasting plasma glucose (FPG).

Methods: This study was conducted on 1200 subjects aged >25 years. Hemoglobin from the above-mentioned subjects was detected using direct-infusion electrospray ionization-MS, and HbA1c and FPG were measured according to the manufacturer's instructions. Regression analysis was performed to estimate the correlations and interactions among HbA1c, FPG, and modified hemoglobin.

Results: Multiple modified forms (α₁, α₂, α₃, β₁, β₂, and β₃) of hemoglobin were observed using MS. Statistical analyses indicated that modified hemoglobin was significantly correlated with FPG (p ≤ .01). The association of FPG with α₁% (p = .021) and β₃% (p < .001) values was independent of HbA1c% and other modified forms of hemoglobin. Interaction analyses implied two significant interaction effects of HbA1c% with gender (β = -0.184, p = .007) and α₃% (β = -0.104, p < .001) on FPG. The relationship between HbA1c% and FPG was stronger in males than in females, and a decreased level of α₃% also affected the association of HbA1c% and FPG.

Conclusions: This MS-based method is an effective tool for monitoring glycated forms of hemoglobin than traditional approaches. For the Han Chinese population, multiple-glycated hemoglobin affects the association of FPG with HbA1c%, and the correlation between FPG and HbA1c% in females is different from that in males. These data suggest that the HbA1c criteria for the diagnosis and monitoring of diabetes should be established according to genders and modified types of hemoglobin.