Fragmento

Several factors might result in falsely high or low HbA1c levels; some of those are common in patients with liver diseases. Falsely high HbA1c levels were related to severe hyperbilirubinemia and alcoholism. On the other hand, HbA1c values are decreased in patients with liver cirrhosis and are not an accurate parameter for glycemic control in those patients, especially in the setting of a more advanced liver disease. Cacciatore, et al. when comparing cirrhotics with nondiabetic subjects with chronic hepatitis without cirrhosis and healthy controls showed that HbA1c levels were not different between groups, even though glucose intolerance and diabetes were present 15% and 27% of the cirrhotics, respectively. Nomura, et al. also observed similar HbA1c levels between patients with cirrhosis and nondiabetic controls, even though blood glucose was significantly higher in cirrhotics as compared to controls. More recently, a study included 200 patients with decompensated cirrhosis evaluated for liver transplant with HbA1c measurement and three glucose levels available for estimating HbA1c based on blood glucose. In this study, a difference > 0.5% between “measured HbA1c” and “calculated HbA1c” was observed in 47% of patients and HbA1c was < 5% in 49% of the cases. The reasons for that are not completely understood, but a possible explanation is the shortened erythrocyte life span and anemia frequent observed in patients with cirrhosis.

Palabras clave:

2017-05-03   |   1,087 visitas   |   Evalua este artículo 0 valoraciones

Vol. 16 Núm.3. Mayo-Junio 2017 Pags. 469-470 Ann Hepatol 2017; 16(3)