Version 2.77

Term Description

This term is not proposed for use in the United States, who will continue to use the NGSP protocol and report the Hgb A1c as %.
Source: Regenstrief LOINC

Hemoglobin A1c measured using IFCC reference materials. The International Federation of Clinical Chemistry Working Group (IFCC-WG) on HbA1c has recommended a new approach to HbA1c analysis that uses mass spectroscopy and capillary electrophoresis as the reference methods, and set of reference laboratories that use prepared mixtures of purified Hemoglobin A1c and HbA0 as calibrators. (http://www.ngsp.org/prog/IFCCstd.pdf). The IFCC method is reported as millimoles/Mole - which resolves to units that are ten times the value of a pure fraction. The value number produced by the IFCC method differs by less than a factor of ten from the NGSP approach which has been the standard in clinical care since DCCT/UKPDS diabetes studies. A value of 6% under the NGSP method would be 42.8 millimole/mole when tested by the IFFCC approach (per the conversion formula in the above reference). Many countries will report the IFCC value along with the NGSP values and the estimated average glucose - at least for a time. In the US the policies are not as clear and there is at least a chance of no change in the current reporting style will occur. (Source- many- written by CJM 2010 04 27).
Source: Regenstrief Help

Part Description

LP16413-4   Hemoglobin A1c
Currently (2010), four standardization protocols exist for measuring Hgb A1c:

1. IFCC - designated as a Reference Method or RM (http://www.ifcchba1c.net/)
2. NGSP - the long standing protocol used in the US and most other countries since the DCCT study (http://www.ngsp.org/factors.asp)
3.JDS/JSCC - a protocol used in Japan, Spain and possibly other countries
4. Swedish - used in Sweden at least

Protocols 2-4 are known as Designated Comparison Methods (DCM) and have been connected to the Reference Method and each other through various regression equations.

Because of the high degrees of standardization within protocol it should no longer be necessary to specify a LOINC code with a method such as "HPLC", "electrophoresis" or anything else. Analytical instruments will be designed so that an Hgb A1c result can be traced back to a specific standardization protocol, so the important distinction will be the standardization protocol as described above and which will be carried in the method field.

A meeting of instrument manufacturers (presumably including Japanese) in Milan, Italy, December 12, 2007, agreed (among other items) that:

-All manufacturers should implement worldwide the traceability to the IFCC reference system for Hgb -A1c.
-All new instruments sold after January 1st, 2011 will report (as a result of an Hgb A1c test) both SI (mmol/mol - no decimals) and NGSP derived units (percentage - one decimal), in agreement with the Consensus Statement.
-Note they only committed to supporting protocol (1) and (2)

Different countries are adopting the international harmonization recommendations in different ways. We have information from the NGSP that the US will continue to report only Hgb A1c/NGSP, with the unit percent - i.e., no change. In Great Britain, labs have already started to report all results both as Hgb A1c (NGSP) in % and Hgb A1c (IFCC) in mmol/mol. In Canada, they are awaiting a recommendation from an expert panel. Any of these measures could be reported in the same units, but the convention for the reporting Hgb A1c under the new IFCC protocol will be to use units of mmol/mol to avoid confusion between the DCCT/NGSP and the IFFCC protocol.

LOINC has defined 59261-8 (Hemoglobin A1c/Hemoglobin.total in Blood) by IFCC protocol.

These protocols produce different results when expressed in the same units. For example, the equivalent of Hgb A1c (NGSP) of 6.5% is Hgb A1c (IFCC) is 4.8%.

The NGSP web site (http://www.ngsp.org/factors.asp) suggests the use of alternate measures, such as glycated albumen, for patients with severe iron deficiency, dialysis patients, and those with SS SC CC because of over or under reading that can occur with these interferences. It also describes the effect of abnormal hemoglobins on results of HbA1c by instrument.

Studies have demonstrated racial and ethnic differences in the relationship between glucose levels and hemoglobin A1C [22238408], and it has been suggested that some descendants of sub-Saharan Africa may have higher levels of measured hemoglobin A1C compared to glucose levels due to hemoglobin variants PMID: 31675503. Source: Regenstrief Help

Reference Information

Type Source Reference
Webcontent Lab Tests Online®Copyright Copyright © 2021 Lab Tests Online. All rights reserved. Hemoglobin A1c

Fully-Specified Name

Component
Hemoglobin A1c/Hemoglobin.total
Property
SFr
Time
Pt
System
Bld
Scale
Qn
Method
IFCC

Additional Names

Short Name
HbA1c SFr Bld IFCC
Display Name
HbA1c IFCC protocol (Bld) [Molar fraction]
Consumer Name Alpha Get Info
HbA1c/Total Hgb, Blood

Basic Attributes

Class
CHEM
Type
Laboratory
First Released
Version 2.32
Last Updated
Version 2.73
Change Reason
Release 2.70: CLASS: Changed Class from HEM/BC to CHEM as A1C tests are more correctly classified in CHEM.;
Order vs. Observation
Both
Common Test Rank Get Info
2804

Member of these Panels

LOINC Long Common Name
67767-4 HEDIS 2012 panel
72199-3 HEDIS 2013 panel
74234-6 HEDIS 2014 Value Sets

Language Variants Get Info

Tag Language Translation
de-AT German (Austria) Synonyms: Hämoglobin A1c IFCC
de-DE German (Germany) Hämoglobin A1c/Hämoglobin.gesamt:Stoffmengenfraktion:Zeitpunkt:Blut:Quantitativ:International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)-Protokoll
Synonyms: HbA1c
es-ES Spanish (Spain) Hemoglobina A1c (Hemoglobina glicosilada)/Hemoglobina.total:Fraccion de sustancia:Punto temporal:Sangre:Qn:Método IFCC
Synonyms: Cuantitativo
es-MX Spanish (Mexico) Hemoglobina A1c / Hemoglobina total:Fracción de sustancia:Punto temporal:Sangre:Cuantitativo:Protocolo IFCC
fr-CA French (Canada) Hémoglobine A1c/Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
fr-FR French (France) Hémoglobine A1c/hémoglobine totale:Fraction molaire:Ponctuel:Sang:Numérique:IFCC
fr-BE French (Belgium) Hémoglobine A1c/Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
Synonyms: Fraction. Concentration Hb Hb.totale HbA1c International Federation Clinical Chemistry
it-IT Italian (Italy) Emoglobina A1c/Emoglobina.totale:SFr:Pt:Sangue:Qn:IFCC
Synonyms: Chimica Emoglobina A1c (HgB glicata ) Frazione di Sostanza Protocollo IFCC Punto nel tempo (episodio) Sangue
nl-NL Dutch (Netherlands) hemoglobine A1c/hemoglobine.totaal:stoffractie:moment:bloed:kwantitatief:IFCC-protocol
pl-PL Polish (Poland) Hemoglobina A1c/hemoglobina całkowita:frakcja molowa:punkt w czasie:krew:ilościowy:protokół IFCC
Synonyms: Hemoglobina A1c/Hemoglobina całkowita
pt-BR Portuguese (Brazil) Hemoglobina A1c/Hemoglobina.total::Pt:SgTotal:Qn:ImunofluorescênciaCC
tr-TR Turkish (Turkey) Hemoglobin A1c/Hemoglobin.total:SubFr:Zmlı:Kan:Kant:IFCC
zh-CN Chinese (China) 血红蛋白 A1c/血红蛋白.总计:物质的量分数:时间点:全血:定量型:IFCC
Synonyms: GHb;HA1c;HBA1c;Hgb A1c;糖化血红蛋白;糖基化血红蛋白;血红蛋白 A1c (糖化血红蛋白) IFCC 方案;International Federation of Clinical Chemists;IFCC;国际临床化学家联合会;国际临床化学联合会;International Federation of Clinical Chemistry and laboratory medicine;国际临床化学和实验室医学联盟;国际临床化学与检验医学联合会 克分子分数;摩尔分数 全体数量 全部 共计 化学;化学检验项目;化学检验项目类;化学类;化学试验;非刺激耐受型化学检验项目;非刺激耐受型化学检验项目类;非刺激耐受型化学试验;非刺激耐受型化学试验类 可用数量表示的;定量性;数值型;数量型;连续数值型标尺 总 总和 总数 总血红蛋白 总量 总额 时刻;随机;随意;瞬间 氧血红蛋白;血红朊;血红素;血色素 汇总 血;血液

Example Units

Unit Source
% Example UCUM Units

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=59261-8