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Hi All,
Can you please provide feedback on an existing concept in SNOMED CT: 259689004 | Glycosylated hemoglobin (substance)?
This concept has a synonym of "Glycated hemoglobin". Although the terms seem to be used interchangeably, there appears to be inconsistency in their usage. We believe that they are not synonymous and that we need three separate concepts to represent Glycated hemoglobin, Glycosylated hemoglobin, and HgA1c (possibly as a child for Glycated hemoglobin?).
We identified issues for the terms that use this concept in their modelling. Some example are as following: Glucohemoglobin measurement (procedure) | SCTID: 40402000 seems to be misspelled and we are not sure if it is needed as a grouper. Perhaps it is an order? Glucose measurement estimated from glycated hemoglobin (procedure) - SCTID: 117346004 doesn’t seem to have the correct modelling
There are a few other concepts that might be affected; e.g. concepts containing HgA1c.
Hemoglobin is glycated through a non-enzymic reaction, not an enzymic reaction as indicated by the description “glycosylated” Roth M. «Glycated hemoglobin,» not «glycosylated» or «glucosylated». Clin Chem 1983; 29: 1991
The doctors reference in Australia: Lab tests online http://www.labtestsonline.org.au/learning/test-index/hba1c have the two names as synonyms. So even though old textbooks and articles, use the glycosylated hemoglobin to describe what actually is glycated hemoglobin (HbA1c) I think it should remain a synonym.
I asked the question in Canada and here is one response I got:
Glycosylation is an enzyme catalyzed process of adding sugar/saccharides and is part of the post-translational modifications of proteins. The modified protein becomes functional.
Glycation is a non-enzymatic process of adding sugar/saccharides, and is a form of protein damage as glycated proteins have reduced functionality.
HbA1c is the glycated hemoglobin, through a non-enzymatic reaction occurs between glucose and the n-terminal of hemoglobin beta chain. It is a DM marker.
5 Comments
Daniel Karlsson
From the original request
Hemoglobin is glycated through a non-enzymic reaction, not an enzymic reaction as indicated by the description “glycosylated” Roth M. «Glycated hemoglobin,» not «glycosylated» or «glucosylated». Clin Chem 1983; 29: 1991
Alexis Carter (Ihtsdo US)
I’m afraid that the problem will be what is in common usage may not match up with what is listed as chemically accurate.
Daniel Karlsson
Absolutely true, but then we should at least make the fully specified name correct.
Michael Osborne
The doctors reference in Australia: Lab tests online http://www.labtestsonline.org.au/learning/test-index/hba1c have the two names as synonyms. So even though old textbooks and articles, use the glycosylated hemoglobin to describe what actually is glycated hemoglobin (HbA1c) I think it should remain a synonym.
Lorie Carey
I asked the question in Canada and here is one response I got:
Glycosylation is an enzyme catalyzed process of adding sugar/saccharides and is part of the post-translational modifications of proteins. The modified protein becomes functional.
Glycation is a non-enzymatic process of adding sugar/saccharides, and is a form of protein damage as glycated proteins have reduced functionality.
HbA1c is the glycated hemoglobin, through a non-enzymatic reaction occurs between glucose and the n-terminal of hemoglobin beta chain. It is a DM marker.
Yu Chen MD, PhD, FACB, FCACB, DABCC (Clin Chem; Toxicology)
Medical Biochemist Chief and Medical Director, Department of Laboratory Medicine
Dr. Everett Chalmers Regional Hospital, Horizon Health Network
700 Priestman Street, Fredericton, NB E3B 5N5, Canada
Tel: (506) 452-5443, Fax: (506) 452-5422
Email: Yu.Chen@HorizonNB.Ca
Associate Professor, Dept. of Pathology, Dalhousie University