59261-8  Hemoglobin A1c/​Hemoglobin.total in Blood by IFCC protocolHemoglobin A1c/​Hemoglobin.total in Blood by IFCC protocolHemoglobin A1c/​Hemoglobin.total: SFr: Pt: Bld: Qn: IFCC  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Hemoglobin A1c/Hemoglobin.total  SFr  Pt  Bld  Qn  IFCC
  Long Common Name:  Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
  Short Name:  Hgb A1c SFr Bld IFCC
  Display Name:  HbA1c IFCC protocol (Bld) [Molar fraction]

TERM DEFINITION/DESCRIPTION(S)
  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 %.
 
 
  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).
 
 

PART DEFINITION/DESCRIPTION(S)
  Part: 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.
 
 

BASIC ATTRIBUTES
  Class/Type: HEM/BC/Lab
  First Released in Version: 2.32
  Last Updated in Version: 2.42
  Order vs. Obs.: Both
  Status: Active

SUBMITTER'S INFORMATION
  Submitted Units: mmol/mol

EXAMPLE ANSWERS
  HbA1c (IFCC) 53 mmol/mol

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67767-4 HEDIS 2012 panel
  72199-3 HEDIS 2013 panel
  74234-6 HEDIS 2014 Value Sets
  

PARTS

Part Type    Part No.  Part Name   
Component   LP16413-4  Hemoglobin A1c 
     Divisors   LP32069-4  Hemoglobin.total 
Property   LP6866-0  SFr   [Substance Fraction] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7057-5  Bld   [Blood] 
Scale   LP7753-9  Qn 
Method   LP99992-7  IFCC   [IFCC protocol] 
Fragments for synonyms   LP21089-5  Total 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from 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
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  hemoglobine A1c/​hemoglobine.totaal:stoffractie:moment:bloed:kwantitatief:IFCC-protocolhemoglobine A1c/​hemoglobine.totaal:stoffractie:moment:bloed:kwantitatief:IFCC-protocol
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Hémoglobine A1c/​Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCCHémoglobine A1c/​Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Hémoglobine A1c/​Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCCHémoglobine A1c/​Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Hemoglobin A1c/​Hemoglobin.total:SFr:Pt:Bld:Qn:IFCCHemoglobin A1c/​Hemoglobin.total:SFr:Pt:Bld:Qn:IFCCHémoglobine A1c/​hémoglobine totale [Fraction molaire] Sang ; Numérique ; IFCC
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Hämoglobin A1c IFCC
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Emoglobina A1c/​Emoglobina.totale:SFr:Pt:Sangue:Qn:IFCCEmoglobina A1c/​Emoglobina.totale:SFr:Pt:Sangue:Qn:IFCC
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Hemoglobina A1c/​Hemoglobina.total::Pt:SgTotal:Qn:ImunofluorescênciaCCHemoglobina A1c/​Hemoglobina.total::Pt:SgTotal:Qn:ImunofluorescênciaCC
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Hemoglobina A1c (Hemoglobina glicosilada)/​Hemoglobina.total:Fraccion de sustancia:Punto temporal:Sangre:Qn:Método IFCCHemoglobina A1c (Hemoglobina glicosilada)/​Hemoglobina.total:Fraccion de sustancia:Punto temporal:Sangre:Qn:Método IFCC
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Hemoglobin A1c/​Hemoglobin.total:SubFr:Zmlı:Kan:Kant:IFCCHemoglobin A1c/​Hemoglobin.total:SubFr:Zmlı:Kan:Kant:IFCC

RELATED NAMES
  Blood HbA1c Quant
  GHb HEMATOLOGY/CELL COUNTS Quantitative
  Glycated hemoglobin Hgb Random
  Glycohaemogolobin Hgb A1c Substance fraction
  Glycohemogolobin International Federation of Clinical Chemistry and Laboratory Medicine Tot
  Glycosylated hemoglobin Percent Totl
  HA1c Point in time WB
  Haemoglobin QNT Whole blood
  Hb Quan  

EXAMPLE UNITS
  Unit  Source Type
  EXAMPLE UCUM UNITS 
  mmol/mol  ORIGINAL SUBMISSION 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit: 
  Source Type:  ORIGINAL SUBMISSION 
  Unit:  mmol/mol 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:24:32 PM
  Attachment Units Required: N
  Long Common Name: Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocol
  Shortname: Hgb A1c SFr Bld IFCC
  Fully Specified Name: Hemoglobin A1c/Hemoglobin.total: SFr: Pt: Bld: Qn: IFCC
     
  Component Word Count: 4
  ID: 54111
  Status (Raw): ACTIVE