CHROMATOGRAPHIC EVALUATION OF MINOR HEMOGLOBINS - CLINICAL-SIGNIFICANCE OF HEMOGLOBIN A(1D), COMPARISON WITH HEMOGLOBIN A(1C), AND POSSIBLEINTERFERENCES

Using an HPLC procedure, we evaluated > 10 minor hemoglobins (Hbs) in healthy adults, individuals on longterm aspirin therapy, diabetic subj ects, and uremic patients. Hb A(1c) and Hb A(1d3) were the most abunda nt and important minor Hb components, respectively, accounting for 4.1 0% +/- 0.50% and 3.46% +/- 0.43% of total Hb in 361 healthy subjects. Acetylated Hb A was a potential interferent in the measurement of Hb A (1c). The amounts of both Hb A(1d3) and Hb A(1carb) were significantly increased in uremic patients, indicating that these Hb adducts may be carbamylated. There was a significant correlation (r = 0.69, P < 0.00 01) between the amounts of Hb A(1d3) and plasma urea in uremic patient s. Nonuremic subjects were clearly separated from uremic patients with regard to the Hb A(1d3) content of their total Hb. Our data suggest t hat Hb A(1d3) is useful for assessment of the uremic state and that th e combination of Hb A(1c) and Hb A(1d3) could be well-suited for simul taneous control of carbohydrate and urea metabolism.