LOINC
Version 2.67

59261-8Hemoglobin A1c/Hemoglobin.total in Blood by IFCC protocolActive

Term Descriptions

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. Source: Regenstrief Help

Fully-Specified Name

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

Additional Names

Short Name
Hgb A1c SFr Bld IFCC
Display Name
HbA1c IFCC protocol (Bld) [Molar fraction]

Basic Attributes

Class
HEM/BC
Type
Laboratory
First Released
Version 2.32
Last Updated
Version 2.42
Order vs. Observation
Both

Reference Information

Type Source Reference
Webcontent Lab Tests Online®Copyright Copyright © 2001-2019 American Association for Clinical Chemistry Hemoglobin A1c

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

zh-CNChinese (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
nl-NLDutch (NETHERLANDS)
hemoglobine A1c/hemoglobine.totaal:stoffractie:moment:bloed:kwantitatief:IFCC-protocol
fr-BEFrench (BELGIUM)
Hémoglobine A1c/Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
fr-CAFrench (CANADA)
Hémoglobine A1c/Hémoglobine.totale:Fraction de substance:Temps ponctuel:Sang:Quantitatif:IFCC
fr-FRFrench (FRANCE)
Hemoglobin A1c/Hemoglobin.total:SFr:Pt:Bld:Qn:IFCC
de-ATGerman (AUSTRIA)
Hämoglobin A1c IFCC
it-ITItalian (ITALY)
Emoglobina A1c/Emoglobina.totale:SFr:Pt:Sangue:Qn:IFCC
pt-BRPortuguese (BRAZIL)
es-ESSpanish (SPAIN)
Hemoglobina A1c (Hemoglobina glicosilada)/Hemoglobina.total:Fraccion de sustancia:Punto temporal:Sangre:Qn:Método IFCC
tr-TRTurkish (TURKEY)
Hemoglobin A1c/Hemoglobin.total:SubFr:Zmlı:Kan:Kant:IFCC

Example Units

Unit Source
% Example UCUM Units
mmol/mol Original Submission

LOINC FHIR® API Example - CodeSystem Request Get Info

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