Absorption spectroscopy for the estimation of glycated hemoglobin (HbA1c) for the diagnosis and management of diabetes mellitus: a pilot study

Label-free electrochemical detection of glycated hemoglobin (HbA1c) and C-reactive protein (CRP) to predict the maturation of coronary heart disease due to diabetes

The pathophysiological link between diabetes and heightened propensity for the development of coronary heart disease (CHD) is well-established. Prevailing evidence confirms that small increases in low concentrations of high-sensitivity C reactive protein (hs-CRP) in the human body can determine the tendency of developing CHD. Additionally, glycated hemoglobin (HbA1c) is a well-recognized biomarker to evaluate diabetes progression. Given the positive correlation between diabetes and CHD, this research presents a notably unprecedented label-free electrochemical approach for the dual detection of %HbA1c regarding Total Hb and hs-CRP, facilitating early CHD prediction and cost-effective point-of-care diagnostics. Furthermore, a novel redox probe O-(4-Nitrophenylphosphoryl)choline (C11H17N2O6P) was used for the electrochemical detection of CRP, a method not documented in scientific literature before. The calibration curves demonstrate a limit of detection (LOD) of 5 mg/mL in PBS (pH 8) and 6 mg/mL in simulated blood (SB) for a linear range of 0-30 mg/mL of HbA1c. Conjointly, a LOD of 0.007 mg/mL and 0.008 mg/mL for measurement in PBS (pH 7.4) and SB are reported for a linear range of 0-0.05 mg/mL of CRP. The electrochemical systems presented could accurately quantify HbA1c and CRP in mixed samples, demonstrating reasonable specificity and practical applicability for complex biological samples.

Comparison of Glycated Hemoglobin (HbA1c) Values Estimated by High-Performance Liquid Chromatography and Spectrophotometry: A Pilot Study

Background Invasive blood sample collection followed by high-performance liquid chromatography (HPLC) based analysis is the gold standard for estimating glycated hemoglobin level or HbA1c currently. Spectrophotometry could be an alternative that holds the potential to be translated into a portable, non-invasive device for glycated hemoglobin level estimation. This study compares HbA1c values obtained from HPLC and spectrophotometry. Methods Venous blood samples were collected from both diabetic and non-diabetic participants in a cross-sectional study. The samples were subjected to both HPLC and spectrophotometry-based estimation of HbA1c%. The results obtained were compared, and the relationship between the two estimations were assessed. Results About 15 diabetic and non-diabetic individuals participated in the study and 28 samples were included in the final analysis. The Pearson's correlation coefficient was 0.65 (95% CI, 0.37-0.82), indicating that there was a strong positive association. This was further supported by the findings from linear regression analysis with a p-value of <0.001. Conclusions The positive correlation between the HPLC and spectrophotometric values supports the hypothesis that spectrophotometry could be an alternative to conventional HPLC for the measurement of HbA1c. This needs to be further validated through larger, well-powered studies.

Analysis of the Site-Specific Myoglobin Modifications in the Melibiose-Derived Novel Advanced Glycation End-Product

MAGE (melibiose-derived advanced glycation end-product) is the glycation product generated in the reaction of a model protein with melibiose. The in vivo analog accumulates in several tissues; however, its origin still needs explanation. In vitro MAGE is efficiently generated under dry conditions in contrast to the reaction carried in an aqueous solvent. Using liquid chromatography coupled with mass spectrometry, we analyzed the physicochemical properties and structures of myoglobin glycated with melibiose under different conditions. The targeted peptide analysis identified structurally different AGEs, including crosslinking and non-crosslinking modifications associated with lysine, arginine, and histidine residues. Glycation in a dry state was more efficient in the formation of structures containing an intact melibiose moiety (21.9%) compared to glycation under aqueous conditions (15.6%). The difference was reflected in characteristic fluorescence that results from protein structural changes and impact on a heme group of the model myoglobin protein. Finally, our results suggest that the formation of in vitro MAGE adduct is initiated by coupling melibiose to a model myoglobin protein. It is confirmed by the identification of intact melibiose moieties. The intermediate glycation product can further rearrange towards more advanced structures, including cross-links. This process can contribute to a pool of AGEs accumulating locally in vivo and affecting tissue biology.

Optical Measurement of Molar Absorption Coefficient of HbA1c: Comparison of Theoretical and Experimental Results

Diabetes can cause dangerous complications if not diagnosed in a timely manner. The World Health Organization accepts glycated hemoglobin (HbA1c) as a measure of diagnosing diabetes as it provides significantly more information on the glycemic behavior from a single blood sample than the fasting blood sugar reading. The molar absorption coefficient of HbA1c is needed to quantify the amount of HbA1c present in a blood sample. In this study, we measured the molar absorption coefficient of HbA1c in the range of 450 nm to 700 nm using optical methods experimentally. We observed that the characteristic peaks of the molar absorption coefficient of HbA1c (at 545 nm and 579 nm for level 1, at 544 nm and 577 nm for level 2) are in close agreement with those reported in previous studies. The molar absorption coefficient values were also found to be close to those of earlier reports. The average molar absorption coefficient values of HbA1c were found to be 804,403.5 M−1cm−1 at 545 nm and 703,704.5 M−1cm−1 at 579 nm for level 1 as well as 503,352.4 M−1cm−1 at 544 nm and 476,344.6 M−1cm−1 at 577 nm for level 2. Our experiments focused on calculating the molar absorption coefficients of HbA1c in the visible wavelength region, and the proposed experimental method has an advantage of being able to easily obtain the molar absorption coefficient at any wavelength in the visible wavelength region. The results of this study are expected to help future investigations on noninvasive methods of estimating HbA1c levels.

Photoacoustic Spectroscopy and Hyperglycemia in Experimental Type 1 Diabetes

According to the World Health Organization, diabetes was the seventh leading cause of death in 2016. Long-term diabetes complications are associated with hyperglycemia. It is difficult to predict the beginning and evolution of those complications. The goal of the study was to evaluate the relationship between glycemia and blood spectroscopic variables in an experimental model of type 1 diabetes (streptozotocin model). Blood samples were taken weekly (10 weeks) from the tail of male Wistar rats with or without diabetes. Blood optical absorption spectra were obtained by means of photoacoustic spectroscopy. It was possible to estimate the time-course of blood characteristic peak ratios. The area under the curve of those peaks correlated with hyperglycemia. The evolution of the optical absorption at 450 nm, related to cytochrome p450, was obtained by using the phase-resolved method. The area under the curve of p450 correlated also with hyperglycemia. It is concluded that photoacoustic spectroscopy is a reliable technology to detect the effects of hyperglycemia on blood with possible applications in the study of long-term diabetes complications.

Characterization of glycated hemoglobin based on Raman spectroscopy and artificial neural networks

The World Health Organization has declared the glycated hemoglobin (HbA1c) as a gold standard biomarker for diabetes diagnosis; this has led to relevant research on the spectral behavior and characterization of HbA1c. This paper presents an analysis of Raman peaks of commercial lyophilized HbA1c, diluted in distilled water, using concentrations of 4.76% and 9.09%, as well as pure powder (100% concentration). Vibrational Raman peak positions of HbA1c powder were found at 1578, 1571, 1536, 1436, 1311, 1308, 1230, 1222, 1114, 1106, 969, 799 and 665 cm^-1; these values are consistent with results reported in other works. Besides, a nonlinear regression model based on a Feed-Forward Neural Network (FFNN) was built to quantify percentages of HbA1c for unknown concentrations. Using the Raman spectra as independent variables, the regression provided a Root Mean Square Error in Cross-Validation (RMSECV) of 0.08% ± 0.04. We also include a detailed molecular assignment of the average spectra of lyophilized powder of HbA1c.

Biophotonics methods for functional monitoring of complications of diabetes mellitus

The prevalence of diabetes complications is a significant public health problem with a considerable economic cost. Thus, the timely diagnosis of complications and prevention of their development will contribute to increasing the length and quality of patient life, and reducing the economic costs of their treatment. This article aims to review the current state-of-the-art biophotonics technologies used to identify the complications of diabetes mellitus and assess the quality of their treatment. Additionally, these technologies assess the structural and functional properties of biological tissues, and they include capillaroscopy, laser Doppler flowmetry and hyperspectral imaging, laser speckle contrast imaging, diffuse reflectance spectroscopy and imaging, fluorescence spectroscopy and imaging, optical coherence tomography, optoacoustic imaging and confocal microscopy. Recent advances in the field of optical noninvasive diagnosis suggest a wider introduction of biophotonics technologies into clinical practice and, in particular, in diabetes care units.

Multimodal Optical Diagnostics of Glycated Biological Tissues

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia accompanied by the disruption of carbohydrate, lipid, and proteins metabolism and development of long-term microvascular, macrovascular, and neuropathic changes. This review presents the results of spectroscopic studies on the glycation of tissues and cell proteins in organisms with naturally developing and model diabetes and in vitro glycated samples in a wide range of electromagnetic waves, from visible light to terahertz radiation. Experiments on the refractometric measurements of glycated and oxygenated hemoglobin in broad wavelength and temperature ranges using digital holographic microscopy and diffraction tomography are discussed, as well as possible application of these methods in the diabetes diagnostics. It is shown that the development and implementation of multimodal approaches based on a combination of phase diagnostics with other methods is another promising direction in the diabetes diagnostics. The possibilities of using optical clearing agents for monitoring the diffusion of substances in the glycated tissues and blood flow dynamics in the pancreas of animals with induced diabetes have also been analyzed.

Label-free quantitation of glycated hemoglobin in single red blood cells by transient absorption microscopy and phasor analysis

As a stable and accurate biomarker, glycated hemoglobin (HbA1c) is clinically used to diagnose diabetes with a threshold of 6.5% among total hemoglobin (Hb). Current methods such as boronate affinity chromatography involve complex processing of large-volume blood samples. Moreover, these methods cannot measure HbA1c fraction at single-red blood cell (RBC) level, thus unable to separate the contribution from other factors such as RBC lifetime. Here, we demonstrate a spectroscopic transient absorption imaging approach that is able to differentiate HbA1c from Hb on the basis of their distinct excited-state dynamics. HbA1c fraction inside a single RBC is derived quantitatively through phasor analysis. HbA1c fraction distribution of diabetic blood is apparently different from that of healthy blood. A mathematical model is developed to derive the long-term blood glucose concentration. Our technology provides a unique way to study heme modification and to derive clinically important information void of bloodstream glucose fluctuation.

Fluorescent 2D WS2 Nanosheets Bearing Chemical Affinity Elements for the Recognition of Glycated Hemoglobin

It is required to exfoliate and functionalize 2D transition metal dichalcogenides (TMDs) in an aqueous solution for biological and medical applications. Herein, the approach for the simultaneous exfoliation and functionalization of 2D WS₂ nanosheets using boronic acid-modified poly(vinyl alcohol) (B-PVA) in an aqueous solution is reported, and the B-PVA-functionalized WS₂ nanosheets (B-PVA-WS₂ ) are exploited as a fluorescent biosensor for the detection of glycated hemoglobin, HbA1c. The synthetic B-PVA polymer facilitates the exfoliation and functionalization of WS₂ nanosheets from the bulk counterpart in the aqueous solution via a pulsed sonication process, resulting in fluorescent B-PVA-WS₂ nanohybrids with a specific recognition of HbA1c. The fluorescence of the B-PVA-WS₂ is quenched in the presence of HbA1c, whereas PVA-functionalized WS₂ (PVA-WS₂ ), not bearing boronic acid as a recognition moiety, shows no fluorescence changes upon the addition of the target. The B-PVA-WS₂ is able to selectively detect HbA1c at the concentration as low as 3.3 × 10^-8 m based on its specific fluorescence quenching.

Emerging trends in optical sensing of glycemic markers for diabetes monitoring

In the past decade, considerable attention has been focused on the measurement of glycemic markers, such as glycated hemoglobin and glycated albumin, that provide retrospective indices of average glucose levels in the bloodstream. While these biomarkers have been regularly used to monitor long-term glucose control in established diabetics, they have also gained traction in diabetic screening. Detection of such glycemic markers is challenging, especially in a point-of-care setting, due to the stringent requirements for sensitivity and robustness. A number of non-separation based measurement strategies were recently proposed, including photonic tools that are well suited to reagent-free marker quantitation. Here, we critically review these methods while focusing on vibrational spectroscopic methods, which offer highly specific molecular fingerprinting capability. We examine the underlying principles and the utility of these approaches as reagentless assays capable of multiplexed detection of glycemic markers and also the challenges in their eventual use in the clinic.