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Although the level of glycated hemoglobin (HbA1c) indicates the body content of the advanced glycation end products, its value is underestimated in clinical practice. In order to discuss the diagnostic and prognostic value of HbA1c, we conducted a comprehensive literature review and analyzed the results of own investigation that included clinical examination and laboratory testing of 116 patients with coronary artery disease, with a detailed analysis of carbohydrate metabolism and subsequent follow-up period of up to 40 months. It was found that HbA1c level tends to represent the content of advanced glycation end products, which stimulate free radical production and oxidative modification of multiple proteins and lipids, reduce cellular transport, activate pro-inflammatory cytokines and chemokines, cause immune responses and mutations, increase the activity of adhesion molecules, and cause malfunction of receptors. Nowadays, the role of advanced glycation end products is discussed in the pathophysiology of different diseases, such as arterial hypertension, diabetic vascular complications, nephropathy, atherosclerosis, Alzheimer’s disease, dementia, cataract, premature aging, loss of muscle mass, poor wound healing, malignant tumors, etc. According to our data, HbA1c not only indicates poor metabolic control within the preceding 3 months, but also is a sensitive marker of vascular diabetic complications, atherogenic dyslipidemia, insulin resistance, systemic inflammation, coronary events, and the risk of transformation to diabetes mellitus during the next 3 years. Besides, HbA1c is an effective tool for differentiation of stress hyperglycemia, which frequently occurs in patients with acute cardiovascular events, and chronic hyperglycemia caused by overt or latent glucose dysregulation. Blood HbA1c levels should be monitored not only in diabetic patients but also in elder people, smokers, patients with atherosclerotic arterial diseases, and Helicobacter pylori infection.
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