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Comparability of hemoglobin A1c level measured in capillary versus venous blood sample applying two point-of-care
Tahereh Keramati1, Farideh Razi2, Ali Tootee2
1Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Capillary blood hemoglobin A1c measurement is a valid alternative to venous blood testing for monitoring diabetes control. This study confirms its accuracy in differentiating between well-controlled and poorly-controlled blood glucose levels.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Diabetes Management
Background:
- Hemoglobin A1c (HbA1c) is a key biomarker for long-term glycemic control in diabetes.
- Venous blood sampling for HbA1c is standard, but capillary blood offers a less invasive alternative.
- Evaluating the accuracy of capillary HbA1c against venous HbA1c is crucial for clinical practice.
Purpose of the Study:
- To assess the validity of capillary blood hemoglobin A1c (HbA1c) measurements compared to venous blood HbA1c.
- To determine the reliability of capillary blood HbA1c for distinguishing between different levels of glycemic control.
Main Methods:
- A cross-sectional study involving 45 Iranian diabetic patients.
- Simultaneous venous and capillary blood samples were collected for HbA1c analysis.
- HbA1c levels were measured using two NGSP-certified systems: CERA STAT 2000 and NycoCard Reader II.
Main Results:
- Strong correlations were found between venous and capillary HbA1c levels (Pearson's concordance correlation coefficients of 0.96 and 0.94).
- Both CERA STAT 2000 (AUC=0.991) and NycoCard Reader II (AUC=0.935) assays showed high accuracy in differentiating glycemic control levels using capillary blood.
- While CERA STAT 2000 showed no significant difference between venous and capillary means (p=0.590), NycoCard Reader II showed a significant difference (p=0.007).
Conclusions:
- Capillary blood hemoglobin A1c measurement is a highly valuable tool for differentiating between poorly-controlled and well-controlled blood glucose levels.
- The findings support the use of capillary blood HbA1c as a reliable alternative to venous blood testing in diabetes management.
Background:
The present study is designed to evaluate the validity of the measurement of capillary blood hemoglobin A1c levels in comparison with venous blood hemoglobin A1c.
Methods:
The data of this cross-sectional study are collected from a sample of 45 Iranian diabetic patients referred to one particular laboratory for the assessment of HbA1c level during a period from April to December 2013. Venous and simultaneous capillary blood samples were obtained from each subject for measurement of hemoglobin A1c levels. Both samples were tested using two different NGSP certified systems: CERA STAT 2000 (Ceragem Medisys Inc) and NycoCard Reader II (Axis-Shield).
Results:
The mean hemoglobin A1c in venous and capillary blood samples measured using CERA STAT 2000 assays were 6.30 ± 1.68% and 6.34 ± 1.65% respectively (p = 0.590). However, when NycoCard Reader II assay was employed, the mean hemoglobin A1c in venous and capillary blood samples were 6.73 ± 1.35% and 6.92 ± 1.50% (p = 0.007). Moreover, a strong correlation was observed between venous and capillary hemoglobin A1c levels with Pearson's concordance correlation coefficients of 0.96 and 0.94 with the use of NycoCard Reader II and CERA STAT 2000 assays respectively. Application of CERA STAT 2000 demonstrated to be of a considerably higher value using the ROC curve analysis assay (AUC = 0.991). Also, similar analysis by using NycoCard Reader II assay demonstrated that capillary hemoglobin A1c measurement had high value for differentiation of uncontrolled from controlled blood glucose level (AUC = 0.935).
Conclusion:
It was demonstrated that capillary hemoglobin A1c measurement had a considerably high value for differentiating between poorly-controlled and well-controlled blood glucose levels.
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