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HbA1c method evaluation for postmortem samples.

Terhi Keltanen¹, Antti Sajantila, Tiina Valonen

¹Department of Forensic Medicine, University of Helsinki, Kytösuontie 11, 00300, Helsinki, Finland, terhi.keltanen@helsinki.fi.

Forensic Science, Medicine, and Pathology

|December 25, 2014

Summary

Glycated hemoglobin (HbA1c) analysis from postmortem blood is reliable and cost-effective using automated HPLC. This method aids in diagnosing diabetic ketoacidosis and other causes of death.

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Area of Science:

Forensic Medicine
Clinical Chemistry
Biomarker Analysis

Background:

Glycated hemoglobin (HbA1c) is crucial for diabetes diagnosis and glycemic control monitoring.
HbA1c is a stable biomarker suitable for postmortem blood analysis, correlating well with clinical data.

Purpose of the Study:

To evaluate the reliability and cost-effectiveness of automated HPLC for HbA1c analysis in postmortem blood.
To assess the utility of postmortem HbA1c in cause of death investigations, particularly for differentiating diabetic ketoacidosis.

Main Methods:

Analysis of autopsy data from 55 cases, including glucose, lactate, ketone bodies, and HbA1c.
Parallel analysis of 71 samples using Mono S HPLC and automated BioRad D-10 HPLC.
Comparison of results from 64 samples using Bland-Altman plots.

Main Results:

Automated HPLC provides reliable and cost-effective HbA1c analysis from postmortem samples.
HbA1c levels are valuable in distinguishing diabetic ketoacidosis from other causes of death.

Conclusions:

Automated HPLC is a suitable method for postmortem HbA1c determination.
HbA1c analysis in postmortem samples is essential for accurate cause of death determination, especially in ketoacidotic cases.