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Hemoglobin E disease and glycosylated hemoglobin.
Niharika Yedla1, Mohammad Shafi Kuchay1, Ambrish Mithal1
1Department of Endocrinology and Diabetes, Medanta - The Medicity, Gurgaon, Haryana, India.
Indian Journal of Endocrinology and Metabolism
|October 2, 2015
Summary
Hemoglobin E variant can interfere with glycosylated hemoglobin (HbA1C) testing accuracy. Clinicians must recognize potential underestimation of glycemic control in patients with Hb E.
Area of Science:
- Clinical Chemistry
- Hematology
- Diabetes Mellitus Research
Background:
- Glycosylated hemoglobin (HbA1C) is crucial for monitoring diabetes mellitus.
- Hemoglobin (Hb) variants can impact the accuracy of HbA1C measurements.
- Hb E is prevalent in South-east Asia and North-east India.
Purpose of the Study:
- To highlight the challenges in HbA1C estimation in the presence of Hb E.
- To inform clinicians about potential inaccuracies in glycemic control monitoring.
Main Methods:
- Comparison of HbA1C detection methods (ion-exchange chromatography, immunoassay, boronate affinity chromatography) in the presence of Hb E.
- Correlation of HbA1C results with plasma glucose and serum fructosamine levels.
Main Results:
- HbA1C may be undetectable by ion-exchange chromatography (HPLC) with Hb E.
- Immunoassay and boronate affinity chromatography can estimate HbA1C, but may underestimate true values.
- Underestimated HbA1C results may not accurately reflect glycemic control.
Conclusions:
- Clinicians must be aware of Hb E's interference with HbA1C assays.
- Alternative or complementary methods may be needed for accurate glycemic monitoring in patients with Hb E.
- Understanding Hb variant interference is vital for effective diabetes management.
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