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Hb variants in Korea: effect on HbA1c using five routine methods.

Yeo-Min Yun1, Misuk Ji1, Dae-Hyun Ko1

  • 1.

Clinical Chemistry and Laboratory Medicine
|January 21, 2017
PubMed
Summary
This summary is machine-generated.

Hemoglobin (Hb) variants significantly impact routine HbA1c assays, leading to unacceptable results in many cases. Laboratories must recognize these limitations and consider alternative quantification methods for accurate patient care.

Keywords:
HPLCHbA1cIFCC reference measurement procedurecapillary electrophoresisimmunoassayvariant hemoglobin

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Hematology

Background:

  • Accurate glycated hemoglobin (HbA1c) measurement is crucial for diabetes management.
  • Hemoglobin (Hb) variants pose a significant challenge to standard HbA1c quantification methods.
  • The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) provides a reference measurement procedure (RMP) for HbA1c.

Purpose of the Study:

  • To evaluate the performance of five routine HbA1c assays in the presence of common hemoglobin variants.
  • To compare the accuracy of these assays against the IFCC reference measurement procedure (RMP).

Main Methods:

  • Analyzed 114 whole blood samples with confirmed Hb variants.
  • Quantified HbA1c using Sebia Capillarys 2, Roche Tina-quant, Bio-Rad Variant II, ADAMS HA-8180, and Tosoh G8 assays.
  • Utilized LC-MS for the IFCC RMP as the gold standard.

Main Results:

  • Significant interference from Hb variants was observed across multiple routine assays.
  • The Bio-Rad Variant II (51%) and Tosoh G8 (95%) showed the highest rates of unacceptable HbA1c results.
  • Sebia Capillarys 2 and ADAMS HA-8180 failed to provide results for a notable number of samples with Hb variants.

Conclusions:

  • Routine HbA1c assays demonstrate variable accuracy and limitations when encountering common Hb variants.
  • Laboratories need to be aware of potential interferences specific to their local population's Hb variant profile.
  • Alternative HbA1c quantification methods should be considered to ensure reliable results in patients with Hb variants.