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Published on: March 14, 2017
Effect of Diabetes Mellitus on Sickle Hemoglobin Quantitation in Sickle Cell Trait
Shih-Hon Li1, David Harro1, John Alfsen1
1Department of Pathology, University of Michigan, Ann Arbor.
Objectives:
We evaluated the effect of diabetes on sickle hemoglobin (HbS) measurement on two common clinical hemoglobin separation platforms.
Methods:
We performed a method comparison between the Bio-Rad Variant II high-performance liquid chromatography (HPLC) and Sebia Capillarys 2 Flex Piercing capillary electrophoresis (CE) using clinical specimens from 38 patients without hemoglobin variants and 57 patients with sickle cell trait (AS) (HbA1c%, 4.1%-15.4%). We investigated the effect of intermethod Hb% differences on result interpretation by a panel of expert clinical observers.
Results:
In diabetic specimens, HPLC undermeasured HbS% up to 7.4% vs CE, due to S1c eluting closely with A0 in HPLC. This increased concern for underlying α-thalassemia in diabetic patients with AS based on HPLC results. HPLC P2% was linearly related to HbA1c% and can be a screen for diabetic AS samples.
Conclusions:
Glycosylation can interfere with HbS% measurement by HPLC. Susceptible specimens should be identified and preferentially analyzed via CE.
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