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Updated: Aug 18, 2025

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Interference of hemoglobin variants in HbA1c quantification.

Neha Yadav1, Amit Kumar Mandal1

  • 1Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal 741246, India.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|December 8, 2022
PubMed
Summary

Glycated hemoglobin (HbA1c) measures long-term diabetes control but can be affected by genetic variants. Mass spectrometry offers a more reliable method for quantifying HbA1c, unaffected by these hemoglobin variations.

Keywords:
Diabetes mellitusGlucoseGlycated hemoglobinHemoglobinHemoglobin variantsMass spectrometry

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Area of Science:

  • Clinical Chemistry
  • Biomarker Analysis
  • Diabetes Mellitus Diagnostics

Background:

  • Fasting blood glucose and glycated hemoglobin (HbA1c) are standard biomarkers for diabetes mellitus screening and monitoring.
  • HbA1c reflects average glucose control over 8-12 weeks, while fasting glucose is a short-term measure.
  • Genetic hemoglobin variants can interfere with common HbA1c quantification methods.

Purpose of the Study:

  • To evaluate mass spectrometry as an alternative method for HbA1c quantification.
  • To assess the impact of genetic hemoglobin variants on HbA1c measurement.
  • To determine the suitability of mass spectrometry for accurate diabetes monitoring.

Main Methods:

  • Comparison of HbA1c quantification using mass spectrometry versus traditional methods (ion exchange chromatography, capillary electrophoresis, immunoassay, boronate affinity chromatography).
  • Analysis of hemoglobin glycation across both alpha and beta globin chains by mass spectrometry.
  • Assessment of mass spectrometry's performance in the presence of genetic hemoglobin variants.

Main Results:

  • Mass spectrometry measures total hemoglobin glycation, correlating well with ion exchange methods.
  • Mass spectrometry is not affected by the presence of genetic hemoglobin variants.
  • Traditional HbA1c methods can yield inaccurate results due to hemoglobin variants.

Conclusions:

  • Mass spectrometry presents a robust analytical approach for HbA1c quantification.
  • This method overcomes the limitations posed by genetic hemoglobin variants in diabetes diagnostics.
  • Mass spectrometry may be a superior analytical choice for monitoring diabetes mellitus.