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通过不同的方法评估血红蛋白变异对HbA_1c测量的影响

Yichuan Song¹, Anping Xu², Mo Wang¹

¹Department of Clinical Laboratory, 74639 Beijing Chao-Yang Hospital, Capital Medical University , Beijing, P.R. China.

Clinical chemistry and laboratory medicine

|April 2, 2024

概括

血红蛋白A1c (HbA1c) 测试的准确性因某些血红蛋白变异而有所不同. 像Sebia Capillarys 3 TERA和Premier Hb9210这样的方法显示出显著的偏差,影响了Hb Ube-2和Hb New York的结果.

科学领域:

临床化学临床化学
血液学血液学血液学
分析化学分析化学

背景情况:

血红蛋白A1c (HbA1c) 是糖尿病管理的关键标志物.
不同的血红蛋白变异可以干扰HbA1c测量方法的准确性.
准确的HbA1c量化对于有效的糖尿病护理和监测至关重要.

研究的目的:

为了评估六种不同的HbA1c测量方法的性能,与液态染色学-双重质谱法 (LC/MS/MS) 参考方法进行比较.
评估七种特定的血红蛋白变体 (Hb Q-泰国,Hb G-霍诺卢卢,Hb Ube-2,Hb 纽约,Hb J-曼谷,Hb G-Coushatta和Hb E) 对HbA1c检测结果的影响.
为了确定这些常见的血红蛋白变异引入的方法特定偏差.

主要方法:

在29个正常和112个变异样本中测量HbA1c水平,使用LC/MS/MS作为参考.
六个分析平台进行了比较:Sebia Capillarys 3 TERA,智能生物系统QuanTOF,Premier Hb9210,Arkray HA-8190V (变体和快速模式),Bio-Rad D-100和Tosoh G11.这些平台都在进行比较.
基于相关性,一致性和平均相对偏差来评估性能,可接受的偏差值为±2.8%.

主要成果:

所有测试方法都表现出与LC/MS/MS的差相关性和一致性,对于含有Hb E.的样本.
对多种方法观察到显著的不可接受偏差,特别是对Hb Ube-2和Hb New York.
塞比亚毛囊3 TERA,Premier Hb9210和Arkray HA-8190V在几个变体中显示出相当大的负偏差,超过了±2.8%的可接受限度.

结论:

衡量HbA1c的准确性受到某些血红蛋白变体存在的显著影响,特别是Hb Ube-2和Hb New York.
实验室必须根据患者群体中血红蛋白变异的流行程度,仔细选择HbA1c测试方法.
在存在特定的血红蛋白变异时量化HbA1c的方法限制需要仔细考虑,以准确管理糖尿病.

关键词:

这就是HbA1c.血红蛋白变体的不同类型方法比较方法比较

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