一个Hb金边病例显示了不同的HbA1c水平,取决于高性能液体染色学系统
Masayuki Tojikubo1, Takafumi Uchimura1, Hidekazu Tamai1
1Department of Internal Medicine, Tojitama Thyroid and Diabetes Clinic, Fukuoka, Japan.
Annals of clinical and laboratory science
|November 13, 2024
概括
金边血红蛋白是一种独特的变体,导致不同的HbA1c结果,具体取决于使用的HPLC系统. 这一案例凸显了方法特定解释对于准确的糖尿病诊断的重要性.
科学领域:
- 临床化学 临床化学
- 血液学 血液学 血液学
- 遗传学 是一个遗传学.
背景情况:
- 糖化血红素A1c (HbA1c) 是糖尿病诊断和管理的关键生物标志物.
- 由于各种因素,包括血红蛋白变异,HbA1c测量的差异可能会出现.
- 准确的HbA1c测量对于适当的临床决策至关重要.
研究的目的:
- 为了呈现HbA1c因特定的血红蛋白变异而变化的情况.
- 调查不同分析方法对HbA1c量化在Hb变异存在时的影响.
- 强调需要对HbA1c结果进行方法特定的解释.
主要方法:
- 一个49岁的男性的病例介绍,HbA1c结果不一致.
- 使用多种方法进行HbA1c分析:HPLC (Tosoh G9,Arkray HA-8180/HA-8180T),亲和力测试,酶测试.
- 间歇扫描的连续血糖监测 (isCGM) 和口服血糖耐受性测试 (OGTT).
- 血红蛋白基因分析用于血红蛋白变体识别.
主要成果:
- 在不同的分析系统中,HbA1c水平存在显著差异.
- 使用Tosoh G9的HPLC产生了高HbA1c (7.3%),而Arkray系统显示了较低的值 (4.9-5.0%).
- isCGM表明没有糖尿病,与OGTT结果形成鲜明对比.
- 全球蛋白基因分析发现了Hb Phnom Penh (α1-117Phe-Ile-α1-118Thr).
结论:
- Hb Phnom Penh 与依赖于方法的 HbA1c 测量变异性有关.
- 某些HPLC系统 (Tosoh G9) 的高HbA1c结果可能导致误诊.
- 对HbA1c的临床解释需要考虑血红蛋白变异和检测方法的潜在干扰.
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