Analytical interference of 33 different hemoglobin variants on HbA1c measurements comparing high-performance liquid chromatography with whole blood enzymatic assay: A multi-center study

Zechmeister, Bozena; Erden, Tanja; Kreutzig, Berit; Weber, M.; Joly, Philippe; Erdmann, Jürgen; Brockmann-Hönig, Christine; Fischer, Andreas; Eidizadeh, Abass

doi:10.1016/j.cca.2022.03.028

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…Recently, Zechmeister et al reported that HPLC provided more information about the presence of Hb-Vars than enzymatic assays. Analyzers used to measure HbA 1c must have high throughput for rapid testing and high resolution for clearer separation, which represent contradicting goals [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Detectability of and interference by major and minor hemoglobin variants using a new-generation ion-exchange HPLC system with two switchable analysis modes

Manita,

Ogino,

Marivoet

et al. 2024

Practical Laboratory Medicine

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Section: Discussionmentioning

confidence: 99%

Detectability of and interference by major and minor hemoglobin variants using a new-generation ion-exchange HPLC system with two switchable analysis modes

Manita,

Ogino,

Marivoet

et al. 2024

Practical Laboratory Medicine

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“…The enzymatic and immunoassay measure cannot give any information about Hb variants, which should be considered when utilizing this strategy for HbA1c alone ( 16 ). Boronate affinity HPLC examination is interfered by rare Hb variants; thus, unable to detect Hb variants.…”

Section: Discussionmentioning

confidence: 99%

Undetectable high-performance liquid chromatography haemoglobin A1c on variant haemoglobin E phenotype

Marpaung,

Sadriani

2023

Biochem. med. (Online)

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The gold standard for long-term monitoring of diabetic patients is glycated haemoglobin (HbA1c), which is routinely tested for glycaemic control. Furthermore, the National glycohemoglobin standardization program (NGSP) has designated high-performance liquid chromatography (HPLC) as the reference method for HbA1c measurement. A woman from the Sumba tribe, Indonesia, aged 52, visited the Internal Medicine Clinic for a routine check-up. She had been taking diabetic and hypertension medicines on a regular basis for over 10 years. The HPLC procedure yielded “no result” for the patient’s HbA1c assessment and there was no peak on the HPLC graphic. However, there was a discrepancy between the data history of HbA1c measured by turbidimetric method (average of 51 mmol/mol, reference range < 48 mmol/mol), fasting blood glucose (average of 7.7 mmol/L, reference range < 7.0 mmol/L) and 2-hour plasma glucose (average of 13 mmol/L, reference range < 11.1 mmol/L). Glycated albumin was 3.1 mmol/L (reference range 1.8-2.4 mmol/L). Haemoglobin electrophoresis identified homozygote haemoglobinopathy E (HbE). Patients with haemoglobin variants are proposed to utilize glycated albumin.

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“…Fasting blood glucose and 2-h oral glucose tolerance test (OGTT) are the traditional methods of screening and diagnosis of diabetes. Following the recommendation by an expert committee in 2009, the use of HbA1c for the diagnosis of diabetes and pre-diabetes was also approved for the diagnosis of these dysglycaemic states ( 9 ). Also, potential limitations due to haemoglobinopathy have been minimised with newer standardised methods and assays ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of haemoglobin A1c based dysglycaemia among adult community dwellers in selected states in Nigeria: a descriptive cross-sectional study

Ajayi,

Balogun,

Olopade

et al. 2023

Front. Endocrinol.

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BackgroundType 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c.MethodologyA cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16.ResultsThe mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p< 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p< 0.001), tribe (p = 0.004), marital status (p< 0.001), blood pressure (p< 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45–54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes.ConclusionOver half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia.

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Analytical interference of 33 different hemoglobin variants on HbA1c measurements comparing high-performance liquid chromatography with whole blood enzymatic assay: A multi-center study

Cited by 10 publications

References 29 publications

Detectability of and interference by major and minor hemoglobin variants using a new-generation ion-exchange HPLC system with two switchable analysis modes

Detectability of and interference by major and minor hemoglobin variants using a new-generation ion-exchange HPLC system with two switchable analysis modes

Undetectable high-performance liquid chromatography haemoglobin A1c on variant haemoglobin E phenotype

Prevalence of haemoglobin A1c based dysglycaemia among adult community dwellers in selected states in Nigeria: a descriptive cross-sectional study

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