Interference of hemoglobinA1c (HbA1c) detection using ion-exchange high performance liquid chromatography (HPLC) method by clinically silent hemoglobin variant in University Malaya Medical Centre (UMMC)—A case report

Thevarajah, M.; Nadzimah, M.N.; Chew, Yee Yean

doi:10.1016/j.clinbiochem.2008.10.015

Cited by 34 publications

(26 citation statements)

References 10 publications

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“…The presence of lower HbA1c by HPLC in patients carrying the Hb D trait has been reported previously. [2][3][4] In our current study, we found no results in 59% of patients and abnormal results in the remaining 41%.…”

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confidence: 65%

Interference of Hemoglobin D on Measurements of Hemoglobin A1c by the High-Performance Liquid Chromatography HA-8160 in 27 Patients

Lorenzo-Medina

Iglesia

Ropero

et al. 2012

J Diabetes Sci Technol

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confidence: 65%

Interference of Hemoglobin D on Measurements of Hemoglobin A1c by the High-Performance Liquid Chromatography HA-8160 in 27 Patients

Lorenzo-Medina

Iglesia

Ropero

et al. 2012

J Diabetes Sci Technol

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“…[25][26][27] In our study, no results were obtained for 59% of samples from patients carrying the HbD trait and abnormal results in the remaining 41% using HPLC method 1. However, presence of the HbD trait had no clinical effect on the results reported by the immunoturbidimetric assay, which were found to be in accordance with the patient's clinical situation.…”

Section: Discussionmentioning

confidence: 86%

Effects of Hemoglobin Variants on Hemoglobin A1c Values Measured Using a High-Performance Liquid Chromatography Method

Lorenzo-Medina

Iglesia

Ropero

et al. 2014

J Diabetes Sci Technol

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Background: Hemoglobin A1c (HbA1c) is routinely used to monitor long-term glycemic control and for diagnosing diabetes mellitus. However, hemoglobin (Hb) gene variants/modifications can affect the accuracy of some methods. The potential effect of Hb variants on HbA1c measurements was investigated using a high-performance liquid chromatography (HPLC) method compared with an immunoturbimetric assay. Methods:Fasting plasma glucose (FPG) and HbA1c levels were measured in 42 371 blood samples. Samples producing abnormal chromatograms were further analyzed to characterize any Hb variants. Fructosamine levels were determined in place of HbA1c levels when unstable Hb variants were identified.Results: Abnormal HPLC chromatograms were obtained for 160 of 42 371 samples. In 26 samples HbS was identified and HbA1c results correlated with FPG. In the remaining 134 samples HbD, Hb Louisville, Hb Las Palmas, Hb N-Baltimore, or Hb Porto Alegre were identified and HbA1c did not correlate with FPG. These samples were retested using an immunoturbidimetric assay and the majority of results were accurate; only 3 (with the unstable Hb Louisville trait) gave aberrant HbA1c results. Conclusions:Hb variants can affect determination of HbA1c levels with some methods. Laboratories should be aware of Hb variants occurring locally and choose an appropriate HbA1c testing method.

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“…In addition, the seemingly non-specific boronate affinity method can be very useful in cases in which hemoglobin variants are present. In fact, it can be employed as a comparative method in cases in which cation-exchange HPLC (the DCCT reference method is Bio-Rex 70 resin cation-exchange HPLC, and NGSP uses the same reference method [31]) yields bizarre chromatograms ("abnormal separation", additional peaks, too low HbA1c concentrations or those above the nondiabetic range) [44].…”

Section: Limitations Of Hba1c Tests In Laboratory Settingsmentioning

confidence: 99%

Current aspects in hemoglobin A1c detection: A review

Ang

Thevarajah

Alias

et al. 2015

Clinica Chimica Acta

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Type 2 diabetes mellitus (T2DM) is a pressing health issue that threatens global health and the productivity of populations worldwide. Despite its long-recognized role in diabetes management, glycated hemoglobin (HbA1c) only received WHO endorsement as a T2DM diagnostic tool in 2011. Although conventional plasma-specific tests have long been utilized to diagnose T2DM, the public should be informed that plasma-specific tests are not markedly better than HbA1c tests, particularly in terms of variability and convenience for diagnosing diabetes. In the midst of the debates associated with establishing HbA1c as the preeminent diabetes diagnostic tool, unceasing efforts to standardize HbA1c tests have played an integral part in achieving more efficient communication from laboratory to clinical practice and thus better diabetes care. This review discusses the current status of HbA1c tests in the diagnosis, prevention, treatment and management of T2DM across the globe, focusing on increasing the recognition of glycated hemoglobin variants with effective utilization of different HbA1c methods, updating the current status of HbA1c standardization programs, tapping into the potential of POC analyzers to establish a cost-effective HbA1c test for diabetes care, and inspiring the advancement of HbA1c biosensors for future clinical usage.

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Interference of hemoglobinA1c (HbA1c) detection using ion-exchange high performance liquid chromatography (HPLC) method by clinically silent hemoglobin variant in University Malaya Medical Centre (UMMC)—A case report

Cited by 34 publications

References 10 publications

Interference of Hemoglobin D on Measurements of Hemoglobin A1c by the High-Performance Liquid Chromatography HA-8160 in 27 Patients

Interference of Hemoglobin D on Measurements of Hemoglobin A1c by the High-Performance Liquid Chromatography HA-8160 in 27 Patients

Effects of Hemoglobin Variants on Hemoglobin A1c Values Measured Using a High-Performance Liquid Chromatography Method

Current aspects in hemoglobin A1c detection: A review

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