Effect of Hemoglobin Variants (Hb J, Hb G, and Hb E) on HbA1c Values as Measured by Cation-Exchange HPLC (Diamat)

Tsai, Liang-Ching; Tsai, Shang-Shyue; Lin, Me Nung; Liu, Shu Fen

doi:10.1093/clinchem/47.4.756

Cited by 24 publications

(10 citation statements)

References 12 publications

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“…The second limitation of this study was HbA1c measurement. The presence of many clinically silent hemoglobin variants can cause deviation in the HbA1c results, leading to falsely high or low values [ 42 , 43 ]. Therefore, the accuracy of the results and validity of the HbA1c interpretation cannot be assured.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Disease is Associated with a Lower Prevalence of Diabetic Retinopathy in Patients with Type 1 Diabetic Mellitus

Stefanowicz-Rutkowska

Matuszewski

Bandurska-Stankiewicz

2020

Medicina

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Background and objectives: The aim of the study was to assess the correlation of autoimmune thyroid diseases (AITD) in patients with diabetes mellitus type 1 (DM1) with the occurrence of diabetic retinopathy (DR). Materials and Methods: The inclusion criteria for the study were: type 1 diabetes diagnosed on the basis of WHO criteria lasting at least a year, presence of AITD for at least a year, and age over 18 years. The control group consisted of patients without diagnosed AITD (DM1noAITD), selected according to age, BMI and DM1 duration. Anthropometric parameters, metabolic risk factors such as glycated hemoglobin (HbA1c), lipids and blood pressure, thyroid status and the presence of DR were assessed. Results: The study involved 200 patients with type 1 diabetes aged 36 ± 12 years, 70 men and 130 women. Patients from the study group (DM1AITD) had significantly lower creatinine concentration, significantly lower systolic blood pressure (SBP), glycated hemoglobin (HbA1c) percentage and triglyceride (TG) concentration, and higher high-density lipoprotein (HDL-cholesterol) concentration than the control group (DM1noAITD). There was a significantly lower chance of non-proliferative diabetic retinopathy (NPDR) among DM1AITD than in the control group. Conclusions: Patients with DM1 and AITD were metabolically better balanced, as evidenced by a significantly lower SBP, percentage of HbA1c and TG, as well as significantly higher HDL-cholesterol in this group. Patients with DM1 and AITD were significantly less likely to have NPDR than the control group.

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Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Disease is Associated with a Lower Prevalence of Diabetic Retinopathy in Patients with Type 1 Diabetic Mellitus

Stefanowicz-Rutkowska

Matuszewski

Bandurska-Stankiewicz

2020

Medicina

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“…In contrast, in samples heterozygous for HbJ a large bias of 52.3% was observed between the c 513 and the Variant II Turbo 2.0. The inability of ion-exchange HPLC methods to accurately quantitate HbA 1C in heterozygous HbJ samples has been observed previously and is the result of a negative interference in the HbA 1C peak on the chromatogram [14]. Immunoassays can reliably quantitate HbA 1C in samples from patients heterozygous for HbJ [15].…”

Section: Discussionmentioning

confidence: 99%

A high-throughput test for diabetes care: An evaluation of the next generation Roche Cobas c 513 hemoglobin A1C assay

Gifford

Higgins

Sadrzadeh

2019

Practical Laboratory Medicine

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ObjectivesThe level of glycated hemoglobin A (HbA1C) in blood is the preferred marker for diabetes monitoring and treatment. Here, we evaluate the analytical performance of the Roche Diagnostics Cobas c 513, a stand-alone HbA1C immunoassay analyzer.Design and MethodsPerformance was assessed with regards to imprecision, accuracy, linearity, method comparison against the Roche Cobas Integra 800 CTS, specimen stability, interference from common hemoglobin variants and hemoglobin F, and throughput.ResultsWithin-run and between-run precisions were 0.5–0.7 and 0.8–1.3%CV, respectively. An average bias of −1.6% to proficiency survey samples was observed. The c 513 correlated well with the Integra (slope = 0.94, y-intercept = 0.50, and correlation coefficient = 0.998). The effect of hemoglobin variants on this assay was negligible while specimens containing ≥10% HbF demonstrated a negative bias. The c 513 instrument can process up to 340 samples per hour.ConclusionsThe c 513 is a precise, accurate, automated high throughput analyzer for measuring HbA1C in large laboratories.

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“…It has not so far been described in the context of diabetes monitoring (Crookson et al, 1969;Harano et al, 1982;Headlee et al, 1983). A number of haemoglobin variants have been described in the literature as interfering with the quantification of glycated haemoglobin (Elder et al, 1998;Tsai et al, 2001;Lahoussen et al, 2002). It is also known that commonly detected haemoglobin variants, such as HbS, HbC and HbF, allow a reliable assessment of HbA 1c using this method (John et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…A number of haemoglobin variants have been described in the literature as interfering with the quantification of glycated haemoglobin (Elder et al. , 1998; Tsai et al. , 2001; Lahoussen et al.…”

Section: Discussionmentioning

confidence: 99%

Haemoglobin Etobicoke, an incidental finding in an Irish diabetic

O’Brien

Flynn

Chuk

et al. 2003

Clinical &Amp; Laboratory Haematology

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It is well recognized that haemoglobin variants can be detected during the measurement of HbA1c by high-performance liquid chromatography (HPLC). A number of variants have been reported as compromising the quantification of HbA1c, a marker used in the assessment of glycaemic control in diabetes. We describe a case of haemoglobin Etobicoke, a rare alpha chain variant detected in an Irish diabetic during HbA1c analysis. Its identity was confirmed using a series of investigations. These included haemoglobin electrophoresis at alkaline and acid pH, isoelectric focusing and globin chain electrophoresis. Ultimately mass spectrometry isolated the mutation at position alpha 84 (F5). Haemoglobin Etobicoke, first described in Canada in 1969 has not previously been detected on HbA1c analysis. In the presence of this rare variant, HbA1c, a standard method using HPLC to assess glycaemic control in diabetes is unreliable and alternatives such as fructosamine need to be considered. HbA1c measured by automated HPLC will effectively screen populations where haemoglobin variants were not previously known. Precise identity of these variants when they are detected is crucial to the reliable interpretation of HbA1c analyses.

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Effect of Hemoglobin Variants (Hb J, Hb G, and Hb E) on HbA1c Values as Measured by Cation-Exchange HPLC (Diamat)

Cited by 24 publications

References 12 publications

Autoimmune Thyroid Disease is Associated with a Lower Prevalence of Diabetic Retinopathy in Patients with Type 1 Diabetic Mellitus

Autoimmune Thyroid Disease is Associated with a Lower Prevalence of Diabetic Retinopathy in Patients with Type 1 Diabetic Mellitus

A high-throughput test for diabetes care: An evaluation of the next generation Roche Cobas c 513 hemoglobin A1C assay

Haemoglobin Etobicoke, an incidental finding in an Irish diabetic

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