Variation of HbA1c with Hemoglobin level: A comparative study betweenD10 Biorad (HpLC) and Nycocard (Immunochromatography) analyser.

Abstract

Background Measurement of Glycosylated Hemoglobin (HbA1c) is an established procedure in evaluating long-term glycemic control in diabetic patients. It is an index of glycemic control which is not affected by diurnal glucose fluctuations. Methods A retrospective cross sectional study was performed in the Biochemistry department of Shree Birendra Hospital, Kathmandu, Nepal involving 100 known cases of type 2 diabetes mellitus. This study was designed to study the variation of HbA1c with hemoglobin levels. HbA1c was measured by Bio-Rad D10 (HPLC method) and Nycocard (Immunochromatography method). Linear regressive analysis with correlation coefficient was used to compare HbA1c with hemoglobin levels and a p-value < 0.05 is considered statistically significant. Results There was a strong correlation of HbA1c values with Hemoglobin levels in HPLC methods p = 0.001, r = 0.6, however no such correlation was seen in Nycocard method p = 0.6, r = 0.08. Conclusion Cation-exchange high performance liquid chromatography (HPLC) is the latest method introduced in our country Nepal. Therefore, interference caused by Hemoglobin variants needs to be evaluated by methods such as HPLC. In such situations, we may consider fructosamine, glycated serum albumin or self-monitoring of blood glucose as an adjunct to HbA1C measurements.