1. bookVolume 24 (2016): Issue 4 (December 2016)
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Comparison of four chromatographic methods used for measurement of glycated hemoglobin

Published Online: 30 Dec 2016
Page range: 431 - 439
Received: 21 Feb 2016
Accepted: 10 Oct 2016
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

This parameter’s results accuracy has a special importance in the management of diabetic patients since targets for optimal glycemic control are established using HbA1c values. Several error sources can influence the obtained value, some of them can be counteracted (ex. pipetting errors, storage), and others should be taken into consideration at the interpretation of the result (ex. presence of hemoglobin variants). The aim of this study was to compare four chromatographic methods regarding the costs and the influence of certain error sources on the accuracy of the result. Materials and methods: Samples and controls were analyzed using Variant I, Micromat II and In2it (Bio-Rad) systems, and the BIOMIDI reagent kit for HbA1c measurement. Results: Positive correlation could be observed comparing the results obtained using different methods, except the patients presenting elevated HbF. Pipetting errors modify the results up to 5% in case of Variant I, and up to 10% in case of Micromat II in the tested range. One day of improper storage at room temperature causes 3% deviation from the actual value using the Variant I analyzer and 5% in case of Micromat II and In2it equipment. As a conclusion, depending on the number of samples, automated chromatographic analyzers are the most appropriate equipments for the determination of HbA1c.

Keywords

1. Sakura H, Tanaka Y, Iwamoto Y. Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patients. Diabetes research and clinical practice, 2010;88(1):65-70. DOI: 10.1016/j.diabres.2009.12.011.10.1016/j.diabres.2009.12.011Search in Google Scholar

2. Gikas A, Sotiropoulos A, Pastromas V, Papazafiropoulou A, Apostolou O, Pappas S. Seasonal variation in fasting glucose and HbA1c in patients with type 2 diabetes. Primary Care Diabetes. 2009;3(2):111-4. DOI: 10.1016/j.pcd.2009.05.004.10.1016/j.pcd.2009.05.004Search in Google Scholar

3. Zoppini G, Galletti A, Targher G, Brangani C, Pichiri I, Negri C, et al. Glycated haemoglobin is inversely related to serum vitamin D levels in type 2 diabetic patients. Plos one, 2013;8(12):p.e82733 DOI: 10.1371/journal.pone.0082733.10.1371/journal.pone.0082733Search in Google Scholar

4. Pani LN, Korenda L, Meigs JB, Driver C, Chamany S, Fox CS, et al. Effect of Aging on A1c Levels in Individuals Without Diabetes Evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001–2004. Diabetes Care. 2008;31(10):1991-6. DOI: 10.2337/dc08-0577.10.2337/dc08-0577Search in Google Scholar

5. Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. Acta haematol. 2004;112(3):126-8. DOI: 10.1159/000079722.10.1159/000079722Search in Google Scholar

6. Nilsson, PM, Gudbjornsdottir S, Eliasson B, Cederholm J. Steering Comité of Swedish Nacional Diabetes Register. Smoking is associated with increased HbA1c values and microalbuminuria in patients with diabetes-data from National Diabetes Register in Sweden. Diabetes Metab. 2004;30:261-8. DOI: 10.1016/S1262-3636(07)70117-9.10.1016/S1262-3636(07)70117-9Search in Google Scholar

7. Hanberger L, Åkesson K, Samuelsson U. Glycated haemoglobin variations in paediatric type 1 diabetes: the impact of season, gender and age. Acta Paediatr. 2014;103(4):398-403. DOI: 10.1111/apa.12530.10.1111/apa.1253024299617Search in Google Scholar

8. Hill CJ, Maxwell AP, Cardwell CR, Freedman BI, Tonelli M, Emoto M, et al. Glycated hemoglobin and risk of death in diabetic patients treated with hemodialysis: a meta-analysis. Am J Kidney Dis. 2014;63(1):84-94. DOI: 10.1053/j.ajkd.2013.06.020.10.1053/j.ajkd.2013.06.02023958400Search in Google Scholar

9. Rhea JM, Molinaro R. Pathology consultation on HbA(1c) methods and interferences. Am J Clin Pathol. 2014;141(1):5-16. DOI: 10.1309/AJCPQ23GTTMLAEVL.10.1309/AJCPQ23GTTMLAEVL24343732Search in Google Scholar

10. Monami M, Vitale V, Lamanna C, Bartoli N, Martelli D, Zannoni S, et al. HbA1c levels and all-cause mortality in type 2 diabetic patients: epidemiological evidence of the need for personalised therapeutic targets. Nutr Metab Cardiovasc Dis. 2012;23(4):300-6. DOI: 10.1016/j.numecd.2012.01.003.10.1016/j.numecd.2012.01.00322633797Search in Google Scholar

11. Onitilo AA, Stankowski RV, Berg RL, Engel JM, Glurich I, Williams GM et al. Type 2 diabetes mellitus, glycemic control, and cancer risk. Eur J Cancer Prev. 2014;23(2):134-40. DOI: 10.1097/CEJ.0b013e3283656394.10.1097/CEJ.0b013e328365639423962874Search in Google Scholar

12. Bio-Rad. Instruction Manual Micromat II Hemoglobin A1c Test. 2004.Search in Google Scholar

13. Bio-Rad. Instruction Manual In2it System A1c Test Cartridges. 2010.Search in Google Scholar

14. Bio-Rad. Instruction Manual Variant Hemoglobin A1c Program. 2005.Search in Google Scholar

15. Little RR, Roberts W. A Review of Variant Hemoglobins Interfering with Hemoglobin A1c Measurement. J Diabetes Sci Technol. 2009;3(3):446–51. DOI: 10.1177/193229680900300307.10.1177/193229680900300307276988720144281Search in Google Scholar

16. Bouzid K, Ahmed HB, Kalai E, Blibeche S, Couque N, Chiari K, et al. Prevalence of hemoglobin variants in a diabetic population at high risk of hemoglobinopathies and optimization of HbA1c monitoring by incorporating HPLC in the laboratory workup. Lybian J Med. 2014;27(9):257-68. DOI: 10.3402/ljm.v9.25768.10.3402/ljm.v9.2576828156273Search in Google Scholar

17. Higgins T: HbA1c – an analyte of increasing importance. Clin Biochem. 2012;45(13-14):1038-45. DOI: 10.1016/j.clinbiochem.2012.06.006.10.1016/j.clinbiochem.2012.06.00622705451Search in Google Scholar

18. Little RR, Rohlfing CL, Hanson S, Connolly S, Higgins T, Weykamp CW, et al: Effects of hemoglobin (Hb) E and HbD traits on measurements of glycated Hb (HbA1c) by 23 methods, Clin Chem. 2008;54(8):1277-82. DOI: 10.1373/clinchem.2008.103580.10.1373/clinchem.2008.10358018556332Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo