血红蛋白变体对 HbA1c 测量的干扰:6 种常用 HbA1c 测量方法与 IFCC 参考方法的比较。

Mingyang Li, Song Ge, Xin Shu, Xiongjun Wu, Haiyan Liu, Anping Xu, Ling Ji
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引用次数: 0

摘要

背景:糖化血红蛋白或血红蛋白 A1c (HbA1c) 是诊断糖尿病和监测其进展的重要指标。我们的目的是评估常见血红蛋白变体对常用 HbA1c 测量系统的干扰:方法:共纳入了 63 个变异和非变异样本,其目标值由国际临床化学和检验医学联合会(IFCC)参考方法指定。我们评估了在 HbS、HbC、HbD、HbE 和胎儿血红蛋白 (HbF) 存在的情况下测量 HbA1c 的 6 种方法:两种阳离子交换高效液相色谱法(HPLC)(Bio-Rad D-100 和 HLC-723 G8)、一种毛细管电泳法(CE)(Sebia Capillarys 3 TERA)、一种免疫测定法(Roche c501)、一种酶测定系统(Mindray BS-600M)和一种硼酸盐亲和法(Primus Premier Hb9210)。结果:6 种方法检测非变异样本的 HbA1c 结果与 IFCC 参考方法的结果非常一致。Bio-Rad D-100、Capillarys 3、Mindray BS-600M、Premier Hb9210 和 Roche c501 没有显示出 HbS、HbC、HbD 和 HbE 的干扰。HLC-723 G8 标准模式出现了明显的临床干扰。HbF 水平升高会对所有 6 种方法造成明显的负偏差,这种偏差会随着 HbF 浓度的增加而增加:结论:HbF 水平升高会严重影响硼酸盐亲和法、免疫测定法和酶测定法的 HbA1c 测量。
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Interference of hemoglobin variants with HbA1c measurements by six commonly used HbA1c methods.

Background: Glycated hemoglobin, or hemoglobin A1c (HbA1c), serves as a crucial marker for diagnosing diabetes and monitoring its progression. We aimed to assess the interference posed by common Hb variants on popular HbA1c measurement systems.

Methods: A total of 63 variant and nonvariant samples with target values assigned by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)-calibrated methods were included. We assessed 6 methods for measuring HbA1c in the presence of HbS, HbC, HbD, HbE, and fetal hemoglobin (HbF): 2 cation-exchange high-performance liquid chromatography (HPLC) methods (Bio-Rad D-100 and HLC-723 G8), a capillary electrophoresis (CE) method (Sebia Capillarys 3 TERA), an immunoassay (Roche c501), an enzyme assay system (Mindray BS-600M), and a boronate affinity method (Primus Premier Hb9210).

Results: The HbA1c results for nonvariant samples from the 6 methods were in good agreement with the IFCC-calibrated method results. The Bio-Rad D-100, Capillarys 3, Mindray BS-600M, Premier Hb9210, and Roche c501 showed no interference from HbS, HbC, HbD, and HbE. Clinically significant interference was observed for the HLC-723 G8 standard mode. Elevated HbF levels caused significant negative biases for all 6 methods, which increased with increasing HbF concentration.

Conclusion: Elevated levels of HbF can severely affect HbA1c measurements by borate affinity, immunoassays, and enzyme assays.

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