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Clinical Chemistry 53: 2202-2205, 2007. First published October 5, 2007; 10.1373/clinchem.2007.093963
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(Clinical Chemistry. 2007;53:2202-2205.)
© 2007 American Association for Clinical Chemistry, Inc.

Technical Briefs

Effects of 7 Hemoglobin Variants on the Measurement of Glycohemoglobin by 14 Analytical Methods

Seung-Tae Lee1, Cas W. Weykamp2, Yong-Wha Lee3, Jong-Won Kim1 and Chang-Seok Ki1,a

1 Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 2 Department of Clinical Chemistry, Queen Beatrix Hospital, Winterswijk, The Netherlands; 3 Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital and Soonchunhyang University College of Medicine, Gyeonggi-do, Korea;

aaddress correspondence to this author at: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-Gu, Seoul 135-710 Korea; fax 82-2-3410-2719, e-mail changski{at}skku.edu)


Abstract

Background: Hemoglobin variants (HbVAR) are not uncommon in the Korean population, with Hb G-Coushatta and Hb Queens being the 2 most common HbVAR. Hb G-Coushatta is also the most common HbVAR in Chinese people from the Silk Road region, as well as in some North American Indian tribes. However, data are scarce on the effect of these HbVAR on the different methods used for analyzing HbA1c.

Methods: Specimens from 24 individuals with 7 HbVAR (Hb G-Coushatta, Hb Queens, Hb G-Hsi-Tsou, Hb Ube-4, Hb G-Waimanalo, Hb Inglewood, and Hb Bologna-St.Orsola) were collected and tested using the International Federation of Clinical Chemistry primary reference method as well as 14 routine HbA1c assay methods.

Results: Hb G-Coushatta showed a clinically significant effect on the measured HbA1c, particularly when analysis was performed with ion-exchange HPLC methods with short elution times. This interference could be resolved by measuring the HbA1c using other methods such as HPLC with a long elution time, immunoassay, boronate affinity chromatography, and enzymatic assay. Hb Queens showed a clinically significant difference, defined as a >10% deviation from regression lines, in results from the 2 HPLC methods but not in the other methods. The remaining 5 rare HbVAR showed different HbA1c results in the different assays.

Conclusion: Hb G-Coushatta, Hb Queens, and other rare HbVAR can interfere with glycohemoglobin assays, including ion-exchange HPLC methods with short elution times, but the interference can be resolved using other unaffected methods. It is important to identify these HbVAR through a careful inspection of the chromatograms and apply other noninterfering methods for accurate measurements of the HbA1c.






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