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Article: A spuriously 'normal' haemoglobin A1c result

TitleA spuriously 'normal' haemoglobin A1c result
Authors
Issue Date2012
PublisherRoyal Society of Medicine Press Ltd. The Journal's web site is located at http://www.roysocmed.ac.uk/pub/acb.htm
Citation
Annals of Clinical Biochemistry, 2012, v. 49 n. 4, p. 408-411 How to Cite?
AbstractWe report a case of spuriously 'normal' haemoglobin A1c (HbA1c) result due to misidentification of HbG Taipei as HbAo by the Variant II built-in retention time algorithm. The defect was circumvented effectively by the implementation of a chromatographic system specific internal quality control mechanism for peak identity verification. HbA1c and estimated average glucose results were corrected from 4.7% to 8.2%, and 4.9 to 10.5 mmol/L, respectively. The results were consistent with the patient's concurrent and previous fasting blood glucose concentrations and existence of diabetes mellitus dermopathy, indicating poor glycaemic control. A review of currently available analytical systems showed that other than mass spectrometry, HbA1c measurements by these systems were generally affected by the presence of haemoglobin variants. The same haemoglobin variant may affect different analytical systems differently, resulting in the deviation of HbA1c results from the true value to different extents. Including the analytical principle of HbA1c measurement in the laboratory report can avoid inappropriate comparison of results obtained by different analytical systems. Moreover, since individual haemoglobinopathy may affect the degree of glucose binding to haemoglobin in a different way, this uncertainty limits the general application of same decision cut-off of established guidelines for glycaemic control monitoring. Adoption of an individualized monitoring system based on the critical difference or reference change value of HbA1c can be considered.
DescriptionCase report
Persistent Identifierhttp://hdl.handle.net/10722/160063
ISSN
2015 Impact Factor: 2.119
2015 SCImago Journal Rankings: 0.687
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLo, VMHen_US
dc.contributor.authorMa, ESKen_US
dc.contributor.authorChau, EMCen_US
dc.contributor.authorSo, JCCen_US
dc.date.accessioned2012-08-16T06:02:11Z-
dc.date.available2012-08-16T06:02:11Z-
dc.date.issued2012en_US
dc.identifier.citationAnnals of Clinical Biochemistry, 2012, v. 49 n. 4, p. 408-411en_US
dc.identifier.issn0004-5632-
dc.identifier.urihttp://hdl.handle.net/10722/160063-
dc.descriptionCase report-
dc.description.abstractWe report a case of spuriously 'normal' haemoglobin A1c (HbA1c) result due to misidentification of HbG Taipei as HbAo by the Variant II built-in retention time algorithm. The defect was circumvented effectively by the implementation of a chromatographic system specific internal quality control mechanism for peak identity verification. HbA1c and estimated average glucose results were corrected from 4.7% to 8.2%, and 4.9 to 10.5 mmol/L, respectively. The results were consistent with the patient's concurrent and previous fasting blood glucose concentrations and existence of diabetes mellitus dermopathy, indicating poor glycaemic control. A review of currently available analytical systems showed that other than mass spectrometry, HbA1c measurements by these systems were generally affected by the presence of haemoglobin variants. The same haemoglobin variant may affect different analytical systems differently, resulting in the deviation of HbA1c results from the true value to different extents. Including the analytical principle of HbA1c measurement in the laboratory report can avoid inappropriate comparison of results obtained by different analytical systems. Moreover, since individual haemoglobinopathy may affect the degree of glucose binding to haemoglobin in a different way, this uncertainty limits the general application of same decision cut-off of established guidelines for glycaemic control monitoring. Adoption of an individualized monitoring system based on the critical difference or reference change value of HbA1c can be considered.-
dc.languageengen_US
dc.publisherRoyal Society of Medicine Press Ltd. The Journal's web site is located at http://www.roysocmed.ac.uk/pub/acb.htm-
dc.relation.ispartofAnnals of Clinical Biochemistryen_US
dc.subject.meshAged-
dc.subject.meshHemoglobin A, glycosylated - analysis-
dc.subject.meshMale-
dc.subject.meshReference values-
dc.subject.meshSensitivity and specificity-
dc.subject.meshAnimals-
dc.subject.meshHumans-
dc.subject.meshRats-
dc.titleA spuriously 'normal' haemoglobin A1c resulten_US
dc.typeArticleen_US
dc.identifier.emailLo, VMH: mhlo@hksh.comen_US
dc.identifier.emailMa, ESK: eskma@hkucc.hku.hken_US
dc.identifier.emailSo, JCC: scc@pathology.hku.hk-
dc.identifier.authoritySo, JCC=rp00391en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1258/acb.2011.011202-
dc.identifier.pmid22589359-
dc.identifier.scopuseid_2-s2.0-84867118775-
dc.identifier.hkuros205193en_US
dc.identifier.volume49en_US
dc.identifier.issue4en_US
dc.identifier.spage408en_US
dc.identifier.epage411en_US
dc.identifier.isiWOS:000307798900017-
dc.publisher.placeUnited Kingdom-

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