Presumptive Identification of Clinically Significant Hemoglobin Variants Hb E, Hb S, Hb D in Hb A1c Capillary Electrophoresis.

Autor:	Puthiyaveettil AK; R&D, Neuberg Anand Academy of Laboratory Medicine Pvt Ltd, Bengaluru, India., Vaz GS; Department of Hematology, Neuberg Anand Reference Laboratory-A Unit of Neuberg Diagnostics Pvt Ltd, Bengaluru, India., Prasad SR; R&D, Neuberg Anand Academy of Laboratory Medicine Pvt Ltd, and Neuberg Anand Reference Laboratory-A Unit of Neuberg Diagnostics Pvt Ltd, Bengaluru, India., Putchen DD; R&D, Neuberg Anand Academy of Laboratory Medicine Pvt Ltd, Bengaluru, India.
Jazyk:	angličtina
Zdroj:	The journal of applied laboratory medicine [J Appl Lab Med] 2024 Oct 04. Date of Electronic Publication: 2024 Oct 04.
DOI:	10.1093/jalm/jfae102
Abstrakt:	Background: The quantitation of glycated hemoglobin (Hb A1c) represents an average blood glucose level for a period of 2 to 3 months for diagnosing, monitoring, and managing diabetes mellitus. Unreliable results are reported when hemoglobin (Hb) variants are present in the sample. Patients are advised to use an alternate method due to the presence of the variant Hb and a reflex test to Hb electrophoresis to obtain precise information about the Hb variant. The present study utilizes x axis values from Hb A1c capillary electrophoresis (CE) to identify clinically significant Hb variants Hb E, S, and D. Methods: Patient samples (n = 60) that showed a variant peak in the Hb A1c test with an x axis value of 190 to 240 were selected for the study. The migration position of the Hb variant (x axis value) and variant percent of the Hb A1c test were compared with the x axis value and variant percent in the Hb electrophoresis test to presumptively identify the variants. The identity of the variants was confirmed using mass spectrometry (MS). Results: Out of 60 samples, 20 samples were identified as Hb E (x axis 225-227), 20 samples were identified as Hb S (x axis 210-214), and 18 samples were identified as Hb D-Punjab (x axis 200-201). Two variants with an x axis value of 194 were identified as an α variant Hb Q India using MS. There is an overall negative shift of the x axis (-1 to -13 units) and a lower variant percent (-0.2% to -8.7%) in Hb A1c CE when compared with Hb electrophoresis. Conclusions: The present study highlights the significance of the x axis value and variant percent to identify clinically significant Hb variants in the Hb A1c CE test. (© Association for Diagnostics & Laboratory Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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