Influence of hemoglobin variants and derivatives on glycohemoglobin determinations, as investigated by 102 laboratories using 16 methods

Clin Chem. 1993 Aug;39(8):1717-23.

Abstract

Influences of hemoglobin (Hb) variants (HbSS, HbCC, beta-thalassemia, HbAE, HbAS, HbAC, hereditary persistent HbF) and Hb derivatives (carbamylated- and acetylated-Hbs, Schiff base, and those formed in stored blood) on results of glyco-Hb assays by 102 laboratories using 16 different methods were investigated. Affinity chromatography shows deviating results only with homozygous Hb S and C. Correct interpretation of results from patients with decreased erythrocyte half-lives requires previous knowledge on this condition. Measurements of HbA1c by HPLC and electrophoresis are obviously unsuitable for homozygous hemoglobinopathies; for heterozygous hemoglobinopathies and Hb synthesis variants, HbA1c should be expressed as percentage of HbA0 + HbA1c; abnormal Hbs are usually recognized; both carbamylated- and acetylated-Hbs interfere and Schiff base must be eliminated. Except for stored blood, all Hb variants and derivatives gave erroneous results with disposable ion-exchange columns. Dako's immunoassay is not affected by Hb derivatives; glycated Hb variants are not recognized as glyco-Hb and percentages are consequently too low. Glyco-Hb by the immunoassay of Bayer (performed by one laboratory) is not affected by Hb variants and derivatives.

Publication types

  • Comparative Study

MeSH terms

  • Chemistry, Clinical / methods*
  • Chromatography, Affinity
  • Chromatography, High Pressure Liquid
  • Electrophoresis
  • Fetal Hemoglobin / analysis
  • Glycated Hemoglobin / analysis*
  • Hemoglobin C / analysis
  • Hemoglobin E / analysis
  • Hemoglobin, Sickle / analysis
  • Hemoglobinopathies / blood
  • Hemoglobins, Abnormal / analysis*
  • Heterozygote
  • Homozygote
  • Humans
  • Immunoassay
  • Quality Control
  • Reference Values
  • beta-Thalassemia / blood

Substances

  • Glycated Hemoglobin A
  • Hemoglobin, Sickle
  • Hemoglobins, Abnormal
  • hemoglobin AC
  • hemoglobin AS
  • Hemoglobin C
  • Hemoglobin E
  • Fetal Hemoglobin