在Bio-Rad Variant II Turbo HbA1c检测中，由于S-β⁺-地中海贫血干扰导致血红蛋白A1c假性升高。
Falsely elevated hemoglobin A1c due to S-beta+-thalassemia interference in Bio-Rad Variant II Turbo HbA1c assay.
作者信息
Zhu Yusheng, Williams Laurie M
机构信息
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
出版信息
Clin Chim Acta. 2009 Nov;409(1-2):18-20. doi: 10.1016/j.cca.2009.08.009. Epub 2009 Aug 19.
BACKGROUND
Hemoglobin (Hb) S-beta(+)-thalassemia is a relatively mild form of S-beta-thalassemia, but it may interfere with HbA1c (A1c) assay. We report a falsely elevated A1c due to S-beta(+)-thalassemia interference in the Bio-Rad Variant II Turbo cation-exchange HPLC assay (Bio-Rad Turbo).
METHODS
A1c was determined with Bio-Rad Turbo and turbidimetric inhibition immunoassay (TINIA, Siemens) respectively. The former measured the A1c fraction only of glycated HbA, while the latter measured all Hb variants that are glycated at the beta chain N-terminus and have epitopes identical to that of A1c. S-beta(+)-thalassemia was confirmed with the Bio-Rad Classic Variant HPLC method using the beta thalassemia short program.
RESULTS
The A1c levels of 4 patients were 30.3%, 26.3%, 25.3%, and 27.6% by Bio-Rad Turbo, while the levels were 5.8%, 4.8%, 4.7%, and 4.9% by TINIA. Hemoglobinopathy analysis showed a typical S-beta(+)-thalassemia pattern: the fraction of HbS is greater than that of HbA with increased HbA2 and F.
CONCLUSIONS
S-beta(+)-thalassemia interferes with Bio-Rad Turbo assay causing falsely elevated A1c. If significantly increased A1c is detected and HbS is >50%, S-beta(+)-thalassemia should be suspected. In this case, A1c should be measured with other assays not significantly subject to S-beta(+)-thalassemia interference.
背景
血红蛋白（Hb）S-β（+）-地中海贫血是S-β-地中海贫血的一种相对较轻的形式，但它可能会干扰糖化血红蛋白A1c（A1c）检测。我们报告了在伯乐Variant II Turbo阳离子交换高效液相色谱法（伯乐Turbo）中，由于S-β（+）-地中海贫血干扰导致A1c假性升高的情况。
方法
分别采用伯乐Turbo和比浊抑制免疫测定法（TINIA，西门子公司）测定A1c。前者仅测量糖化HbA的A1c部分，而后者测量所有在β链N端糖化且具有与A1c相同表位的Hb变异体。使用β地中海贫血短程序，通过伯乐经典Variant高效液相色谱法确认S-β（+）-地中海贫血。
结果
采用伯乐Turbo检测时，4例患者的A1c水平分别为30.3%、26.3%、25.3%和27.6%，而采用TINIA检测时，水平分别为5.8%、4.8%、4.7%和4.9%。血红蛋白病分析显示典型的S-β（+）-地中海贫血模式：HbS比例大于HbA，同时HbA2和F增加。
结论
S-β（+）-地中海贫血干扰伯乐Turbo检测，导致A1c假性升高。如果检测到A1c显著升高且HbS>50%，应怀疑S-β（+）-地中海贫血。在这种情况下，应使用其他不受S-β（+）-地中海贫血显著干扰的检测方法测量A1c。
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