Bouzid Kahena, Bahlous Afef, Ferjani Wafa, Kalai Eya, Ducrocq Rolande, Ben Mami Faika, Abdelmoula Jaouida
Laboratory of Clinical Biochemistry, Boulevard 9 Avril, 1006-Tunis, Tunisia.
Clin Lab. 2012;58(7-8):821-8.
Several studies demonstrate significant bias in analytical methods used to measure glycohemoglobin. The clinical importance of that fact is evident when HbA1c overestimation leads to aggressive glucose management, resulting in more frequent hypoglycaemic episodes. Our study was aimed to compare two automated instruments (Integra 400 and D-10) in the evaluation of HbA1c in the Tunisian population.
Samples of 205 Tunisian diabetic patients were collected. The HbA1c assay was done simultaneously with a first generation immunoturbidimetric assay on an INTEGRA 400 (ROCHE) and using ionic exchange high pressure liquid chromatography (HPLC) on a D-10 system (BIO-RAD).
Correlation is determined by linear regression analysis: D-10 = 0.921*(Integra 400) +1.125; coefficient of correlation (r) = 0.946. This r increases to 0.973 when samples of carriers for HbS and HbC (n = 9) are filtered out. For the carrier patients, significant differences in the percentage of HbA1c were observed relating to the methodology used.
Laboratories must be aware of hemoglobin variant interferences on their methods of assessment of glycated hemoglobin. Using ion-exchange HPLC to control glycated hemoglobin seems to be essential to prevent mis-management in diabetic patients and to permit the diagnosis of the presence of HbS in patients.
多项研究表明，用于测量糖化血红蛋白的分析方法存在显著偏差。当糖化血红蛋白（HbA1c）估计过高导致积极的血糖管理，进而引发更频繁的低血糖发作时，这一事实的临床重要性便显而易见。我们的研究旨在比较两种自动仪器（Integra 400和D - 10）在突尼斯人群中评估HbA1c的情况。
收集了205名突尼斯糖尿病患者的样本。使用第一代免疫比浊法在INTEGRA 400（罗氏公司）上同时进行HbA1c检测，并在D - 10系统（伯乐公司）上使用离子交换高压液相色谱法（HPLC）进行检测。
通过线性回归分析确定相关性：D - 10 = 0.921×（Integra 400）+1.125；相关系数（r）= 0.946。当滤除携带镰状血红蛋白（HbS）和血红蛋白C（HbC）的样本（n = 9）时，该r值增至0.973。对于携带这些变异的患者，观察到所使用的方法在HbA1c百分比方面存在显著差异。
实验室必须意识到血红蛋白变异对其糖化血红蛋白评估方法的干扰。使用离子交换HPLC来控制糖化血红蛋白似乎对于防止糖尿病患者的管理失误以及诊断患者是否存在HbS至关重要。
