Miyashita Tetsuo, Sugiyama Takahiro, Yamadate Shuukoh, Nagashima Masaaki, Satomura Atsushi, Nakayama Tomohiro
Department of Clinical Laboratory, Nihon University Itabashi Hospital, Tokyo, Japan.
Department of Clinical Laboratory, Nihon University Itabashi Hospital, Tokyo, Japan Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.
Ann Clin Biochem. 2014 Sep;51(Pt 5):591-601. doi: 10.1177/0004563213513244. Epub 2014 Jan 7.
This study examined the new high-performance liquid chromatography analyser HLC-723GX (GX) and investigated its ability to both measure glycosylated haemoglobin (HbA1c) values and determine whether haemoglobin variants could cause interference with these measurements in the Japanese population.
For the basic GX examination, the within- and between-run precision, linearity of measurements, correlation of HbA1c values with current systems and the interference of chemically modified haemoglobin were determined. GX interference caused by the haemoglobin variant was examined by analysing 39 clinical laboratory samples that contained haemoglobin variants.
Good within- and between-run precision were found, with the coefficients of variation at ≤1.0%. A wide range of HbA1c measurement values were confirmed, with the HbA1c values strongly correlated with the results of the currently used HLC-723G8 system. Chemically modified haemoglobins were prepared by adding glucose, sodium cyanate, acetaldehyde or acetylsalicylic acid to normal blood samples. None of these samples had any influence on the HbA1c values determined by GX. GX analysis showed haemoglobin variants that eluted after HbA0 and were similar to HbD, or HbS had HbA1c values that were close to those measured by boronate affinity chromatography and immunoassay. GX found lower HbA1c values in blood that contained HbE or haemoglobin variants, which elute before or at nearly the same time as HbA0.
GX is useful for the analysis of HbA1c samples that contain HbD, HbS, HbC and haemoglobin variants, even though the elution times are similar. However, a countermeasure is needed in order to avoid overlooking other haemoglobin variants in Japan.
本研究对新型高效液相色谱分析仪HLC - 723GX(GX)进行了检测,并调查了其测量糖化血红蛋白(HbA1c)值的能力,以及确定血红蛋白变异体是否会干扰日本人群的这些测量结果。
对于GX的基本检测,测定了批内和批间精密度、测量线性、HbA1c值与现有系统的相关性以及化学修饰血红蛋白的干扰情况。通过分析39份含有血红蛋白变异体的临床实验室样本,检测由血红蛋白变异体引起的GX干扰。
发现批内和批间精密度良好,变异系数≤1.0%。确认了广泛的HbA1c测量值,HbA1c值与当前使用的HLC - 723G8系统的结果高度相关。通过向正常血液样本中添加葡萄糖、氰酸钠、乙醛或乙酰水杨酸制备化学修饰血红蛋白。这些样本均未对GX测定的HbA1c值产生任何影响。GX分析显示,在HbA0之后洗脱且类似于HbD的血红蛋白变异体,或HbS的HbA值与硼酸盐亲和色谱法和免疫测定法测量的值接近。GX发现含有HbE或在HbA0之前或几乎与HbA0同时洗脱的血红蛋白变异体的血液中HbA1c值较低。
尽管洗脱时间相似,但GX对于分析含有HbD、HbS、HbC和血红蛋白变异体的HbA1c样本很有用。然而,为了避免在日本忽略其他血红蛋白变异体,需要采取对策。