Kinoshita Maki, Shimomura Daiki, Shimada Masashi, Kamioka Mikio, Koga Masafumi
Department of Laboratory Medicine, Tenri Hospital, Nara, Japan.
Department of Internal Medicine, Hakuhokai Central Hospital, 4-23-1 Higashisonodacho, Amagasaki, Hyogo 661-0953 Japan.
Diabetol Int. 2024 Jan 6;15(2):302-306. doi: 10.1007/s13340-023-00682-6. eCollection 2024 Apr.
Hemoglobin variants are often discovered when hemoglobin A1c (HbA1c) levels measured with a high-performance liquid chromatography (HPLC) system in fast mode are found to be low. The HA-8180V HPLC analyzer by Arkray offers two measurement modes: fast mode (FM) and variant mode (VM). Two Japanese patients with α-chain variant Hb Q-Iran detected incidentally after analyses with the HA-8180V in VM showed an abnormal peak, are presented. The first patient was a man in his 70 s, and the second patient was a man in his 50 s. Both were non-diabetic, but their results from HbA1c measurement in VM showed an abnormal peak. The VM-HbA1c, FM-HbA1c, and HbA1c measured by enzymatic assay and glycated albumin levels of the two patients were all within the reference ranges. They were diagnosed as having Hb Q-Iran (α2-75Asp → His) by globin gene analysis. It is difficult to detect α-chain hemoglobin variants based on abnormal FM-HbA1c levels, but measuring HbA1c in VM is useful for efficiently detecting hemoglobin variants.
当使用高效液相色谱(HPLC)系统在快速模式下测得的糖化血红蛋白A1c(HbA1c)水平较低时,常常会发现血红蛋白变异体。爱科来公司的HA-8180V HPLC分析仪提供两种测量模式:快速模式(FM)和变异体模式(VM)。本文介绍了两名日本患者,他们在使用HA-8180V的VM模式进行分析后偶然检测出α链变异型血红蛋白Q-伊朗,结果显示有异常峰。第一名患者是一名70多岁的男性,第二名患者是一名50多岁的男性。两人均无糖尿病,但他们在VM模式下的HbA1c测量结果显示有异常峰。两名患者的VM-HbA1c、FM-HbA1c、通过酶法测定的HbA1c以及糖化白蛋白水平均在参考范围内。通过珠蛋白基因分析,他们被诊断为患有血红蛋白Q-伊朗(α2-75Asp→His)。基于异常的FM-HbA1c水平很难检测出α链血红蛋白变异体,但在VM模式下测量HbA1c有助于高效检测血红蛋白变异体。