Influence of common hemoglobin variants on different glycated hemoglobin determination systems

doi:10.3969/j.issn.1673-8640.2024.12.015

Abstract

Abstract:

Objective To evaluate the recognition ability and the accuracy of quantitative determination results of 6 commonly used clinical glycated hemoglobin A_1c（HbA_1c） determination systems for hemoglobin（Hb） variants. Methods A total of 245 suspected Hb variant interference samples were collected from HbA_1c routine test in Shanghai Jiahui International Hospital and the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2020 to December 2022. Six commonly used clinical determination systems（5 systems were high performance liquid chromatography，and 1 system was capillary electrophoresis） were used to determine suspected interference samples，and the types of Hb variants were confirmed by sequencing method. Based on the results of cobas c513 automatic glycated hemoglobin analyzer，the accuracy of 6 determination systems was evaluated. Results Totally，245 suspected Hb variant interference samples were verified by sequencing，141 Hb variant interference samples were determined. Eleven Hb variants（Hb G-Coushatta，Hb G-Taipei，Hb J-Bangkok，Hb D-Los Angeles，Hb Pyrgos，Hb Q-Thailand，Hb Queens，Hb Quong Sze，Hb C，Hb E，Hb S） were determined. Only Hb D-Los Angeles and Hb S can be determined by all the 6 determination systems，and the determination systems for the other 9 Hb variants had different recognition abilities. Except for Hb S，the results of 6 determination systems for the interference samples of other 10 Hb variants were different from those of cobas c513. Conclusions The commonly used clinical HbA_1c determination system is not able to identify most of the Hb variants. For the interference of Hb variants，different methods can be used for determination and sequencing verification if necessary.

Key words: Glycated hemoglobin A_1c, Hemoglobin variant, High performance liquid chromatography, Capillary electrophoresis

CLC Number:

R446.1

SONG Beiling, WU Jiong, HU Jiahua, WANG Yufei. Influence of common hemoglobin variants on different glycated hemoglobin determination systems[J]. Laboratory Medicine, 2024, 39(12): 1219-1223.

Figures/Tables 3

References 11

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序号	变异体名称	突变链	突变位点	样本数量
1	Hb G-Coushatta	β链	22 GAA→GCA	42
2	Hb G-Taipei	β链	22 GAA→GGA	28
3	Hb J-Bangkok	β链	56 GGC→GAC	13
4	Hb D-Los Angeles	β链	121 GAA→CAA	10
5	Hb Pyrgos	β链	83 GGC→GAC	10
6	Hb Q-Thailand	α链	74 GAC→CAC	9
7	Hb Queens	α链	34 CTG→CGG	7
8	Hb Quong Sze	α链	125 CTG→CCG	5
9	Hb C	β链	6 GAG→AAG	5
10	Hb E	β链	26 GAG→AAG	6
11	Hb S	β链	6 GAG→GTG	6

序号	变异体名称	突变链	突变位点	样本数量
1	Hb G-Coushatta	β链	22 GAA→GCA	42
2	Hb G-Taipei	β链	22 GAA→GGA	28
3	Hb J-Bangkok	β链	56 GGC→GAC	13
4	Hb D-Los Angeles	β链	121 GAA→CAA	10
5	Hb Pyrgos	β链	83 GGC→GAC	10
6	Hb Q-Thailand	α链	74 GAC→CAC	9
7	Hb Queens	α链	34 CTG→CGG	7
8	Hb Quong Sze	α链	125 CTG→CCG	5
9	Hb C	β链	6 GAG→AAG	5
10	Hb E	β链	26 GAG→AAG	6
11	Hb S	β链	6 GAG→GTG	6

检测系统	Hb G-Coushatta	Hb G-Taipei		Hb J-Bangkok		Hb D-Los Angeles	Hb Pyrgos	Hb Q-Thailand
D-100
干扰报警	E-Window	E-Window		不报警		D-Window	不报警	S-Window
异常峰位置/s	27.10	27.23				28.31		66.77
异常峰面积/%	37.54	38.73				39.96		39.96
G8
干扰报警	不报警	不报警		不报警		H-VD	不报警	H-V1
异常峰位置/s						1.01		1.16
异常峰面积/%						29.00		75.10
MQ-6000
干扰报警	变异体报警	变异体报警		变异体报警		变异体报警	不报警	变异体报警
异常峰位置/s	63.10	64.70		59.30		69.50		72.00
异常峰面积/%	48.14	48.38		70.96		39.38		38.72
MQ-8000
干扰报警	变异体报警	变异体报警		变异体报警		变异体报警	不报警	不报警
异常峰位置/s	57.80	57.90		54.50		62.80
异常峰面积/%	48.01	49.23		76.76		40.03
Variant Ⅱ
干扰报警	E-D报警	不报警		不报警		E-D报警	不报警	S报警
异常峰位置/s	1.85					1.91		1.98
异常峰面积/%	49.30					42.10		70.70
Capillarys 2
干扰报警	未知峰报警	未知峰报警		未知峰报警		未知峰报警	未知峰报警	未知峰报警
异常峰位置/s
异常峰面积/%	33.00	33.00		38.20		30.00	25.60	12.70
检测系统	Hb Queens	Hb Quong Sze	Hb C		Hb E	Hb S
D-100
干扰报警	S-Window	不报警	C-Window		E-Window	S-Window
异常峰位置/s	28.85		30.00		27.10	28.00
异常峰面积/%	30.16		17.46		37.58	18.69
G8
干扰报警	H-V1	不报警	H-V1		不报警	H-V1
异常峰位置/s	1.12		1.18			1.15
异常峰面积/%	9.20		14.60			16.00
MQ-6000
干扰报警	不报警	不报警	变异体报警		变异体报警	变异体报警
异常峰位置/s			84.10		62.10	71.50
异常峰面积/%			38.57		57.41	17.69
MQ-8000
干扰报警	不报警	不报警	变异体报警		变异体报警	变异体报警
异常峰位置/s			78.20		52.60	64.40
异常峰面积/%			18.76		55.51	19.36
检测系统	Hb Queens	Hb Quong Sze	Hb C		Hb E	Hb S
Variant Ⅱ
干扰报警	不报警	不报警	不报警		不报警	S报警
异常峰位置/s						1.95
异常峰面积/%						19.50
Capillarys 2
干扰报警	未知峰报警	未知峰报警	未知峰报警		未知峰报警	未知峰报警
异常峰位置/s
异常峰面积/%	34.80	38.20	6.80		33.20	12.40

检测系统	Hb G-Coushatta	Hb G-Taipei		Hb J-Bangkok		Hb D-Los Angeles	Hb Pyrgos	Hb Q-Thailand
D-100
干扰报警	E-Window	E-Window		不报警		D-Window	不报警	S-Window
异常峰位置/s	27.10	27.23				28.31		66.77
异常峰面积/%	37.54	38.73				39.96		39.96
G8
干扰报警	不报警	不报警		不报警		H-VD	不报警	H-V1
异常峰位置/s						1.01		1.16
异常峰面积/%						29.00		75.10
MQ-6000
干扰报警	变异体报警	变异体报警		变异体报警		变异体报警	不报警	变异体报警
异常峰位置/s	63.10	64.70		59.30		69.50		72.00
异常峰面积/%	48.14	48.38		70.96		39.38		38.72
MQ-8000
干扰报警	变异体报警	变异体报警		变异体报警		变异体报警	不报警	不报警
异常峰位置/s	57.80	57.90		54.50		62.80
异常峰面积/%	48.01	49.23		76.76		40.03
Variant Ⅱ
干扰报警	E-D报警	不报警		不报警		E-D报警	不报警	S报警
异常峰位置/s	1.85					1.91		1.98
异常峰面积/%	49.30					42.10		70.70
Capillarys 2
干扰报警	未知峰报警	未知峰报警		未知峰报警		未知峰报警	未知峰报警	未知峰报警
异常峰位置/s
异常峰面积/%	33.00	33.00		38.20		30.00	25.60	12.70
检测系统	Hb Queens	Hb Quong Sze	Hb C		Hb E	Hb S
D-100
干扰报警	S-Window	不报警	C-Window		E-Window	S-Window
异常峰位置/s	28.85		30.00		27.10	28.00
异常峰面积/%	30.16		17.46		37.58	18.69
G8
干扰报警	H-V1	不报警	H-V1		不报警	H-V1
异常峰位置/s	1.12		1.18			1.15
异常峰面积/%	9.20		14.60			16.00
MQ-6000
干扰报警	不报警	不报警	变异体报警		变异体报警	变异体报警
异常峰位置/s			84.10		62.10	71.50
异常峰面积/%			38.57		57.41	17.69
MQ-8000
干扰报警	不报警	不报警	变异体报警		变异体报警	变异体报警
异常峰位置/s			78.20		52.60	64.40
异常峰面积/%			18.76		55.51	19.36
检测系统	Hb Queens	Hb Quong Sze	Hb C		Hb E	Hb S
Variant Ⅱ
干扰报警	不报警	不报警	不报警		不报警	S报警
异常峰位置/s						1.95
异常峰面积/%						19.50
Capillarys 2
干扰报警	未知峰报警	未知峰报警	未知峰报警		未知峰报警	未知峰报警
异常峰位置/s
异常峰面积/%	34.80	38.20	6.80		33.20	12.40

检测系统	Hb G-Coushatta	Hb G-Taipei	Hb J-Bangkok	Hb D-Los Angeles	Hb Pyrgos	Hb Q-Thailand	Hb Queens	Hb Quong Sze	Hb C	Hb E	Hb S
cobas c513/例	42	38	13	10	10	9	7	5	5	6	6
D-100
r²值	0.97	0.96	0.80	1.00	0.01	0.59	0.99	0.99	1.00	0.99	0.99
不一致例数^①/例	0	6	13	0	10	9	0	0	0	0	0
G8
r²值	0.91	0.90	0.97	0.97	0.80	0.94	0.95	0.87	1.00	0.82	1.00
不一致例数^①/例	0	28	12	3	10	1	0	5	0	6	0
MQ-6000
r²值	0.98	0.70	0.88	0.99	0.32	0.86	0.64	0.73	0.99	1.00	0.99
不一致例数^①/例	0	4	12	3	10	6	6	5	0	0	0
MQ-8000
r²值	1.00	0.97	0.98	0.98	—	1.00	0.81	—	0.99	1.00	0.99
不一致例数^①/例	0	3	13	6	10	0	6	5	0	0	0
Variant Ⅱ
r²值	0.75	0.74	0.97	0.99	0.94	0.92	0.89	1.00	0.88	0.93	1.00
不一致例数^①/例	42	28	13	0	10	7	7	0	3	4	0
Capillarys 2
r²值	0.95	0.77	1.00	0.96	0.99	1.00	0.78	0.94	0.99	1.00	0.99
不一致例数^①/例	0	5	0	0	0	0	5	0	0	0	0