Interference of hemoglobin variants in HbA1c quantification

Clin Chim Acta. 2023 Jan 15:539:55-65. doi: 10.1016/j.cca.2022.11.031. Epub 2022 Dec 5.

Abstract

Fasting blood glucose and glycated hemoglobin (HbA1c) are routine biomarkers to screen and monitor diabetes mellitus. HbA1c results from glycation at the N-terminus of the β globin chain of tetrameric human hemoglobin. Fasting blood glucose level varies with the nature and amount of food intake, physical exercise, etc., and, accordingly, is a short-term measure of glucose control. In contrast, HbA1c provides an average measure of glucose control for the long-term (8-12 weeks). Unfortunately, genetic variants of hemoglobin may interfere with HbA1c quantification using ion exchange chromatography, capillary electrophoresis, immunoassay and boronate affinity chromatography. Mass spectrometry, however, measures total glycation of hemoglobin across both α and β globin chains and correlates well with the ion exchange based method. Additionally, mass spectrometry based quantification is not impacted by the presence of genetic variants of hemoglobin and thus might be a better analytical choice for diabetes mellitus.

Keywords: Diabetes mellitus; Glucose; Glycated hemoglobin; Hemoglobin; Hemoglobin variants; Mass spectrometry.

Publication types

  • Review

MeSH terms

  • Blood Glucose* / analysis
  • Chromatography, High Pressure Liquid / methods
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / genetics
  • Glycated Hemoglobin / genetics
  • Hemoglobins / analysis
  • Humans
  • beta-Globins

Substances

  • Blood Glucose
  • Glycated Hemoglobin
  • Hemoglobins
  • beta-Globins