title: Advantage of HbA1c assay by HPLC D-10 versus cobas integra 400 in a population carrier for HbS and HbC.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Laboratory of Clinical Biochemistry, Boulevard 9 Avril, 1006-Tunis, Tunisia. kahh2005@yahoo.fr
authors.forename: Kahena
authors.initials: K
authors.lastname: Bouzid
authors.forename: Afef
authors.initials: A
authors.lastname: Bahlous
authors.forename: Wafa
authors.initials: W
authors.lastname: Ferjani
authors.forename: Eya
authors.initials: E
authors.lastname: Kalai
authors.forename: Rolande
authors.initials: R
authors.lastname: Ducrocq
authors.forename: Faika
authors.initials: F
authors.lastname: Ben Mami
authors.forename: Jaouida
authors.initials: J
authors.lastname: Abdelmoula
mesh_terms: D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D002852:Chromatography, Ion Exchange / Q000379:methods*; D003920:Diabetes Mellitus / Q000097:blood; D006580:Genetic Carrier Screening; D006442:Glycated Hemoglobin / Q000032:analysis*; D006444:Hemoglobin C / Q000235:genetics*; D006451:Hemoglobin, Sickle / Q000235:genetics*; D006801:Humans
chemical_list: D006442:Glycated Hemoglobin; D006444:Hemoglobin C; D006451:Hemoglobin, Sickle