This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- Kristina J Behan, PhD, MLS(ASCP)⇑
- Jane Merschen, MPH, MLS(ASCP)
- Address for Correspondence: Kristina Behan, PhD, MLS(ASCP), University of West Florida, Bldg 58, Room 80, 11000 University Parkway, Pensacola, FL 32514, (850) 474-3060, fax (850) 474-2749, kbehan{at}uwf.edu
Abstract
Hemoglobin A1c (HbA1c) testing can be inaccurate in persons with elevated amounts of Hemoglobin F, or with abnormal hemoglobins found in sickle cell trait, HbC trait and HbE trait. These variants are more prevalent in African and Asian Americans, the same demographic that has an increased risk of diabetes. Variant hemoglobins might cause a false increase or decrease in HbA1c, depending on methodology and manufacturer. Case studies of two African American patients, one with and one without variant hemoglobins, are presented. The major methods used to assay HbA1c, immunoassay, HPLC and boronate affinity are described, and compared for their ability to detect variant hemoglobins. An algorithm is proposed to test new patients using the HPLC method to identify or rule out the presence of the most common variant hemoglobins. Patients with variant hemoglobins can subsequently be assigned to HbA1c methods proven to be accurate in the presence of those hemoglobins.
- INDEX TERMS
- Hemoglobinopathy
- A1c
- African-American
- diabetes
- © Copyright 2011 American Society for Clinical Laboratory Science Inc. All rights reserved.