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影响A1C检测结果的罕见血红蛋白C变异体1例报告

梁利波 何訸 孙婉婷 李友琼 张玫

梁利波, 何訸, 孙婉婷, 等. 影响A1C检测结果的罕见血红蛋白C变异体1例报告[J]. 四川大学学报(医学版), 2023, 54(3): 659-662. doi: 10.12182/20230560209
引用本文: 梁利波, 何訸, 孙婉婷, 等. 影响A1C检测结果的罕见血红蛋白C变异体1例报告[J]. 四川大学学报(医学版), 2023, 54(3): 659-662. doi: 10.12182/20230560209
LIANG Li-bo, HE He, SUN Wan-ting, et al. Hemoglobin C Variant Affecting Glycated Hemoglobin Test Results: A Rare Case Report[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES), 2023, 54(3): 659-662. doi: 10.12182/20230560209
Citation: LIANG Li-bo, HE He, SUN Wan-ting, et al. Hemoglobin C Variant Affecting Glycated Hemoglobin Test Results: A Rare Case Report[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES), 2023, 54(3): 659-662. doi: 10.12182/20230560209

影响A1C检测结果的罕见血红蛋白C变异体1例报告

doi: 10.12182/20230560209
基金项目: 国家自然科学基金(No. 81902142)和四川省科技厅科技计划项目(重点研发项目)(No. 2021 YFG0176)资助
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    E-mail:meizhang@wchscu.cn

Hemoglobin C Variant Affecting Glycated Hemoglobin Test Results: A Rare Case Report

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  • 摘要: 血红蛋白(hemoglobin, Hb)变异体是影响糖化血红蛋白A1C(glycated hemoglobin, A1C)检测结果的常见因素。不同的血红蛋白变异体对检测结果的影响各不相同。本文首次报道了1例中国人中血红蛋白C(Hb C)对A1C测定结果的影响。本研究分别使用高效液相色谱法(high performance liquid chromatography, HPLC)和毛细管电泳法检测A1C;采用血红蛋白电泳识别血红蛋白变异体;Hb测序确定β链上的突变位点。HPLC检测A1C结果降低,可通过电泳法纠正,但电泳图谱仍存在异常峰。Hb电泳结果提示存在Hb变异,测序结果显示为Hb C。因此,我们建议对A1C常规开展解释性报告模式,对每份报告中的检测方法进行注释,并对图谱进行分析,避免单一检验结果影响临床决策。
  • 图  1  使用不同方法测定的A1C结果

    Figure  1.  A1C results determined with different methods

    A: HPLC showed an extra band (black band); B: capillary electrophoresis showed an abnormal band in A2; C: Hb variant identified by hemoglobin electrophoresis (fraction); D: gene sequencing of the patient showed Hb C mutation sites. * The coincidence of the bands of A2 and Hb variant.

    表  1  A1C检验报告关键要素

    Table  1.   Key reporting elements for A1C

    TestResultsMethodologyNotes
    Quantitation %, mmol/mol[10] HPLC, electrophoresis, immunoassay or ion-exchange For example, comigration of multiple bands and interferences due to hemoglobin variants
    Abnormal band(s) presence Yes/no/equivocal
    Variant mode Yes/no
    Previous history Yes/no For example, describing changes in the quantity of plasma glucose in comparison with what it was before
    Recommendation Follow-up testing For example, glycated albumin recommended (if A1C does not reflect the glucose)[11]
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出版历程
  • 收稿日期:  2022-07-11
  • 修回日期:  2022-12-09
  • 网络出版日期:  2023-05-20
  • 刊出日期:  2023-05-20

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