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Mossine VV, Mawhinney TP. 1-Amino-1-deoxy-d-fructose ("fructosamine") and its derivatives: An update. Adv Carbohydr Chem Biochem 2023; 83:1-26. [PMID: 37968036 DOI: 10.1016/bs.accb.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
1-Amino-1-deoxy-d-fructose (fructosamine, FN) derivatives are omnipresent in all living organisms, as a result of non-enzymatic condensation and Amadori rearrangement reactions between free glucose and biogenic amines such as amino acids, polypeptides, or aminophospholipids. Over decades, steady interest in fructosamine was largely sustained by its role as a key intermediate structure in the Maillard reaction that is responsible for the organoleptic and nutritional value of thermally processed foods, and for pathophysiological effects of hyperglycemia in diabetes. New trends in fructosamine research include the discovery and engineering of FN-processing enzymes, development of advanced tools for hyperglycemia monitoring, and evaluation of the therapeutic potential of both fructosamines and FN-recognizing proteins. This article covers developments in the field of fructosamine and its derivatives since 2010 and attempts to ascertain challenges in future research.
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Affiliation(s)
- Valeri V Mossine
- Department of Biochemistry, University of Missouri, Columbia, MO, United States
| | - Thomas P Mawhinney
- Department of Biochemistry, University of Missouri, Columbia, MO, United States.
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Zhou X, Lai W, Zhong J, Yang Y, Chen Z, Zhang C. Point-of-care detection of glycated hemoglobin using a novel dry chemistry-based electrochemiluminescence device. Anal Chim Acta 2023; 1279:341829. [PMID: 37827624 DOI: 10.1016/j.aca.2023.341829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 10/14/2023]
Abstract
As a good biomarker to reflect the average level of blood glucose, glycated hemoglobin (HbA1c) is mainly used for long-term glycemic monitoring and risk assessment of complications in diabetic patients. Previous analysis methods for HbA1c usually require complex pretreatment processes and large-scale biochemical analyzers, which makes it difficult to realize the point-of-care testing (POCT) of HbA1c. In this work, we have proposed a three-electrode dry chemistry-based electrochemiluminescence (ECL) biosensor and its self-contained automatic ECL analyzer. In this enzymatic biosensor, fructosyl amino-caid oxidase (FAOD) reacts with the hydrolysis product of HbA1c, and the produced hydrogen peroxide further reacts with luminol under the appropriate driving voltage, generating photons to realize the quantitative detection of HbA1c. Under optimized conditions, the biosensors have a good linear response to different concentrations of fructosyl valine (FV) ranging from 0.05 to 2 mM, with a limit of detection of 2 μM. The within-batch variation is less than 15%, and the biosensors still have 78% of the initial response after the accelerated aging test of 36 h at 37 °C. Furthermore, the recoveries for different concentrations of samples in whole blood were within 92.3-99.7%. These results illustrate that the proposed method has the potential for use in POCT of HbA1c.
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Affiliation(s)
- Xinya Zhou
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China
| | - Wei Lai
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China
| | - Jinbiao Zhong
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China
| | - Yang Yang
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China
| | - Zhenyu Chen
- Guangzhou First People's Hospital Nansha Hospital, Guangzhou, 511457, China.
| | - Chunsun Zhang
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China; Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China.
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Tucker CM, Stickle DF. Quantitation of hemoglobins using Sebia Capillarys-2 capillary electrophoresis (CE) for A1c: Comparison to results using CE for hemoglobins. Pract Lab Med 2023; 34:e00312. [PMID: 37090931 PMCID: PMC10113832 DOI: 10.1016/j.plabm.2023.e00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/21/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
Background Measurement of A1c using the Sebia Capillarys-2 capillary electrophoresis (A1c CE) involves relative quantitative measurements of peaks for hemoglobins A1c, A, A2. We examined correlation of A1c CE results with results of CE analysis for hemoglobins (Hb CE) for homozygous A and S-trait patients. We specifically examined whether abnormalities in A2 or the A/S ratio by A1c CE alone would reasonably be the basis for recommendation of red cell indices for evaluation of possible thalassemia. Methods Selection of patients was from results for A1c CE, exhibiting either a normal pattern or a pattern consistent with S-trait. We then examined correlation of results of quantitation for A, S and A2 between A1c CE and Hb CE. Results %A2 by A1c CE (y) had high correlation with %A2 by Hb CE (x): y = 0.88 x; r = 0.948. %A2 in S-trait patients was right-shifted in comparison to normals by 0.5%. For S-trait patients, the A/S ratio by A1c CE (y) had high correlation with the A/S ratio by Hb CE (x): y = 1.02 x; r = 0.995. Conclusions Given high correlation of results between A1c CE and Hb CE, patent elevation of A2 by A1c CE for either normal or S-trait patients is a reasonable basis for recommendation of red cell indices for evaluation of possible beta thalassemia. For S-trait patients, patent abnormality in the A/S ratio by A1c CE is a reasonable basis for recommendation of red cell indices for evaluation of possible alpha or beta thalassemia.
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Liddy AM, Grundy S, Sreenan S, Tormey W. Impact of haemoglobin variants on the use of haemoglobin A1c for the diagnosis and monitoring of diabetes: a contextualised review. Ir J Med Sci 2023; 192:169-176. [PMID: 35362846 PMCID: PMC9892076 DOI: 10.1007/s11845-022-02967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/04/2022] [Indexed: 02/05/2023]
Abstract
HbA1c is the established test for monitoring glycaemic control in diabetes, and intervention trials studying the impact of treatment on glycaemic control and risk of complications focus predominantly on this parameter in terms of evaluating the glycaemic outcomes. It is also the main parameter used when targets for control are being individualised, and more recently, it has been used for the diagnosis of type 2 diabetes. For laboratories performing this test and clinicians utilising it in their decision-making process, a thorough understanding of factors that can impact on the accuracy, and appropriate interpretation of the test is essential. The changing demographic in the Irish population over the last two decades has brought this issue sharply into focus. It is therefore timely to review the utility, performance and interpretation of the HbA1c test to highlight factors impacting on the results, specifically the impact of haemoglobin variants, and the impact of these factors on its utilisation in clinical practice.
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Affiliation(s)
- Anne Marie Liddy
- Department of Diabetes and Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephan Grundy
- Department of Diabetes and Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Seamus Sreenan
- Department of Diabetes and Endocrinology, Connolly Hospital, Dublin 15, Blanchardstown, Ireland
| | - William Tormey
- Department of Chemical Pathology, Beaumont Hospital, Dublin, Ireland ,Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland
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Kaur J, Jiang C, Liu G. Different strategies for detection of HbA1c emphasizing on biosensors and point-of-care analyzers. Biosens Bioelectron 2018; 123:85-100. [PMID: 29903690 DOI: 10.1016/j.bios.2018.06.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/23/2018] [Accepted: 06/06/2018] [Indexed: 12/21/2022]
Abstract
Measurement of glycosylated hemoglobin (HbA1c) is a gold standard procedure for assessing long term glycemic control in individuals with diabetes mellitus as it gives the stable and reliable value of blood glucose levels for a period of 90-120 days. HbA1c is formed by the non-enzymatic glycation of terminal valine of hemoglobin. The analysis of HbA1c tends to be complicated because there are more than 300 different assay methods for measuring HbA1c which leads to variations in reported values from same samples. Therefore, standardization of detection methods is recommended. The review outlines the current research activities on developing assays including biosensors for the detection of HbA1c. The pros and cons of different techniques for measuring HbA1c are outlined. The performance of current point-of-care HbA1c analyzers available on the market are also compared and discussed. The future perspectives for HbA1c detection and diabetes management are proposed.
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Affiliation(s)
- Jagjit Kaur
- Graduate School of Biomedical Engineering, ARC Centre of Excellence in Nanoscale Biophotonics (CNBP), Faculty of Engineering, The University of New South Wales, Sydney 2052, Australia; Australian Centre for NanoMedicine, The University of New South Wales, Sydney 2052, Australia
| | - Cheng Jiang
- Nuffield Department of Clinical Neurosciences, Department of Chemistry, University of Oxford, Oxford OX1 2JD, United Kingdom
| | - Guozhen Liu
- Graduate School of Biomedical Engineering, ARC Centre of Excellence in Nanoscale Biophotonics (CNBP), Faculty of Engineering, The University of New South Wales, Sydney 2052, Australia; Australian Centre for NanoMedicine, The University of New South Wales, Sydney 2052, Australia; International Joint Research Center for Intelligent Biosensor Technology and Health, Central China Normal University, Wuhan 430079, PR China.
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Ke P, Liu J, Chao Y, Wu X, Xiong Y, Lin L, Wan Z, Wu X, Xu J, Zhuang J, Huang X. Measurement of HbA 1c and HbA 2 by Capillarys 2 Flex Piercing HbA 1c programme for simultaneous management of diabetes and screening for thalassemia. Biochem Med (Zagreb) 2017; 27:030704. [PMID: 28900367 PMCID: PMC5575649 DOI: 10.11613/bm.2017.030704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 07/22/2017] [Indexed: 11/07/2022] Open
Abstract
Introduction Thalassemia could interfere with some assays for haemoglobin A1c (HbA1c) measurement, therefore, it is useful to be able to screen for thalassemia while measuring HbA1c. We used Capillarys 2 Flex Piercing (Capillarys 2FP) HbA1c programme to simultaneously measure HbA1c and screen for thalassemia. Materials and methods Samples from 498 normal controls and 175 thalassemia patients were analysed by Capillarys 2FP HbA1c programme (Sebia, France). For method comparison, HbA1c was quantified by Premier Hb9210 (Trinity Biotech, Ireland) in 98 thalassaemia patients samples. For verification, HbA1c from eight thalassaemia patients was confirmed by IFCC reference method. Results Among 98 thalassaemia samples, Capillarys 2FP did not provide an HbA1c result in three samples with HbH due to the overlapping of HbBart’s with HbA1c fraction; for the remaining 95 thalassaemia samples, Bland-Altman plot showed 0.00 ± 0.35% absolute bias between two systems, and a significant positive bias above 7% was observed only in two HbH samples. The HbA1c values obtained by Capillarys 2FP were consistent with the IFCC targets (relative bias below ± 6%) in all of the eight samples tested by both methods. For screening samples with alpha (α-) thalassaemia silent/trait or beta (β-) thalassemia trait, the optimal HbA2 cut-off values were ≤ 2.2% and > 2.8%, respectively. Conclusions Our results demonstrated the Capillarys 2FP HbA1c system could report an accurate HbA1c value in thalassemia silent/trait, and HbA2 value (≤ 2.2% for α-thalassaemia silent/trait and > 2.8% for β-thalassemia trait) and abnormal bands (HbH and/or HbBart’s for HbH disease, HbF for β-thalassemia) may provide valuable information for screening.
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Affiliation(s)
- Peifeng Ke
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiawei Liu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Chao
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaobin Wu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujuan Xiong
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Lin
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zemin Wan
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinzhong Wu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianhua Xu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junhua Zhuang
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xianzhang Huang
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Current Status of HbA1c Biosensors. SENSORS 2017; 17:s17081798. [PMID: 28777351 PMCID: PMC5579747 DOI: 10.3390/s17081798] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 07/24/2017] [Accepted: 08/01/2017] [Indexed: 01/08/2023]
Abstract
Glycated hemoglobin (HbA1c) is formed via non-enzymatic glycosylation reactions at the α–amino group of βVal1 residues in the tetrameric Hb, and it can reflect the ambient glycemic level over the past two to three months. A variety of HbA1c detection methods, including chromatography, immunoassay, enzymatic measurement, electrochemical sensor and capillary electrophoresis have been developed and used in research laboratories and in clinics as well. In this review, we summarize the current status of HbA1c biosensors based on the recognition of the sugar moiety on the protein and also their applications in the whole blood sample measurements.
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Klingenberg O, Furuset T, Hestbråten CR, Hallberg MH, Steiro A, Orset IR, Berg JP. HbA1c analysis by capillary electrophoresis – comparison with chromatography and an immunological method. Scandinavian Journal of Clinical and Laboratory Investigation 2017. [DOI: 10.1080/00365513.2017.1338747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Olav Klingenberg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Furuset
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | | | - Marit H. Hallberg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Astrid Steiro
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Iren R. Orset
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Jens P. Berg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Wu X, Chao Y, Wan Z, Wang Y, Ma Y, Ke P, Wu X, Xu J, Zhuang J, Huang X. A comparative evaluation of the analytical performances of Capillarys 2 Flex Piercing, Tosoh HLC-723 G8, Premier Hb9210, and Roche Cobas c501 Tina-quant Gen 2 analyzers for HbA 1c determination. Biochem Med (Zagreb) 2017; 26:353-364. [PMID: 27812304 PMCID: PMC5082223 DOI: 10.11613/bm.2016.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/08/2016] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Haemoglobin A1c (HbA1c) is widely used in the management of diabetes. Therefore, the reliability and comparability among different analytical methods for its detection have become very important. MATERIALS AND METHODS A comparative evaluation of the analytical performances (precision, linearity, accuracy, method comparison, and interferences including bilirubin, triglyceride, cholesterol, labile HbA1c (LA1c), vitamin C, aspirin, fetal haemoglobin (HbF), and haemoglobin E (Hb E)) were performed on Capillarys 2 Flex Piercing (Capillarys 2FP) (Sebia, France), Tosoh HLC-723 G8 (Tosoh G8) (Tosoh, Japan), Premier Hb9210 (Trinity Biotech, Ireland) and Roche Cobas c501 (Roche c501) (Roche Diagnostics, Germany). RESULTS A good precision was shown at both low and high HbA1c levels on all four systems, with all individual CVs below 2% (IFCC units) or 1.5% (NGSP units). Linearity analysis for each analyzer had achieved a good correlation coefficient (R2 > 0.99) over the entire range tested. The analytical bias of the four systems against the IFCC targets was less than ± 6% (NGSP units), indicating a good accuracy. Method comparison showed a great correlation and agreement between methods. Very high levels of triglycerides and cholesterol (≥ 15.28 and ≥ 8.72 mmol/L, respectively) led to falsely low HbA1c concentrations on Roche c501. Elevated HbF induced false HbA1c detection on Capillarys 2FP (> 10%), Tosoh G8 (> 30%), Premier Hb9210 (> 15%), and Roche c501 (> 5%). On Tosoh G8, HbE induced an extra peak on chromatogram, and significantly lower results were reported. CONCLUSIONS The four HbA1c methods commonly used with commercial analyzers showed a good reliability and comparability, although some interference may falsely alter the result.
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Affiliation(s)
- Xiaobin Wu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Yan Chao
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Zemin Wan
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Yunxiu Wang
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Yan Ma
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Peifeng Ke
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Xinzhong Wu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Jianhua Xu
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Junhua Zhuang
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
| | - Xianzhang Huang
- Department of Laboratory Science, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China
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Ris M, Božičević S, Biljak VR, Vučić Lovrenčić M. Analytical verification and quality assessment of the Tosoh HLC-723GX HbA 1c analyzer. Pract Lab Med 2016; 7:15-18. [PMID: 28856213 PMCID: PMC5575365 DOI: 10.1016/j.plabm.2016.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/01/2016] [Accepted: 12/05/2016] [Indexed: 11/16/2022] Open
Abstract
Objectives Ion-exchange high-performance liquid chromatography (IE-HPLC) has long been used as a reproducible and versatile analytical tool for HbA1c measurement. In this study, we performed analytical verification and quality assessment of the recently introduced small IE-HPLC Tosoh HLC-723GX HbA1c analyzer, and a comparison of results to immunoassay (IA) and capillary electrophoresis (CE). Design and methods The total imprecision of Tosoh HLC-723GX was verified according to CLSI EP15-A2 protocol using commercial control materials (C-QC) and pooled human whole blood samples (HWB). The Sigma metric was used for the evaluation of quality targets. HbA1c results were compared to automated CE (MiniCap Flex Piercing, Sebia, France) and IA (Tina-quant HbA1c Gen 2, Cobas Integra 400+, Roche Diagnostics, USA) procedures. Results The total imprecision of Tosoh HLC-723GX-HbA1c for IFCC(mmol/mol) and NGSP(%) units was: 1.91/1.25% (HbA1c=31 mmol/mol/5.0%) and 0.51/0.63% (HbA1c=84 mmol/mol/9.8%) for C-QC, and 0.39/0.2% (HbA1c=47 mmol/mol/6.5%) and 0.77/0.46% (HbA1c=94 mmol/mol/10.8%) in HWB samples, respectively. Bland-Altman analysis did not reveal any deviation of the results between Tosoh HLC-723GX and CE: mean difference 0.0% (95%CI: −0.02927 to 0.02653%), while the mean HbA1c difference against IA was −0.07% (95%CI: −0.1039 to −0.02765). At the selected HbA1c clinical decision level (48 mmol/mol/6,5%), six sigma analysis gave σ value of 3.91, within a desirable classification of performance. Conclusion The analytical performance of the Tosoh HLC-723GX complies with the rigorous quality criteria for clinical use of HbA1c, with the results comparable to the CE procedure. Tosoh HLC-723GX provides a plausible analytical choice for reliable HbA1c measurement in low-volume laboratories. Compliance to the rigorous quality targets is necessary for the reliable clinical use of HbA1c. A small, fully automated benchtop HbA1c analyzer (Tosoh HLC-723GX) was evaluated. Tosoh HLC-723GX anaylzer met the six sigma-based quality targets. Low-volume laboratories could provide clinically reliable HbA1c results by the Tosoh HLC-723GX analyzer.
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Affiliation(s)
- Marko Ris
- Clinical Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zajčeva 19, Zagreb, Croatia
| | - Sandra Božičević
- Clinical Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zajčeva 19, Zagreb, Croatia
| | - Vanja Radišić Biljak
- Clinical Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zajčeva 19, Zagreb, Croatia
| | - Marijana Vučić Lovrenčić
- Clinical Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zajčeva 19, Zagreb, Croatia
- Scientific Research Unit, Merkur University Hospital, Zajčeva 19, Zagreb, Croatia
- Correspondence to: Clinical Department of Medical Biochemistry and Laboratory Medicine, Scientific Research Unit, Merkur University Hospital, Zajčeva 19, 10000 Zagreb, Croatia.
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Hattan SJ, Parker KC, Vestal ML, Yang JY, Herold DA, Duncan MW. Analysis and Quantitation of Glycated Hemoglobin by Matrix Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2016; 27:532-541. [PMID: 26733405 DOI: 10.1007/s13361-015-1316-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 06/05/2023]
Abstract
Measurement of glycated hemoglobin is widely used for the diagnosis and monitoring of diabetes mellitus. Matrix assisted laser desorption/ionization (MALDI) time of flight (TOF) mass spectrometry (MS) analysis of patient samples is used to demonstrate a method for quantitation of total glycation on the β-subunit of hemoglobin. The approach is accurate and calibrated with commercially available reference materials. Measurements were linear (R(2) > 0.99) across the clinically relevant range of 4% to 20% glycation with coefficients of variation of ≤ 2.5%. Additional and independent measurements of glycation of the α-subunit of hemoglobin are used to validate β-subunit glycation measurements and distinguish hemoglobin variants. Results obtained by MALDI-TOF MS were compared with those obtained in a clinical laboratory using validated HPLC methodology. MALDI-TOF MS sample preparation was minimal and analysis times were rapid making the method an attractive alternative to methodologies currently in practice.
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Affiliation(s)
| | | | | | - Jane Y Yang
- Department of Pathology, University of California San Diego, La Jolla, CA, 92093-0612, USA
| | - David A Herold
- Department of Pathology, University of California San Diego, La Jolla, CA, 92093-0612, USA
- VA San Diego Healthcare System, PALMS, MS 113, San Diego, CA, 92161, USA
| | - Mark W Duncan
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, MS 8106, Aurora, CO, 80045, USA
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Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights 2016; 11:95-104. [PMID: 27398023 PMCID: PMC4933534 DOI: 10.4137/bmi.s38440] [Citation(s) in RCA: 555] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 02/06/2023] Open
Abstract
Diabetes is a global endemic with rapidly increasing prevalence in both developing and developed countries. The American Diabetes Association has recommended glycated hemoglobin (HbA1c) as a possible substitute to fasting blood glucose for diagnosis of diabetes. HbA1c is an important indicator of long-term glycemic control with the ability to reflect the cumulative glycemic history of the preceding two to three months. HbA1c not only provides a reliable measure of chronic hyperglycemia but also correlates well with the risk of long-term diabetes complications. Elevated HbA1c has also been regarded as an independent risk factor for coronary heart disease and stroke in subjects with or without diabetes. The valuable information provided by a single HbA1c test has rendered it as a reliable biomarker for the diagnosis and prognosis of diabetes. This review highlights the role of HbA1c in diagnosis and prognosis of diabetes patients.
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Affiliation(s)
- Shariq I. Sherwani
- Department of Internal Medicine, Division of Pulmonary Medicine, The Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Haseeb A. Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
- CORRESPONDENCE: ;
| | - Aishah Ekhzaimy
- Division of Endocrinology, Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Afshan Masood
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Meena K. Sakharkar
- Drug Discovery and Development Research Group, College of Pharmacy and Nutrition, University of Saskatchewan, Canada
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Zhao Z, Basilio J, Hanson S, Little RR, Sumner AE, Sacks DB. Evaluation of hemoglobin A1c measurement by Capillarys 2 electrophoresis for detection of abnormal glucose tolerance in African immigrants to the United States. Clin Chim Acta 2015; 446:54-60. [PMID: 25861848 DOI: 10.1016/j.cca.2015.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/11/2015] [Accepted: 03/17/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hemoglobin A1c (HbA1c) is used to monitor long-term glycemic control in individuals with diabetes, guide therapy, predict the risk of microvascular complications, and more recently to diagnose diabetes. An automated liquid-flow capillary electrophoresis method was recently developed to measure HbA1c using the Capillarys 2 Flex Piercing instrument. METHODS Analytical evaluation was performed at 2 clinical centers. A clinical analysis was conducted in 109 African-born individuals, 24% of whom have variant hemoglobin (HbAS or HbAC). Abnormal glucose tolerance (which includes both diabetes and prediabetes) was defined as 2h glucose of ≥ 140 mg/dl (7.8 mmol/l) during an oral glucose tolerance test. RESULTS Interlaboratory CVs were ≤ 2.1%. The method showed satisfactory correlation with 2 other analyzers that measure HbA1c by high-performance liquid chromatography. Neither labile HbA1c, carbamylated hemoglobin, uremia, bilirubin nor common hemoglobin variants (HbC/HbS/HbE) interfered. Forty-five individuals (41%) had abnormal glucose tolerance. The sensitivity of HbA1c for diagnosing abnormal glucose tolerance was 38%, 36% and 42% for total, normal and variant hemoglobin groups, respectively. CONCLUSIONS The analytical performance of HbA1c on the Capillarys 2 is suitable for clinical application. Variant hemoglobin in Africans did not interfere with the detection of abnormal glucose tolerance by HbA1c measured on the Capillarys 2.
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Affiliation(s)
- Zhen Zhao
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Jeffrey Basilio
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Steven Hanson
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, United States
| | - Randie R Little
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, United States
| | - Anne E Sumner
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.
| | - David B Sacks
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States.
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Wang B, Anzai JI. Recent Progress in Electrochemical HbA1c Sensors: A Review. MATERIALS (BASEL, SWITZERLAND) 2015; 8:1187-1203. [PMID: 28787996 PMCID: PMC5455452 DOI: 10.3390/ma8031187] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 11/18/2022]
Abstract
This article reviews recent progress made in the development of electrochemical glycated hemoglobin (HbA1c) sensors for the diagnosis and management of diabetes mellitus. Electrochemical HbA1c sensors are divided into two categories based on the detection protocol of the sensors. The first type of sensor directly detects HbA1c by binding HbA1c on the surface of an electrode through bio-affinity of antibody and boronic acids, followed by an appropriate mode of signal transduction. In the second type of sensor, HbA1c is indirectly determined by detecting a digestion product of HbA1c, fructosyl valine (FV). Thus, the former sensors rely on the selective binding of HbA1c to the surface of the electrodes followed by electrochemical signaling in amperometric, voltammetric, impedometric, or potentiometric mode. Redox active markers, such as ferrocene derivatives and ferricyanide/ferrocyanide ions, are often used for electrochemical signaling. For the latter sensors, HbA1c must be digested in advance by proteolytic enzymes to produce the FV fragment. FV is electrochemically detected through catalytic oxidation by fructosyl amine oxidase or by selective binding to imprinted polymers. The performance characteristics of HbA1c sensors are discussed in relation to their use in the diagnosis and control of diabetic mellitus.
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Affiliation(s)
- Baozhen Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, Shandong, China.
- Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki, Aoba-ku, Sendai 980-8578, Japan.
| | - Jun-Ichi Anzai
- Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki, Aoba-ku, Sendai 980-8578, Japan.
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Fortuitous detection of a case of unknown haemoglobin Athens-Georgia from atypical HbA1c electropherogram. Clin Chim Acta 2015; 440:6-7. [DOI: 10.1016/j.cca.2014.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 11/23/2022]
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Barbaro M, Ku-Chulim C, Johnston F, Cochrane R, Rota F, Passerini G, Guerra E, Ceriotti F, Carobene A. Evaluation of the performance of an immunoturbidimetric HbA1c reagent applied to the Siemens ADVIA 2400 automatic analyzer. Clin Biochem 2015; 48:177-80. [DOI: 10.1016/j.clinbiochem.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/17/2014] [Accepted: 11/03/2014] [Indexed: 12/19/2022]
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Chen YC, Chang PL. Baseline separation of amino acid biomarkers of hepatocellular carcinoma by polyvinylpyrrolidone-filled capillary electrophoresis with light-emitting diode-induced fluorescence in the presence of mixed micelles. Analyst 2015; 140:847-53. [DOI: 10.1039/c4an01550a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Separation of amino acid biomarkers could be performed by polyvinylpyrrolidone-filled capillary electrophoresis in the presence of mixed micelles.
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Affiliation(s)
- Yen-Chu Chen
- Department of Chemistry
- Tunghai University
- Taichung 40704
- Taiwan
| | - Po-Ling Chang
- Department of Chemistry
- Tunghai University
- Taichung 40704
- Taiwan
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Heylen O, Van Neyghem S, Exterbille S, Wehlou C, Gorus F, Weets I. Evaluation of the Sebia CAPILLARYS 2 flex piercing for the measurement of HbA(1c) on venous and capillary blood samples. Am J Clin Pathol 2014; 141:867-77. [PMID: 24838332 DOI: 10.1309/ajcpru5qc2jbansv] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES We evaluated the Sebia CAPILLARYS 2 Flex Piercing (Cap 2FP; Sebia, Lisses, France) for measurement of hemoglobin A1c (HbA1c) on venous and capillary blood samples. METHODS We analyzed whole-blood samples and control materials with the Cap 2FP and Tosoh G8 (Tosoh Corporation, Tokyo, Japan). Capillary blood samples were analyzed on the Cap 2FP on different storage conditions and were compared with venous samples. RESULTS Both instruments achieved total imprecision of less than 2.5% (International Federation of Clinical Chemistry units). Bias was 1 mmol/mol or less and 4 mmol/mol or less for the Cap 2FP and Tosoh G8, respectively. The Cap 2FP was not prone to common interferences. The Tosoh G8 showed significant bias only for carbamylated hemoglobin and did not completely separate hemoglobin D and hemoglobin E. On the Cap 2FP, storage of capillary blood at room temperature showed no significant bias. There was good agreement with venous blood. CONCLUSIONS The Cap 2FP and Tosoh G8 perform excellently for HbA1c determination. Capillary blood can be analyzed on the Cap 2FP as an acceptable alternative to venous blood and point-of-care testing. Home collection and central analysis of capillary blood could contribute to a reduction of health care costs without reducing quality of HbA1c determination.
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Affiliation(s)
- Olivier Heylen
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Stefaan Van Neyghem
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Sandra Exterbille
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Charline Wehlou
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Frans Gorus
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ilse Weets
- Department of Clinical Chemistry and Radio-immunology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Rhea JM, Molinaro R. Rare presumptive Hb variant misidentification prevents appropriate Hb A1c result. Clin Chim Acta 2014; 431:111-2. [PMID: 24513537 DOI: 10.1016/j.cca.2014.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 01/21/2014] [Accepted: 01/22/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Jeanne M Rhea
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Ross Molinaro
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, United States.
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Dessi M, Pieri M, Pignalosa S, Martino FG, Zenobi R. Performances of capillary electrophoresis and HPLC methods in HbA1c determination: diagnostic accuracy in HbS and HbD-Iran variants' presence. J Clin Lab Anal 2014; 29:57-60. [PMID: 24687307 DOI: 10.1002/jcla.21728] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 11/12/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Glycated hemoglobin (HbA1c) provides a useful estimate of mean glycemia in patients with diabetes and is directly related to risks for diabetes complications. The aim of this study is to compare a capillary electrophoresis method and two high-performance liquid chromatography (HPLC) cation-exchange analyzers (Variant II (Bio-Rad Laboratories, Inc., Hercules, CA) and G8 (Tosoh Biosciences, San Francisco, CA)) to identify the most reliable method in Hb variants' presence. METHODS Measurements of HbA1c were carried out in blood samples from 200 Tor Vergata Hospital patients, using G8 Tosoh, and from 107 San Filippo Neri Hospital patients, using Variant II Bio-Rad methods. All samples were analyzed by Capillarys 2 Flex Piercing (FP; Sebia, Lisses, France). RESULTS There was a good concordance between the results of capillary electrophoresis and HPLC methods (R(2) = 0.99, P < 0.0001 for G8 HPLC; R(2) = 0.99, P < 0.0001 for Variant II HPLC). During the study, we observed that some Hb variants, HbS and HbD-Iran, can alter the HbA1c level. CONCLUSIONS Since the HbA1c test is now recommended for diagnosing diabetes, and minimal variation of the concentration affects the clinical therapy, it is very important that the results are reliable and interference-free. Capillarys 2-FP analyzer is suitable for this purpose and sometimes it showed some advantages with respect to the HPLC analyzers tested, especially when Hb variants are present.
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Affiliation(s)
- Mariarita Dessi
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata" Hospital, Rome, Italy
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