Measurement with High-Performance Liquid Chromatography (HPLC)

Document Type : مقاله کوتاه

Authors

1 Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The global prevalence of diabetes mellitus is increasing rapidly. Measurement of glycated hemoglobin, predominantly HbA1c, is fundamental to the management of patients with diabetes. HbA1c is used to monitor long-term glycemic control, adjust therapy, assess the quality of diabetes care and predict the risk for the development of complications. While HbA1c is the standard indicator for long-term glycemic control in diabetes, there are different methods for measurement of HbA1c and all laboratories do not use the reference method of high-performance liquid chromatography (HPLC). This study aimed to compare three different methods of measuring HbA1c with HPLC to find out which method have acceptable concordance and correlation with the reference method.Methods: 58 patients with diabetes mellitus were assessed. Blood sample of each patient was checked via Diazyme (enzymatic assay), Nycocard (boronate-affinity binding) and Biosystem (microcalumn chromatography). The values of HbA1c in each method were compared with the Knauer-HPLC results.Findings: The mean (SD) of differential values between each method and HPLC in ANOVA test was 1.8 (1.1) for Nycocard-HPLC, 1.5 (1.1) for Biosystem-HPLC, and 1.3 (1.2) for Diazyme-HPLC. Pearson's correlation coefficient was 0.76 between Nycocard and HPLC, 0.75 between Diazyme and HPLC and 0.68 between Biosystem and HPLC. With HPLC linear regression parameters were also determined for each method.Conclusion: Diazyme had a better performance and showed a greater concordance with HPLC among others; although it was not an ideal alternative for HPLC.

Keywords


  1. Tavafi M. Complexity of diabetic nephropathy pathogenesis and design of investigations. J Renal Inj Prev 2013; 2(2): 59-62.
  2. Syed IA. Glycated haemoglobin; past, present, and future are we ready for the change. J Pak Med Assoc 2011; 61(4): 383-8.
  3. Baradaran A. Lipoprotein(a), type 2 diabetes and nephropathy; the mystery continues. J Nephropathol 2012; 1(3): 126-9.
  4. Nazar CMJ. Mechanism of hypertension in diabetic nephropathy. J Nephropharmacol 2014; 3(2): 49-55.
  5. Beladi-Mousavi SS, Bashardoust B, Nasri H, Ahmadi A, Tolou-Ghamari Z, Hajian S, et al. The theme of the world diabetes day 2014; healthy living and diabetes; a nephrology view point. J Nephropharmacol 2014; 3(2): 43-5.
  6. Assadi F. The epidemic of pediatric chronic kidney disease: the danger of skepticism. J Nephropathol 2012; 1(2): 61-4.
  7. Rafieian-Kopaei M, Baradaran A. On the occasion of world diabetes day 2105; act today to change tomorrow. J Renal Endocrinol 2015; 1: e02.
  8. Ardalan MR, Sanadgol H, Nasri H, Baradaran A, Tamadon MR, Rafieian-Kopaei R. Vitamin D therapy in diabetic kidney disease; current knowledge on a public health problem. J Parathy Dis 2014; 2(1):15-7.
  9. Nasri H. Comment on: Serum cholesterol and LDL-C in association with level of diastolic blood pressure in type 2 diabetic patients. J Renal Inj Prev 2012; 1(1): 13-4.
  10. Hajivandi A, Amiri M. World Kidney Day 2014: Kidney disease and elderly. J Parathyr Dis 2014; 2(1):3-4.
  11. Nasri H, Yazdani M. The relationship between serum LDL-cholesterol, HDL-cholesterol and systolic blood pressure in patients with type 2 diabetes. Kardiol Pol 2006; 64(12): 1364-8.
  12. Bryskiewicz ME, Majkowska L. Glycated hemoglobin (HbA1c) as a standard diagnostic criterium for diabetes? Pol Merkur Lekarski 2011; 30(176): 150-4. [In Polish].
  13. Nasri H. Association of serum lipoprotein (a) with hypertension in diabetic patients. Saudi J Kidney Dis Transpl 2008; 19(3): 420-7.
  14. Bryskiewicz ME, Majkowska L. Aspects of the standardization of glycated hemoglobin (HbA1c) measurement. Pol Merkur Lekarski 2011; 30(176): 155-9. [In Polish].
  15. Jeppsson JO, Kobold U, Barr J, Finke A, Hoelzel W, Hoshino T, et al. Approved IFCC reference method for the measurement of HbA1c in human blood. Clin Chem Lab Med 2002; 40(1): 78-89.
  16. Gaborit B, Nicolay A, Valero R, Begu A, Badens C, Bellanne-Chantelot C, et al. Comparison of performances of various HbA1c methods in Haemoglobin Camperdown variant detection: consequences in diabetes management. Clin Chim Acta 2009; 403(1-2): 262-3.
  17. Klenk DC, Hermanson GT, Krohn RI, Fujimoto EK, Mallia AK, Smith PK, et al. Determination of glycosylated hemoglobin by affinity chromatography: comparison with colorimetric and ion-exchange methods, and effects of common interferences. Clin Chem 1982; 28(10): 2088-94.
  18. John WG. Glycated haemoglobin analyses--assessment of within- and between-laboratory performance in a large UK region. Ann Clin Biochem 1987; 24 (Pt 5): 453-60.
  19. Bodor GS, Little RR, Garrett N, Brown W, Goldstein DE, Nahm MH. Standardization of glycohemoglobin determinations in the clinical laboratory: three years of experience. Clin Chem 1992; 38(12): 2414-8.
  20. Reinauer H. Biochemistry of protein glycation in diabetes mellitus. Klin Lab 1993; 39: 984-7.
  21. Peterson KP, Pavlovich JG, Goldstein D, Little R, England J, Peterson CM. What is hemoglobin A1c? An analysis of glycated hemoglobins by electrospray ionization mass spectrometry. Clin Chem 1998; 44(9): 1951-8.
  22. Roberts NB, Amara AB, Morris M, Green BN. Long-term evaluation of electrospray ionization mass spectrometric analysis of glycated hemoglobin. Clin Chem 2001; 47(2): 316-21.
  23. Weykamp CW, Penders TJ, Muskiet FA, van der Slik W. Effect of calibration on dispersion of glycohemoglobin values determined by 111 laboratories using 21 methods. Clin Chem 1994; 40(1): 138-44.
  24. Westgard J. Desirable biological variation database specifications [Online]. [cited 2014]; Available from:
  25. URL:http://www.westgard.com/biodatabase1.htm.
  26. Nasri H, Baradaran A. Association of serum lipoprotein (a) with ultrasonographically determined early atherosclerotic changes in the carotid and femoral arteries in kidney transplanted patients. Transplant Proc 2004; 36(9): 2683-6.
  27. Nasri H, Baradaran A. Correlation of serum magnesium with dyslipidemia in maintenance hemodialysis patients. Acta Medica (Hradec Kralove) 2004; 47(4): 263-5.
  28. Nasri H, Shirzad H. Toxicity and safety of medicinal plants. J HerbMed Plarmacol 2013; 2(2): 21-2.
  29. Nasri H, Rafieian-Kopaei M. Protective effects of herbal antioxidants on diabetic kidney disease. J Res Med Sci 2014; 19(1): 82-3.
  30. Halwachs-Baumann G, Katzensteiner S, Schnedl W, Purstner P, Pieber T, Wilders-Truschnig M. Comparative evaluation of three assay systems for automated determination of hemoglobin A1c. Clin Chem 1997; 43(3): 511-7.
  31. Turpeinen U, Karjalainen U, Stenman UH. Three assays for glycohemoglobin compared. Clin Chem 1995; 41(2): 191-5.
  32. Hawkins RC. Comparison of four point-of-care HbA1c analytical systems against central laboratory analysis. Singapore Med J 2003; 44(1): 8-11.
  33. Goldberg RB, Mather K. Targeting the consequences of the metabolic syndrome in the Diabetes Prevention Program. Arterioscler Thromb Vasc Biol 2012; 32(9): 2077-90.
  34. Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H. Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med 2014; 5(8): 927-46.
  35. Nasri H, Ardalan MR, Rafieian-Kopaei M. On the occasion of world hypertension day 2014: A nephrology point of view. J Res Med Sci 2014; 19(9): 911-2.
  36. Nasri H, Rafieian-Kopaei M. Metformin: Current knowledge. J Res Med Sci 2014; 19(7): 658-64.
  37. Hoelzel W, Miedema K. Development of a reference system for the international standardization of HbA1c/glycohemoglobin determinations. J Int Fed Clin Chem 1996; 8(2): 62-7.
  38. Nasri H, Kheiri S. Effects of diabetes mellitus, age, and duration of dialysis on parathormone in chronic hemodialysis patients. Saudi J Kidney Dis Transpl 2008; 19(4): 608-13.
  39. Nasri H, Baradaran HR. Lipids in association with serum magnesium in diabetes mellitus patients. Bratisl Lek Listy 2008; 109(7): 302-6.
  40. Baradaran A, Behradmanesh S, Nasri H. Association of body mass index and serum vitamin D level in healthy Iranian adolescents. Endokrynol Pol 2012; 63(1): 29-33.
  41. Nasri H. World kidney day 2013: acute kidney injury; a public health aware. Iran J Public Health 2013; 42(3): 338-40.