مقایسه‌ی سه روش مختلف اندازه‌گیری HbA1c با روش مرجع کروماتوگرافی مایع با کارایی بالا (HPLC)

نوع مقاله : مقاله کوتاه

نویسندگان

1 دانشیار، گروه پاتولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دستیار، گروه پاتولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: شیوع جهانی دیابت شیرین به سرعت در حال افزایش است. اندازه‌گیری هموگلوبین گلیکوزیله، بیشتر HbA1c، اساس ارزیابی بیماران مبتلا به دیابت است. HbA1c برای پایش طولانی مدت کنترل قند خون، تنظیم درمان، ارزیابی کیفیت مراقبت از بیمار و پیش‌گویی خطر ایجاد عوارض به کار می‌رود. از آن جایی که HbA1c روش استاندارد برای کنترل طولانی مدت قند خون در مبتلایان به دیابت است، روش‌های متعددی برای اندازه‌گیری آن وجود دارد و همه‌ی آزمایشگاه‌ها از روش مرجع کروماتوگرافی مایع با کارایی بالا (HPLC یا High-performance liquid chromatography) استفاده نمی‌کنند. هدف این مطالعه، مقایسه‌ی سه روش متفاوت با روش HPLC بود تا ببینیم کدام روش، هم‌خوانی و همبستگی قابل قبولی با روش مرجع دارد.روش‌ها: در این مطالعه، 58 بیمار مبتلا به دیابت مورد بررسی قرار گرفتند. نمونه‌ی خون هر بیمار با دستگاه‌های Diazyme (روش انزیماتیک)، Nycocard (Boronate-affinity binding) و Biosystem (کروماتوگرافی ستونی) برای اندازه گیری مقدار HbA1c چک شد و مقدار HbA1c هر دستگاه با جواب Knauer-HPLC مقایسه شد.یافته‌ها: میانگین فاصله مقادیر در آزمون ANOVA برای Nycocard-HPLC برابر 8/1 با انحراف معیار 09/1، برای Biosystem-HPLC مساوی 5/1 با انحراف معیار 08/1 و برای Diazyme-HPLC برابر 3/1 با انحراف معیار 2/1 به دست آمد. ضریب همبستگی Pearson بین HPLC و Nycocard مساوی 76/0، بین  Diazymeو  HPLCبرابر 75/0 و بین Biosystem و HPLC مساوی 68/0 به دست آمد. معادله‌ی خط Regression برای هر روش با HPLC نیز به دست آمد.نتیجه‌گیری: از بین این روش‌ها، Diazyma عملکرد بهتری نسبت به دو روش دیگر داشت و همبستگی بیشتری نشان داد؛ هر چند، جایگزین مطلوبی برای HPLC نیست.

کلیدواژه‌ها

عنوان مقاله [English]

Measurement with High-Performance Liquid Chromatography (HPLC)

نویسنده [English]

  • Azadeh Karami 2
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
چکیده [English]

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.

کلیدواژه‌ها [English]

  • HbA1c
  • High-performance liquid chromatography (HPLC)
  • Enzymatic assay
  • Column chromatograghy
  • Diabetes Mellitus

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مجله دانشکده پزشکی اصفهان
دوره 33، شماره 325 - شماره پیاپی 325
فروردین و اردیبهشت 1394
صفحه 258-266

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  • تاریخ دریافت: 22 تیر 1392
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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