HPLC법을 이용한 HbA1c 측정시 Abnormal Peak의 빈도와 원인

Factors Influencing Frequency of Abnormal Peak in the Measurement of HbA1c by HPLC

We experienced the specimen that contains a hemoglobin variant known as interference from HbAS in October 2003. It was the first case of Hb variants since Samsung Medical Center began conducting glycohemoglobin College of American Pathologists surveys in 1997. The purpose of this study is to share our experience with the specimen and promote the understanding of Hb variants & derivatives. We've performed cross checks to examine HbA1c by using two pieces of equipment; the TOSHOH G7 and BIO-RAD VARIANT-T(turbo), and Automatic High Performance Liquid Chromatography(HPLC) as an analytic measurement method. HPLC provides different fractional information of hemoglobin with a two-dimensional graph as well as numeric results. We have been performing a "Systematic Checking Process". Three specimen suspicious of Hb variants & derivatives were found through this process. College of American Pathologists notified that it is important for users to be aware of the limitation of their glycohemoglobin method to avoid reporting incorrect results due to interference from hemoglobin variants or hemoglobin adducts. Therefore, laboratory findings of Hb variants & derivatives are very important. The experience of qualified technicians with professional knowledge in Hb variants is the most important aspect in finding Hb variants. Korea is homogeneous in race and is not in an area with a higher finding rate of Hb variants. While 1,024 cases of Hb variants have been found in Japan, we do not have specific data on how many cases of Hb variants have been found in Korea. Considering Hb variant cases in Japan, which is geographically close to us, it is presumed that there must be various Hb variant cases in Korea. If domestic laboratories set a systemic protocol and build a network to share our experience in Hb variants, I expect the Korean Hb variants could also be listed on the world's Hb variant list.