(บทความวิจัย) การศึกษาระดับ HbA1c และความผิดปกติของฮีโมโกลบิน ในเลือดที่ใช้ EDTA blood,  NaF blood และ Lithium-heparin blood โดยวิธี capillary electrophoresis

Pittaya Treerat; Naphatohn  Bhornsrivathanyou; Pensiri  Choosongsang; Phattanapong  Choosongsang

Authors

Pittaya Treerat Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla Province, Thailand
Naphatohn Bhornsrivathanyou Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla Province, Thailand
Pensiri Choosongsang Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla Province, Thailand
Phattanapong Choosongsang Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla Province, Thailand

Keywords:

EDTA blood, HbA1c, Lithium-heparin blood, NaF blood

Abstract

Hemoglobin A1c (HbA1c) is widely used for monitoring glycemic control in diabetic patients, reflecting average plasma glucose over the past 2-3 months. It is typically measured using blood collection in EDTA tubes. However, patients are often required to provide multiple types of blood samples in large volumes, which can be problematic for those with difficult venipuncture, leading to incomplete collection. In cases when HbA1c testing is requested after the initial blood draw without an EDTA sample, re-venipuncture may be necessary. This study compares HbA1c levels among EDTA blood, NaF blood, and LH blood using the Sebia Capillarys 3 Tera system with capillary electrophoresis, which simultaneously reports hemoglobin screening types. A total of 234 leftover clinical samples were analyzed, including 104 with normal hemoglobin and 130 with abnormal hemoglobin profiles. HbA1c values ranged from 4.6% to 16.4%. In the normal hemoglobin group, EDTA and NaF samples showed statistically significant differences (p < 0.001), while EDTA and LH samples did not (p = 0.328). In abnormal hemoglobin cases, no significant differences were found across all tube types (p = 0.233, 0.126). Bland-Altman analysis revealed acceptable bias within ±8%. Linear regression yielded R² values of 0.996, 0.995, 0.995, and 0.994 for comparisons across groups. In conclusion, NaF and LH blood samples are viable alternatives to EDTA blood for HbA1c analysis using the Sebia Capillarys 3 Tera system, with the added benefit of simultaneous hemoglobin typing screening within the same day.

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