Comparative Study of HbA1c levels Measurement using EDTA Blood and By Turbidimetric Inhibition Immunoassay
Keywords:
HbA1c, Li-Heparin Blood, EDTA Blood, Turbidimetric Inhibition ImmunoassayAbstract
Objective: The objective of this study was to compare the HbA1c levels measured from EDTA blood samples and Li-Heparin blood samples of patients at Sakon Nakhon Hospital using the Turbidimetric Inhibition Immunoassay method.
Materials and Methods: This experimental study aimed to compare HbA1c levels measured using the Turbidimetric Inhibition Immunoassay principle with the Cobas 6000 analyzer. The study used residual blood samples from routine tests of patients at Sakon Nakhon Hospital who had HbA1c tests ordered from both EDTA blood and Li-Heparin blood samples on the same day and time. A total of 370 samples were collected. Data analysis and statistical tests were performed. The distribution of data was tested using the Kolmogorov-Smirnov test (KS test), and if p ≥ 0.05, the data were considered normally distributed. Pearson correlation was used to test the relationship between HbA1c levels from EDTA blood and Li-Heparin blood for normally distributed data, while Spearman’s correlation was used for non-normally distributed data. The difference in HbA1c levels from EDTA blood and Li-Heparin blood was tested using a paired t-test for normally distributed data and the Wilcoxon Signed Rank Test for non-normally distributed data. Statistical analyses were performed using statistical software, with significance set at p < 0.05.
Results: The average HbA1c levels measured from EDTA blood and Li-Heparin blood were 7.25% and 7.23%, respectively, with standard deviations of 2.38% and 2.37%. A t-test was used to test the difference between the two methods, and no significant difference was found (p = 0.237, p > 0.05). The results from both blood sample types showed a strong correlation (r = 0.9901).
Conclusion: Li-Heparin blood samples can be used as an alternative to EDTA blood samples for HbA1c measurement using the Turbidimetric Inhibition Immunoassay method, as long as the analysis is performed within the same day.
References
Diabetes Association of Thailand Department of Medicine. Clinical Practice Guideline for Diabetes 2017. 2nd ed. Romyen Media Ltd., 2017: 9.
Classification of diabetes mellitus. World Health Organization. 2019: 6-15.
Sacks DB. Diabetes Mellitus. In: Rifal N, Horvath AR, Wittwer CT. editors. Tietz textbook of clinical chemistry and molecular diagnostics. 6th ed. St. Louis, Missouri: Elsevier; 2018:1160-94.
Nadkarni P, Weinstock RS. Carbohydrates. In: McPherson RA, Pincus MR. editors. Henry’s clinical diagnosis and management by laboratory methods. Elsevier. 23rded. St. Louis, Missouri: 2017: 209-12.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2017; 40 Suppl 1: S11-S24.
Watanabe T, Ken Kato, Yamada D, et al. A nondiabetic case of hemoglobin variant (Hb Niigata) with inappropriately high and low HbA1c titers detected by different methods. Clin Chem 1998; 44: 1562-4.
Krishnamurti U, Steffes MW. Glycohe-moglobin: a primary predictor of the development or reversal of complications of diabetes mellitus. Clin Chem 2001; 47: 1157-65.
Rhea JM and Molinaro R. Pathology Consultation on HbA1c Methods and Interferences; 2014; 141: 8-13.8.
Weykamp C. HbA1c: A Review of Analytical and Clinical Aspects. Ann Lab Med 2013; 33: 393-5.
Jury C, Yutaka Y, Noriyuki N. In. Bain BJ, Bates I, Laffan MA, Lewis SM. Editors. Collection and handling of blood. Dacie and Lewis practical haematology. 11st ed. Elsevier: 2012: 6-7.
Haverstick DM, Jones PM. Specimen collection and processing. In: Rifal N, Horvath AR, Wittwer CT. editors. Tietz textbook of clinical chemistry and molecular diagnostics. 6th ed. St. Louis, Missouri: Elsevier; 2018; 6: 70-2.
Lifshitz MS. Preanalysis. In: McPherson RA, Pincus MR. editors. Henry’s clinical diagnosis and management by laboratory methods. Elsevier. 23rd ed. St. Louis, Missouri: 2017: 24-5.
Marlon LB, Prasanna Tadi. Laboratory Tube Collection. StatPearls Publishing; 2021; PMID: 32310451
Royal College of Internal Medicine of Thailand, Diabetes Association of Thailand, The Endocrine Society of Thailand, Department of Medical Services, Ministry of Public Health and National Health Security Office. Practice Guidelines for Diabetes 2014. Bangkok: Arun printing; 2014. (in Thai).
Cressey,R. Diabetes:Basicknowledgeand related laboratory tests. Chiang Mai: Department of Medical Technology Chiang Mai University; 2015. (in Thai).
Cas Weykamp. HbA1c: Review of analytical and clinical aspects. Ann Lab Med 2013.
สมาคมโรคเบาหวานแห่งประเทศไทย สถิติเบาหวานทั่วโลก [เข้าถึงเมื่อ 10 กันยายน 2567].เข้าถึงจาก:http://i-regist.igenco.co.th/web/dmthai_old/sites/default/files/idf_atlas_2015_uk_0.pdf
Chusongsang P, Musigawan P, Wannapong N, et al. Comparative study of HbA1c measurement using EDTA blood vs.NaF blood. Songkla Med J 2005; 23:73-79.
Boonlert W, Narakantha P, Onseng S, Yamphochai S, Nuanmuang N, Mooph prasit K. Hemoglobin A1c levels obtained from EDTA, lithium heparin, lithium heparin plus glycerides, and sodium fluoride blood samples. Songkla Med J 2010; 28: 107-16. (in Thai)
Pongruea P, Teerajetgul Y. Comparative Study of HbA1c Levels in EDTA Blood Versus Lithium-heparinized Blood Determined by Boronate Affinity Chromatography Method. Med Tech Assoc Thailand 2021; 49:7965-7974. (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nakhonphanom Hospital Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
- บทความที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของ โรงพยาบาลนครพนม
- ข้อความหรือข้อคิดเห็นต่างๆ เป็นของผู้เขียนบทความนั้นๆ ไม่ใช่ความเห็นของกองบรรณาธิการ
