Identification of hemoglobin variants in samples received for glycated hemoglobin testing

Abstract

Background: In 2010 Singapore's National Health Survey reported 11.3% of the population between 18-69years of age with diabetes, compared to 8.2% in 2006. This increasing trend reinforces the dependence on HbA1c for management of glycemic control. Methods: To determine the incidence of hemoglobin variants received from our diabetic population who are attending the National University Hospital for testing of their HbA1c and determine whether the hemoglobin variant caused an interpretation issue, we reviewed all chromatograms from patients sending a sample for HbA1c analysis for a three-month period. Analysis was performed on the Variant II using the HbA2/HbA1c Dual program. Results: Our sub-analysis identified 2 cases of α thalassemia, 2 cases of β thalassemia; 5 cases of hemoglobin E variant homozygous, 1 case of hemoglobin J variant, 110 cases of hemoglobin E, 7 cases of hemoglobin S, 1 case of hemoglobin C and 1 case of hemoglobin D, all heterozygous. HbA1c results could be confidently reported in all cases except the homozygote variant and the hemoglobin J variant. Conclusions: Overall we obtained a prevalence of 2.3% of hemoglobin variants in our diabetic population being screened by HbA1c using Variant II. © 2012 Elsevier B.V.