Evaluation of biological variation of glycated hemoglobin and glycated albumin in healthy Chinese subjects

• Published in: Journal of clinical laboratory analysis 2019-03, Vol.33 (3), p.e22715-n/a
• Main Authors: Liang, Libo, He, He, Zeng, Yuping, Zhang, Mei, Wang, Xia, Li, Xiaoling, Liang, Shanshan, An, Zhenmei, Huang, Hengjian
• Format: Article
• Language: English
• Subjects: Adult; Albumin; Asian Continental Ancestry Group - statistics & numerical data; between‐subject variation; Biological variation; Biological Variation, Population; Blood Chemical Analysis - standards; Data processing; Female; Females; Glucose; glycated albumin; glycated hemoglobin; Glycated Hemoglobin A - analysis; Hemoglobin; High-performance liquid chromatography; Humans; Male; Males; Reference Values; Serum Albumin - analysis; Variation; within‐subject variation
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.22715

Background Glycated hemoglobin (HbA1c) and glycated serum albumin (GSA) are used to evaluate the mean blood glucose levels. To ensure safe clinical application of HbA1c and GSA, reliable biological variation (BV) data are required. The aim of this research was to define the BV of HbA1c and GSA employing stringent rules. Methods Blood samples were drawn from 19 healthy subjects (10 females, nine males) once per week for 5 weeks. All samples were analyzed using enzymatic method for GSA and HPLC for HbA1c. The data were assessed for outliers, normality and variance homogeneity, and coefficient of variation (by ANOVA) for BV. Sex‐stratified BV including within‐subject (CVI) and between‐subject (CVG) was defined for HbA1c and GSA. Results The following estimates for BV values for CVI and CVG, respectively, were GSA: 1.23% and 4.67%, Alb: 0.75% and 3.18%, and HbA1c: 0.12% and 2.91%. The RCV of GSA was 3.61%, and HbA1c was 1.41%. And the II was 0.26 for GSA, and 0.07 for HbA1c, both of them less than 0.6. According to the 95% CI, the CVI of HbA1c was statistically different between females and males. And both the CVG of HbA1c and GSA were statistically different between females and males. Conclusion All CVI and CVG estimates were lower than those reported in the online BV database. And there is a significant difference between males and females. Analytical performance specifications derived from BV of this research can be applied internationally.