Erratum: [Corrigendum] Interpretation of HbA1c lies at the intersection of analytical methodology, clinical biochemistry and hematology (Review).

[This corrects the article DOI: 10.3892/etm.2022.11643.].

Interpretation of HbA1c lies at the intersection of analytical methodology, clinical biochemistry and hematology (Review).

Over past few decades, diabetes has become widespread on a global scale. Hemoglobin A1c (HbA1c) assessment is crucial for diabetes care, since it allows for the monitoring of an individual's level of glycemic control over the course of 2 to 3 months and risk assessment to determine any possible complications. Numerous methods, including cation-exchange chromatography, electrophoresis, immunoassays and affinity chromatography, can be used to determine the HbA1c level. Each method has its limitations, however. The amount of HbA1c in patient samples is not only dependent on blood glucose levels, but is also strongly influenced by changes in red blood cell lifespan and globin chain structure. Consequently, hematological, clinical biochemistry and analytical methods all intertwine when interpreting HbA1c. There are numerous reports on the interactions of HbA1c with inherited and acquired diseases. Some of these impacts are inconsistent and difficult to explain. The present review article aimed to summarize and classify these effects and evaluate their clinical relevance. The findings discussed herein may serve as a reminder that clinical HbA1c values need to be analyzed with caution.

Identification of a rare compound heterozygous hemoglobin variant ß0-thal [ß17(A14) Lys>Stop, HBB: c.52A>T] and Hb J-Lome [ß59(E3) Lys>Asn, HBB: c.180G>C].

BACKGROUND: HbA1c is the validated biomarker for glycemic management in diabetic individuals. Here, we report a compound heterozygote for ß0-thal and Hb J-Lomeand evaluate its effect on HbA1c measurements. METHODS: A 51-year-old female was suspected of harboring a hemoglobin variant following no value of HbA1c levelby Arkray HA-8180 V (48s HbA1c mode), abnormal hematological data, and abnormalhemoglobin analysison capillary electrophoresis (Capillarys 2 Flex Piercing, Hb program). Sanger sequencing of the α and ß genes was subsequently performed on the proband.HbA1c was reanalyzed using D10 (Bio-Rad), Capillarys 2 Flex Piercing (Sebia), and Roche Cobas c501 (Roche Diagnostics). RESULTS: Sanger sequencing identified a compound heterozygote for ß0-thal [ß17(A14) Lys > Stop, HBB: c.52A > T] and Hb J-Lome [ß59(E3) Lys > Asn, HBB: c.180G > C].HbA1c values ⁣⁣determinedby D10, Capillarys 2 Flex Piercing (HbA1c program), and Roche Cobas c501were 2.3%, no HbA1c value, and 5.1 (32 mmol/mol), respectively. During pedigree analysis, the son of the proband was found to have normal blood glucose (5.55 mmol/L), decreased HbA1c (3.6%, 16 mmol/mol)by Arkray HA-8180 V (48s HbA1c mode), an abnormal band on the electrophoretogram of Capillarys2 (Hb program), and the Hb J-Lome mutation in the ß globin gene.Subsequently, HbA1c values ⁣⁣determinedby D10, Capillarys 2 Flex Piercing (HbA1c program), and Roche Cobas c501 were4.0% (20 mmol/mol), no HbA1c value, and 5.0 (31 mmol/mol), respectively. CONCLUSION: Atypically low HbA1c levels or a discrepancy between blood glucose and HbA1c levels should raise concerns about hemoglobin variations.