Comparison of Capillary Zone Electrophoresis with High-pressure Liquid Chromatography in the Evaluation of Hemoglobinopathies

Objective: The capillary zone electrophoresis (CZE) and high-performance liquid chromatography (HPLC) methods were compared in terms of HbA2 measurement for the assessment of hemoglobinopathies. Materials and Methods: CZE was compared with HPLC for the evaluation of patients without hemoglobinopathy (n=321), with ß-thalassemia trait (n=113), and with common (HbD-Punjab, E, C, S/A, and S/S) and rare (HbS/D, O-Arap, Lepore, G-Coushata, Setif, Hamadan, Q-Iran, and H) variants (n=21). The reference range for HbA2 was determined by CZE. Results: Among patients without hemoglobinopathy, the median (2.5th-97.5th percentiles) values were 97.4% (97.0-98.0%) and 97.5% (96.6-98.4%) for HbA (p=0.060) and 2.4% (1.6-3.0%) and 2.5% (1.6-3.1%) for HbA2 (p<0.001) by HPLC and CZE, respectively. The reference range for HbA2 was 1.6-3.1% by CZE. In the comparison of methods for HbA2, there was a constant error of 0.255 (confidence interval: 0.062-0.448) and bias of 0.10% (limit of agreement: 0.33-0.53), and higher values were obtained with CZE. A strong correlation was observed between the methods (r=0.782). Interrater agreement was almost perfect for clinical diagnosis (Ï°=0.911). The two methods detected and identified the common variants similarly. All rare variants, except HbH by HPLC and HbS/D by CZE, were detected as separate peaks by both methods. Conclusion: The two methods were in agreement regarding the preliminary identification of ß-thalassemia patients. Different Hb variants were detected by both methods but with possible methodological interference for HbA2 measurements. CZE is a reliable and simple alternative for the evaluation of hemoglobinopathies. The standardization of HbA2 measurements should be prioritized as more techniques become available in routine laboratory practice.

Predictive Value of Betatrophin for Determining the Cardiovascular Risks of Obese Individuals.

OBJECTIVE: To determine cardiovascular risk factors, calculate cardiovascular risk, and the value of betatrophin, a novel biomarker in predicting the risk of cardiovascular disease (CVD) in obese individuals. STUDY DESIGN: Cross-sectional and descriptive study. PLACE AND DURATION OF STUDY:  University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Turkey, from August to November 2019. METHODOLOGY:  Three hundred and sixty-three patients sociodemographic information was obtained, anthropometric measurements were made, and routine laboratory examinations were taken for obesity. In addition, betatrophin was studied from the samples collected and stored under appropriate conditions. The risk of CVD development in the patients was calculated using Framingham and PRCAE risk calculation systems. RESULTS: The median betatrophin level of the participants was 745.8 (636.3-935.7) ng/L. A significant relationship was found between Framingham sub-risk groups and betatrophin level (p=0.049). Moreover, a significant relationship was also found, especially between the medium-risk group and the high-risk group (p=0.029). A significant correlation was found between the triglyceride and the betatrophin levels (p=0.001, r=-0.166). No relation was found between betatrophin level and risk score in the PRCAE sub-risk groups. CONCLUSION: Its significant relationship with the risk groups determined by the Framingham scoring system and triglyceride level is promising for betatrophin to be used as a new biomarker in predicting the CVD risk. Key Words: Betatrophin, Framingham score, Cardiovascular disease, Obesity, Risk.

Evaluation of the Analytical Properties of the Diagon CoagXL Coagulation Analyzer.

BACKGROUND: This study aims to evaluate the analytical properties of the DIAGON CoagXL (Budapest, Hungary) coagulation system. METHODS: The study includes a total of 212 normal, 49 pathologic plasma samples sent to our laboratory. The par-tial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) measurements were performed on the Diagon CoagXL and Stago StaR coagulometers. The precision, method comparison, carry-over, activity determination, and reference range verification studies were performed with Diagon CoagXL, the test analyzer. RESULTS: In the precision study performed with normal and pathologic plasma samples for the PT and aPTT tests, the within-day coefficient of variation (CV%) was 1.9 in the normal and 0.68 in the pathologic plasma for the PT, and for the aPTT it was 0.61 in the normal and 0.9 in the pathologic plasma. The between-day CV% was 1.6 in the normal plasma and 5.5 in the pathologic plasma for the PT and 3.7 in the normal plasma and 2.1 in the pathologic plasma for the aPTT. In the comparison study, the entire group mean ± standard deviation (mean ± SD) value for the INR was found to be 3.13 ± 1.26 in the CoagXL and 2.67 ± 0.82 in the StaR analyzer. The difference between these values was statistically significant (p < 0.006). For aPTT, mean ± SD value was found to be 39.44 ± 25.02 seconds (sec) in the CoagXL analyzer and 43.4 ± 27.63 sec in the StaR analyzer. The difference between these values was not statistically significant (p > 0.5). In the carryover study, the carryover value was -0.16 for the PT and 0 for the aPTT, which was under the allowable limit value (< 3 SD). In the percent activity determination study, regression equation of prothrombin activity (%) versus time (sec) was found as y = 341.6567 ± 37.1920x + 1.0913x2 (R2 = 0.97). The reference range verification analyses reveal that the manufacturer ranges were acceptable. CONCLUSIONS: Verification studies of CoagXL analyzer system was acceptable. But in comparison studies of PT we saw that there are still problems with recommended INR system.