葡萄糖-6-磷酸脱氢酶缺乏对3种HbA1c检测系统结果的干扰评价

Interference of glucose-6-phosphate dehydrogenase deficiency on measurements of glycated hemoglobin by three detection systems

目的观察葡萄糖-6-磷酸脱氢酶(G6PD)缺乏对糖化血红蛋白(Hb A1c)检测结果的影响。方法收集2012年8月至2016年4月中山大学附属中山医院286份标本,分别为健康组122例、糖尿病组82例、G6PD缺乏症组61例及糖尿病伴G6PD缺乏症组21例。用Primus Ultra2、VariantⅡTurbo 2.0和Modular P 3种检测系统检测Hb A1c,将Hb A1c换算成估计平均血糖浓度(e AG),计算与空腹血糖(FPG)的差值(△e AG-FPG),对各组△e AG-FPG进行统计学分析。结果 G6PD缺乏组及糖尿病伴G6PD缺乏组在3个检测系统中的Hb A1c、△e AG-FPG均偏低,且分别与健康组及糖尿病组差异有统计学意义(P均<0.05)。结论 G6PD缺乏均使Primus Ultra2、VariantⅡTurbo和Modular P检测系统Hb A1c结果假性偏低,临床医生用Hb A1c评估G6PD缺乏人群血糖控制水平时,应注意G6PD缺乏所造成的影响。

Objective To observe the interference of glucose-6-phosphate dehydrogenase（ G6PD） deficiency on glycated hemoglobin（ Hb A1c） detected by three measurement systems. Methods A total of 286 cases of blood and serum samples were collected at Zhongshan Hospital of Sun Yat-Sun University from August 2012 to April 2016. The blood samples were divided into healthy control group（ 122 cases）,diabetes group（ 82 cases）,glucose-6-phosphate dehydrogenase deficiency group（ 61 cases） and diabetes with G6 PD deficiency group（ 21 cases）. The levels of Hb A1 c were detected by three measurement systems,including Primus Ultra2,Variant Ⅱ Turbo 2. 0 and Modular P. The results of Hb A1 c were converted into the estimated average blood glucose concentration（ e AG）.The values of △e AG-FPG in different groups were calculated and statistical analysis was performed for evaluation of the differences from the three measurement systems. Results The Hb A1 c results measured by the three systems and △e AG-FPG values in G6 PD deficiency group were all lower than healthy control group（ all P〈0. 05）. The measured results were similar in both diabetes group and diabetes with G6 PD deficiency group. Conclusion G6 PD deficiency may cause false Hb A1 c results detected by three measurement systems. In the case of Hb A1 c for evaluating blood glucose control,the interference of G6 PD deficiency should be noticed.