A 45 years-old Chinese woman presented with an abnormally low HbA1c level of 3.7% (3.9%-6.1%) in a health examination. Fasting blood glucose was normal. Blood routine examination and serum bilirubin were in the normal range. HbA1c was determined by Tosoh HLC-723G11. There was an abnormal peak between A1c and A0 on the chromatogram. Hemoglobin electrophoresis indicated that the Hb E zone accounted for 25.1%. The β-thalassemia-related genes (mutant type) were βE M/N, and the related gene CD26 (A > G) was mutated. OGTT indicated prediabetes.
Hb E heterozygosity may reduce HbA1c value with abnormal chromatograms, as determined by a Tosoh HLC G11 analyzer. The Tosoh HLC G11 analyzer can well identify Hb E variation. In this case, further blood glucose-related tests should be performed to avoid missed diagnoses. However, a large sample size is needed to confirm this conclusion.
■一名45岁的中国女性在健康检查中出现3.7%的HbA1c异常低(3.9%-6.1%)。空腹血糖正常。血常规及血清胆红素均在正常范围内。通过TosohHLC-723G11测定HbA1c。色谱上A1c和A0之间存在异常峰。血红蛋白电泳显示HbE区占25.1%。β-地中海贫血相关基因(突变型)为βEM/N,相关基因CD26(A>G)发生突变。OGTT提示糖尿病前期。
■HbE杂合性可能会降低异常色谱图的HbA1c值,由TosohHLCG11分析仪测定。TosohHLCG11分析仪可以很好地识别HbE变异。在这种情况下,应进行进一步的血糖相关检测,以避免漏诊.然而,需要大量的样本来证实这一结论。