Two patients with α-chain hemoglobin variant Hb Q-Iran detected by measuring hemoglobin A1c using the variant mode of the HA-8180V HPLC analyzer

Maki Kinoshita; Daiki Shimomura; Masashi Shimada; Mikio Kamioka; Masafumi Koga

doi:10.1007/s13340-023-00682-6

Two patients with α-chain hemoglobin variant Hb Q-Iran detected by measuring hemoglobin A1c using the variant mode of the HA-8180V HPLC analyzer

Diabetol Int. 2024 Jan 6;15(2):302-306. doi: 10.1007/s13340-023-00682-6. eCollection 2024 Apr.

Authors

Maki Kinoshita¹, Daiki Shimomura¹, Masashi Shimada¹, Mikio Kamioka¹, Masafumi Koga²

Affiliations

¹ Department of Laboratory Medicine, Tenri Hospital, Nara, Japan.
² Department of Internal Medicine, Hakuhokai Central Hospital, 4-23-1 Higashisonodacho, Amagasaki, Hyogo 661-0953 Japan.

Abstract

Hemoglobin variants are often discovered when hemoglobin A1c (HbA1c) levels measured with a high-performance liquid chromatography (HPLC) system in fast mode are found to be low. The HA-8180V HPLC analyzer by Arkray offers two measurement modes: fast mode (FM) and variant mode (VM). Two Japanese patients with α-chain variant Hb Q-Iran detected incidentally after analyses with the HA-8180V in VM showed an abnormal peak, are presented. The first patient was a man in his 70 s, and the second patient was a man in his 50 s. Both were non-diabetic, but their results from HbA1c measurement in VM showed an abnormal peak. The VM-HbA1c, FM-HbA1c, and HbA1c measured by enzymatic assay and glycated albumin levels of the two patients were all within the reference ranges. They were diagnosed as having Hb Q-Iran (α2-75Asp → His) by globin gene analysis. It is difficult to detect α-chain hemoglobin variants based on abnormal FM-HbA1c levels, but measuring HbA1c in VM is useful for efficiently detecting hemoglobin variants.

Keywords: Glycated albumin; Hb Q-Iran; Hemoglobin A1c; Hemoglobin variant.