Naslov
Capillary electrophoresis significantly improves clinical utility of hemoglobin A1c in gestational diabetes

Autori
Vučić Lovrenčić, Marijana ; Božičević, Sandra ; Krhač, Maja ; Radišić Biljak, Vanja ; Prašek, Manja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Clin Chem Lab Med ; 53, Special Supplement / - Berlin : Walter de Gruyter, 2015, S652-S652

Skup
EuroMedLab-2015

Mjesto i datum
Pariz, Francuska, 21.06.2015. - 26.06.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
HbA1c; capillary electrophoresis; gestational diabetes

Sažetak
BACKGROUND-AIM Clinical utility of hemoglobin A1c (Hb A1c) in diagnosis and monitoring of gestational diabetes (GDM) has been seriously compromised due to a lack of diagnostic accuracy originating from both biological variability and analytical limitations of contemporary methodology. Recently introduced capillary electrophoresis system for HbA1c analysis (Capillarys 2 Flex Piercing ®/ Minicap Flex Piercing®, Sebia, France) has been reported to have an excellent analytical performance and was found to be free from the common analytical interferences and hemoglobin variants, as well as fetal hemoglobin, which might be particularly interesting when measuring HbA1c in pregnancy complicated with diabetes. In this study we aimed to validate the clinical utility of HbA1c, as measured by the capillary electrophoresis, in diagnosis of GDM. METHODS 256 pregnant women (mean gestational age: 26±4, 7 weeks) were screened for GDM with a standard 75g oral glucose tolerance procedure followed by the venous plasma glucose measurement (hexokinase ; Beckman Coulter AU680, USA) at fasting, 1h and 2h after glucose load. Their glycaemic status was classified according to the WHO-2013 criteria. HbA1c was sampled at fasting and assayed with capillary electrophoresis [HbA1c- CAP (Minicap Flex Piercing®, Sebia, France)] and an automated immunoturbidimetric procedure [HbA1c-IT (TinaQuant-Integra 400Plus, Roche Diagnostics, USA)]. RESULTS GDM was diagnosed in 91 women (35, 5%), who did not differ regarding age and gestational age from women with normoglycaemia (NG ; N=165). HbA1c-CAP was significantly lower than HbA1c-IT (4, 7±0, 30%/28±3, 3 mmol/mol vs. 5, 2±0, 24%/33±2, 6 mmol/mol, P<0, 0001), and both systematic and proportional differences were found between the methods (y=1, 625+0, 750x ; intercept A/95%CI=1, 625/1, 233-2, 033 ; slope B/95%CI=0, 75/0, 667-0, 833 ; Passing Bablok). ROC- curve comparison showed a significantly better diagnostic accuracy of HbA1c-CAP vs. HbA1c-IT in discriminating between GDM and NG: [AUC/sensitivity(%)/specificity(%)/criterion(% /mmol/mol)=0, 727/70, 5/69/>4, 7/>28 vs. 0, 681/53, 7/74, 2/>5, 2/>33, respectively ; P=0, 0176]. CONCLUSIONS Our study indicates a significant improvement in clinical utility of hemoglobin A1c in GDM diagnosis with the use of capillary electrophoresis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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