血红蛋白变异体对糖化血红蛋白检测结果及方法学的影响

Effects of Hemoglobin Variants on the Detection Results and Methodology of Glycosylated Hemoglobin

摘要: 糖化血红蛋白(HbA1c)是评估糖尿病患者血糖长期控制水平的重要指标。然而，血红蛋白变异体的存在会干扰HbA1c的准确检测。本文系统综述了血红蛋白变异体对糖化血红蛋白(HbA1c)检测结果的影响。首先，阐述了血红蛋白变异体的类型及其地理分布，并分析了这些变异体如何影响高效液相色谱法(HPLC)和毛细管电泳法(CE)。其次，讨论了这些变异体如何具体影响HbA1c的检测系统，包括变异体的影响程度、范围及其具体表现。进一步，本综述详细探讨了血红蛋白变异体如何影响HbA1c水平的机制，并对不同检测方法下的HbA1c水平进行了比较，特别是IE-HPLC与CE法，同时也提及了LC-MS/MS法的应用及其结果。此外，还讨论了血红蛋白变异体的检测与鉴定方法，包括Sanger测序法和其他分子生物学技术，并探讨了这些方法的选择与应用。最后，本综述总结了主要发现，讨论了研究的局限性和未来研究方向，并为临床实践提供了启示与建议。

Abstract: Glycated hemoglobin (HbA1c) is a critical indicator for assessing the long-term blood glucose control in diabetic patients. However, the presence of hemoglobin variants can interfere with the accurate measurement of HbA1c. This article systematically reviews the impact of hemoglobin variants on HbA1c testing results. It begins by detailing the types and geographical distribution of hemoglobin variants and how these variants affect high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE). The article then discusses how these variants specifically influence the HbA1c detection system, including the extent, scope, and specific manifestations of their effects. Furthermore, it explores the mechanisms by which hemoglobin variants affect HbA1c levels and compares HbA1c levels under different testing methods, particularly IE-HPLC and CE methods. It also mentions the application and results of LC-MS/MS methods. Additionally, the article examines the detection and identification methods for hemoglobin variants, including Sanger sequencing and other molecular biology techniques, and discusses the selection and application of these methods. Finally, the article summarizes the main findings, discusses the limitations of the research, and outlines future research directions, providing insights and recommendations for clinical practice.