Evaluation of Glycated Hemoglobin Results in Different Anticoagulant Materials and Methods

Background: Samples for glycated hemoglobin (HbA1c) measurements should be collected in ethylenediaminetetraacetic acid (EDTA) tubes, and only a few studies were available for the assessment of its measurements by another anticoagulant tube. There are different methods with different principles for the measurement of HbA1c in addition to high-performance liquid chromatography (HPLC) standard method, and one of these methods is ion exchange chromatography (IEC) which depends on the charge differences principle. Aim of the study: The aim is to compare the effect of different anticoagulant additives (EDTA, lithium heparin, and sodium citrate) on HbA1c value and to compare the results of HbA1c obtained by the IEC method with those by the HPLC method. Materials and Methods: This case methodology study investigated the effect of different anticoagulant additives on HbA1c values on 40 diabetic patients and compared the results of HbA1c values between HPLC method and IEC method on another 40 diabetic patients. Results: The study showed that there were non-significant differences in HbA1c mean values among different types of these anticoagulant materials and non-significant differences in glycated hemoglobin mean values between the methods of HPLC and IEC, and sensitivity and specificity for these techniques were 97.3% and 100% and 97.1% and 100%, respectively. Conclusion: This study showed that HbA1c can be tested with lithium heparin or sodium citrate as an alternative to EDTA tube, and the IEC method can be used as one of the main methods for the assessment of HbA1c.