Effects of Hemoglobin C and S Traits on Eight Glycohemoglobin Methods

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Abstract
Glycohemoglobin (gHb) is a biochemical marker of long-term glycemic control that is highly correlated with complications of diabetes mellitus (1). The presence of hemoglobin (Hb) variants can adversely affect the accuracy of some gHb methods, depending on the variant [for recent reviews, see Refs. (2)(3)]. Previous studies have shown that some gHb methods yield inaccurate results with samples heterozygous for Hb C or S (4)(5)(6)(7). In 2000, there were an estimated 26 million black or African Americans over age 17, of whom at least 10% had either Hb C or S trait (8)(9)(10)(11). The prevalence of diabetes is estimated to be 5.1% of the adult population, with rates for non-Hispanic blacks 1.6 times greater than in non-Hispanic whites (12). It is therefore probable that at least 200 000 Americans with diabetes have either Hb C or S trait. We investigated the measurement of gHb in specimens containing Hb C or S trait, using eight commercial gHb methods that are currently in clinical use.