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J Clin Pathol 2004;57:346-349 doi:10.1136/jcp.2002.007088
  • Original article

Conditions associated with very low values of glycohaemoglobin measured by an HPLC method

  1. J L Camargo1,
  2. J L Gross2
  1. 1Clinical Pathology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  2. 2Endocrinology Division, Hospital de Clínicas de Porto Alegre
  1. Correspondence to:
 Dr J L Gross
 Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcellos, 2350 Prédio 12, 40 andar, Porto Alegre, RS, Brazil, 90035-003; jorgegrossterra.com.br; jcamargohcpa.ufrgs.br
  • Accepted 30 May 2003

Abstract

Aims: To identify the causes of very low glycohaemoglobin (GHb) values in a sample of patients with diabetes in southern Brazil using high performance liquid chromatography.

Methods: Between August 1996 and December 2001 all samples from patients with diabetes at a university hospital with GHb values below the reference range (4.7–6.0% HbA1c) were submitted to cellulose acetate electrophoresis. Medical records were reviewed to identify conditions that might be associated with these low values.

Results: Among 29 657 samples analysed, 130 patients had GHb < 4.7%. Seventy three patients (56%) were heterozygous for HbS, HbC, or HbD (19 black, two mulatto, and 52 white patients). The other 57 patients (44%) without Hb variants had low haematocrit and haemoglobin values (42 patients) or other conditions such as pregnancy, lipaemia, malignancy, cirrhosis, acetylsalicylic acid use, and absence of diabetes (15 patients).

Conclusions: The presence of an Hb variant may falsely lower GHb measurements. However, anaemia is also a source of negative interference. The haematological status should be considered for the correct interpretation of GHb results.

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