Ann Lab Med 2019; 39(3): 237-244  https://doi.org/10.3343/alm.2019.39.3.237
Accurate and Rapid Measurement of Glycated Hemoglobin Using HLC-723 G11 Variant Mode
Min-Seung Park, M.D.1, Kyunghoon Lee, M.D.2, Kyunghoon Lee, M.D.3, Junghan Song, M.D., Ph.D.3, and Hyung-Doo Park , M.D., Ph.D.1
1Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 2Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; 3Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Corresponding author: Hyung-Doo Park, M.D. https://orcid.org/0000-0003-1798-773X
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-0290
Fax: +82-2-3410-2719
E-mail: nayadoo@hanmail.net
Received: February 27, 2018; Revised: July 3, 2019; Accepted: December 11, 2018; Published online: May 1, 2019.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Type II diabetes mellitus causes many complications, and its prevalence continues to increase in Korea. Accurate measurement of glycated Hb (HbA1c) is important because of its usefulness in diagnosis, follow-up, and prediction of prognosis. We tested the analytical performance of the HLC-723 G11 Variant Mode (G11vr; Tosoh Bioscience, Inc., Tokyo, Japan), recently introduced to Korea, in detecting HbA1c.
Methods: We evaluated precision, linearity, carry-over, and turnaround time. Using 208 samples, including 108 flagged samples, we compared HbA1c concentrations from four analyzers through correlation analysis: G11vr, HLC-723 G8 Variant Mode (G8vr, Tosoh Bioscience), HLC-723 G11 Standard Mode (G11st, Tosoh Bioscience), and HLC-723 G8 Standard Mode (G8st, Tosoh Bioscience). We used HPLC mass spectrometry (MS) and capillary electrophoresis (CE) to confirm the HbA1c concentrations of 15 additional known Hb variant samples.
Results: Repeatability (% CV) in measuring low- and high-concentration controls was 0.57% and 0.35%, respectively; within-laboratory precision was 0.86% and 0.69%, respectively. In a linearity test, the coefficient of determination was 0.9999 (measurement range: 3.64% to 18.59%) for HbA1c. The correlations between G11vr and other analyzers were weaker for flagged samples than for non-flagged samples. The carry-over effect was less than 0.4%. Turnaround time for a single sample was lower in G11vr (one minute) than in G8vr (1.6 minutes). For 15 samples with Hb variants, G11vr HbA1c results were more similar than those of other analyzers to HPLC-MS and CE results.
Conclusions: G11vr showed adequate performance and rapid turnaround time in measuring HbA1c.
Keywords: HbA1c, Hb variants, Glycated Hb, Tosoh HLC-723 G11 analyzer, Performance



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