Comparative Study of HbA1c Measurement using EDTA Blood and NaF-EDTA Blood by Automatic Analyzer Furuno CA-800

Pussadee Tobunluepop, Praewnapa Khlaithong


According to Clinical practice guideline for Diabetes (2017), analysis of hemoglobin

A1c (HbA1c) or glycated hemoglobin is used to assess glucose levels during the past 1-2 months, and it is recommended for diagnosis and monitoring of blood glucose level in diabetes mellitus patients. At present, HbA1c analysis by HPLC, affinity chromatography, immunoassay or enzymatic assay methods uses blood sample collected in ethylenediaminetetraacetic acid (EDTA) anticoagulant tube. However, the sample required for blood glucose testing uses sodium fluoride as anticoagulant and glycolysis inhibitor, and mostly, HbA1c was requested concurrently with blood glucose. The commonly found problems were no EDTA blood sent for HbA1c determination, and collecting of blood in EDTA tube added one more tube in the practice which can cause confusion, as well more amount of blood was drawn. Thus the aim of this study was to introduce the use of NaF-EDTA blood for HbA1c and glucose determination in the one tube. HbA1c measurement using NaF-EDTA blood samples were compared with those of EDTA blood. A total of 199 blood samples were collected from people who attended the annual checkup in both EDTA tube and NaF 3.0 mg plus Na2EDTA 6.0 mg (NaF-EDTA) tube in the same person to analyze for HbA1C by Furuno CA-800 automatic analyzer using turbidimetric immunoassay principle. The results showed the mean ± SD of HbA1c, obtained from EDTA blood and NaF-EDTA blood samples which were 5.9549 ± 0.9553 (%) and 5.8567

± 0.9519 (%) respectively. There was no significant difference between the HbA1c obtained from EDTA blood and NaF-EDTA blood samples (p > 0.05), linear regression equation showed good correlation in which y = 0.9854x-0.0315, r = 0.9869 (p = 0.001). In conclusion, HbA1c

measured from NaF-EDTA blood and EDTA blood are almost equal. The NaF-EDTA blood can also be used for HbA1c measurement. However, it should be further studied in samples with various HbA1C levels or with different Hb variants. The evaluation of glucose level in NaF-EDTA and NaF blood is also needed

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