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In clinical practice, all the measured results should exclude the influence of interference. In this study, the ion exchange high\u2010performance liquid chromatography of hemoglobin A1c (HbA1c) was evaluated via three brands of HbA1c analyzers, and 12 endogenous and 24 exogenous substances were added to hemoglobin solutions with different HbA1c levels to simulate the corresponding clinical samples. After the potential interfering substances were screened via interference screening testing, the interference concentration thresholds of each potential interfering substance were determined on the basis of dose\u2013response experiment. When these substances exceed the interference concentration thresholds, elevated HbA1c values are caused by endogenous cholic acid and low pH, whereas exogenous ethanol increases HbA1c measurements in samples with low values. However, HbA1c measurements decreased in samples with high values. Although there are some differences in the thresholds of interferent concentrations between different brands of analyzers, the differences are not significant. On the basis of the detailed interference concentration thresholds and interference substances, this evidence can be provided to clinical laboratory experts and help them interpret and determine the testing results of clinical laboratories.<\/jats:p>","DOI":"10.1002\/bmc.70382","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T14:44:14Z","timestamp":1770129854000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interference Assessment for High\u2010Performance Liquid Chromatography HbA1c Assays"],"prefix":"10.1002","volume":"40","author":[{"given":"Linghao","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of IVD Research and Development Lirimax (Tianjin) Medical Technology Co. Ltd.  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of IVD Reagent Review Tianjin Medical Device Evaluation and Inspection Center  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9405-5546","authenticated-orcid":false,"given":"Shengjin","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingang","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Xiang'an Hospital of Xiamen University, School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaxin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of IVD Reagent Review Tianjin Medical Device Evaluation and Inspection Center  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Affiliated Nanhua Hospital, Hengyang Medical School University of South China  Hengyang Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Affiliated Nanhua Hospital, Hengyang Medical School University of South China  Hengyang Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Clinical Biochemistry","author":"Ahmed N.","year":"2017"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath\u20102017\u2010204755"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296821997179"},{"key":"e_1_2_12_5_1","volume-title":"Interference Testing in Clinical Chemistry","author":"CLSI","year":"2018"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.09.014"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.41.2.167"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.27.2.102"},{"key":"e_1_2_12_9_1","unstructured":"Department of Health & Human Services US FDA.2017.510(k) Premarket Notification. 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