{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:09:08Z","timestamp":1780632548488,"version":"3.54.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Glucose-6-phosphate dehydrogenase (G6PD)\/hemoglobin (Hb) ratio helps detect G6PD deficiency, an X-linked disorder that can be asymptomatic or cause acute hemolytic anemia and chronic hemolysis. We investigated preanalytical, analytical, and postanalytical aspects to optimize G6PD\/Hb measurement and interpretation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>G6PD was measured with the Pointe Scientific assay and Hb with Drabkin\u2019s reagent on Alinity c\u00ae (Abbott Diagnostics). Stability of G6PD\/Hb was assessed after 7 and 14\u2009days while stored at 2\u20138\u2009\u00b0C. Stability of hemolysate prepared for G6PD analysis was assessed using QC and patient samples up to 4\u2009h at room temperature or 2\u20138\u2009\u00b0C. Analytical performance specifications including precision, method comparison, linearity, LOQ, and carry-over were established for the enzymatic reaction of G6PD and spectrophotometric reading of Hb. G6PD\/Hb reference interval and cut-offs were established indirectly using truncated maximum likelihood method (TML) using retrospective data (n\u2009=\u20094715 patient data points).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Samples were stable after 7\u2009days at 2\u20138\u00b0C, unless grossly hemolyzed. Hemolysate prepared for G6PD measurement remained stable for up to 4\u2009h for QC at room temperature and 2\u20138\u00b0C, but up to 30\u2009min\u20131 h at room temperature and 1\u20132 h at 2\u20138\u2009\u00b0C for patient samples. Precision, linearity, LOQ, and carryover were acceptable. G6PD\/Hb cut-offs were &amp;lt;3.3, \u22653.3, 3.3\u20138.9, and \u22658.9\u2009U\/g Hb for deficient males\/females, normal males, intermediate females, and normal females, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In vitro hemolysis and delayed hemolysate analysis significantly reduce G6PD\/Hb stability. QC material cannot detect the impact of delayed hemolysate analysis. These findings were foundational for optimizing G6PD\/Hb protocols for a new platform and establishing laboratory-specific G6PD\/Hb cut-offs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab008","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T20:54:18Z","timestamp":1613508858000},"page":"1251-1263","source":"Crossref","is-referenced-by-count":3,"title":["Optimizing Measurement and Interpretation of the G6PD\/Hb Ratio"],"prefix":"10.1093","volume":"6","author":[{"given":"Victoria","family":"Higgins","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pow Lee","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeevan","family":"Selvaratnam","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Laboratory Medicine, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davor","family":"Brinc","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Laboratory Medicine, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"2021090112220273100_jfab008-B1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.bcmd.2008.12.005","article-title":"The global prevalence of glucose-6-phosphate dehydrogenase 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