{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:08:53Z","timestamp":1785510533577,"version":"3.56.0"},"reference-count":33,"publisher":"Akademiai Kiado Zrt.","issue":"5","funder":[{"name":"Debreceni Egyetem Klinikai K\u00f6zpont Laborat\u00f3riumi Medicina"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"Haemoglobinopathi\u00e1k eset\u00e9n a hemoglobin-A1c meghat\u00e1roz\u00e1sa torzulhat, ami\n megnehez\u00edti a diabetes pontos monitoroz\u00e1s\u00e1t. A klinikai t\u00fcneteket okoz\u00f3 form\u00e1k\n mellett \u201ecsendes\u201d hemoglobinvari\u00e1nsok is el\u0151fordulnak, amelyek nem befoly\u00e1solj\u00e1k\n a v\u00e9rk\u00e9pet, \u00e9s rutinvizsg\u00e1latokkal (nagy teljes\u00edtm\u00e9ny\u0171 folyad\u00e9kkromatogr\u00e1fia,\n elektrofor\u00e9zis) sem mindig mutathat\u00f3k ki. K\u00e9t beteg v\u00e9rmint\u00e1j\u00e1n v\u00e9gezt\u00fcnk\n hemoglobin-A1c-m\u00e9r\u00e9st nagy teljes\u00edtm\u00e9ny\u0171 folyad\u00e9kkromatogr\u00e1fi\u00e1val \u00e9s k\u00e9miai\n immunturbidimetri\u00e1s m\u00f3dszerrel, tov\u00e1bb\u00e1 hemoglobinelektrofor\u00e9zist \u00e9s a\n b\u00e9ta-globin-g\u00e9n szekven\u00e1l\u00e1s\u00e1t. Or\u00e1lis gl\u00fck\u00f3ztolerancia-teszttel mindk\u00e9t esetben\n ism\u00e9telten kiz\u00e1rhat\u00f3 volt a diabetes mellitus fenn\u00e1ll\u00e1sa. Az els\u0151 betegn\u00e9l a\n kromatogr\u00e1fi\u00e1s hemoglobin-A1c-meghat\u00e1roz\u00e1s abnorm\u00e1lis kromatogram miatt nem volt\n \u00e9rt\u00e9kelhet\u0151, ez\u00e9rt alternat\u00edv m\u00f3dszer v\u00e1lt sz\u00fcks\u00e9gess\u00e9. A m\u00e1sodik betegn\u00e9l a\n kromatogr\u00e1fi\u00e1val m\u00e9rt magas hemoglobin-A1c ellentmondott a klinikai adatoknak. A\n labor\u2013klinikus egyeztet\u00e9s ut\u00e1n mindk\u00e9t esetben elektrofor\u00e9zis \u00e9s k\u00e9miai\n hemoglobin-A1c-meghat\u00e1roz\u00e1s t\u00f6rt\u00e9nt; az elektrofor\u00e9zis sor\u00e1n k\u00f3ros frakci\u00f3 egyik\n esetben sem mutatkozott. Az els\u0151 betegn\u00e9l k\u00e9miai m\u00f3dszerrel m\u00e9rhet\u0151, de\n szokatlanul alacsony hemoglobin-A1c-\u00e9rt\u00e9ket kaptunk. A genetikai vizsg\u00e1lat\n hemoglobin Graz mut\u00e1ci\u00f3t igazolt, amely folyad\u00e9kkromatogr\u00e1fi\u00e1val t\u00e9vesen magas\n vagy nem \u00e9rt\u00e9kelhet\u0151, immunoassay-vel pedig t\u00e9vesen alacsony\n hemoglobin-A1c-\u00e9rt\u00e9ket okozhat, klinikai t\u00fcnetek n\u00e9lk\u00fcl. A m\u00e1sodik betegn\u00e9l a\n k\u00e9miai m\u00f3dszer alacsonyabb, de praediabeteses tartom\u00e1ny\u00fa hemoglobin-A1c-\u00e9rt\u00e9ket\n mutatott; a genetikai anal\u00edzis hemoglobin Rainier vari\u00e1nst igazolt, amely\n familiaris erythrocytosissal t\u00e1rsul, \u00e9s hib\u00e1san magas hemoglobin-A1c-eredm\u00e9nyhez\n vezethet mindk\u00e9t m\u00f3dszerrel. A jelzett hemoglobinvari\u00e1nsok hazai k\u00f6zlem\u00e9nyben\n m\u00e9g nem szerepeltek. Esettanulm\u00e1nyaink kiemelik az alternat\u00edv\n hemoglobin-A1c-meghat\u00e1roz\u00e1si technik\u00e1k \u00e9s a genetikai vizsg\u00e1latok jelent\u0151s\u00e9g\u00e9t,\n valamint az olyan gl\u00fckometabolikus markerek (p\u00e9ld\u00e1ul frukt\u00f3zamin) hasznoss\u00e1g\u00e1t,\n amelyek seg\u00edthetnek a hossz\u00fa t\u00e1v\u00fa anyagcserekontroll meg\u00edt\u00e9l\u00e9s\u00e9ben. A pontos\n diagn\u00f3zis \u00e9s monitoroz\u00e1s alapja a szoros klinikus\u2013labor egy\u00fcttm\u0171k\u00f6d\u00e9s. Orv\n Hetil. 2026; 167(5): 196\u2013203.<\/jats:p>","DOI":"10.1556\/650.2026.33478","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T09:05:38Z","timestamp":1769936738000},"page":"196-203","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Hemoglobinvari\u00e1nsok okozta neh\u00e9zs\u00e9gek a hemoglobin-A1c \u00e9rt\u00e9kel\u00e9se sor\u00e1n k\u00e9t eset kapcs\u00e1n"],"prefix":"10.1556","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7158-5890","authenticated-orcid":true,"given":"No\u00e9mi","family":"Derzsi","sequence":"first","affiliation":[{"name":"SYNLAB Budapesti Diagnosztikai K\u00f6zpont, Klinikai K\u00e9miai Laborat\u00f3rium Budapest, Weiss Manfr\u00e9d \u00fat 5\u20137., 1211 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cz\u00e9geni","sequence":"additional","affiliation":[{"name":"\u00c9szak-budai Szent J\u00e1nos Centrumk\u00f3rh\u00e1z, II. Belgy\u00f3gy\u00e1szati \u2013 Diabetol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyula","family":"Tomasics","sequence":"additional","affiliation":[{"name":"\u00c9szak-budai Szent J\u00e1nos Centrumk\u00f3rh\u00e1z, II. Belgy\u00f3gy\u00e1szati \u2013 Diabetol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Konder\u00e1k","sequence":"additional","affiliation":[{"name":"SYNLAB Budapesti Diagnosztikai K\u00f6zpont, Klinikai K\u00e9miai Laborat\u00f3rium Budapest, Weiss Manfr\u00e9d \u00fat 5\u20137., 1211 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"Schandl","sequence":"additional","affiliation":[{"name":"\u00c9szak-budai Szent J\u00e1nos Centrumk\u00f3rh\u00e1z, II. Belgy\u00f3gy\u00e1szati \u2013 Diabetol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Winkler","sequence":"additional","affiliation":[{"name":"\u00c9szak-budai Szent J\u00e1nos Centrumk\u00f3rh\u00e1z, II. Belgy\u00f3gy\u00e1szati \u2013 Diabetol\u00f3giai Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzs\u00e9bet","family":"Pint\u00e9r","sequence":"additional","affiliation":[{"name":"SYNLAB Budapesti Diagnosztikai K\u00f6zpont, Klinikai K\u00e9miai Laborat\u00f3rium Budapest, Weiss Manfr\u00e9d \u00fat 5\u20137., 1211 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Wang M, Hng TM. HbA1c: More than just a number. Aust J Gen Pract.\n 2021; 50: 628-632.\n https:\/\/doi.org\/10.31128\/AJGP-03-21-5866","DOI":"10.31128\/AJGP-03-21-5866"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Weykamp C, John WG, Mosca A. A review of the challenge in measuring\n hemoglobin A1c. J Diabetes Sci Technol. 2009; 3: 439-445.\n https:\/\/doi.org\/10.1177\/193229680900300306","DOI":"10.1177\/193229680900300306"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Little RR, Roberts WL. A review of variant hemoglobins interfering\n with hemoglobin A1c measurement. J Diabetes Sci Technol. 2009; 3: 446-451.\n https:\/\/doi.org\/10.1177\/193229680900300307","DOI":"10.1177\/193229680900300307"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Safadi H, L\u00e1m J, Tisl\u00e9r A, et al. Analysis of laboratory tests in\n adults with diabetes in Hungary. A retrospective cohort study based on\n administrative data from 2014 to 2021. [A feln\u0151tt kor\u00fa cukorbetegek\n laborat\u00f3riumi vizsg\u00e1latainak elemz\u00e9se haz\u00e1nkban. Retrospekt\u00edv kohorszvizsg\u00e1lat a\n 2014-2021 k\u00f6z\u00f6tti ig\u00e9nybev\u00e9teli adatok alapj\u00e1n.] Orv Hetil. 2024; 165:\n 2047-2060. [Hungarian]\n https:\/\/doi.org\/10.1556\/650.2024.33185","DOI":"10.1556\/650.2024.33185"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"American Diabetes Association. Erratum. Classification and diagnosis\n of diabetes. Sec. 2. In: Standards of medical care in diabetes - 2016. Diabetes\n Care 2016; 39(Suppl 1): S13-S22. Diabetes Care 2016; 39: 1653.\n https:\/\/doi.org\/10.2337\/dc16-er09","DOI":"10.2337\/dc16-er09"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Weykamp C. HbA1c: a review of analytical and clinical aspects. Ann\n Lab Med. 2013; 33: 393-400.\n https:\/\/doi.org\/10.3343\/alm.2013.33.6.393","DOI":"10.3343\/alm.2013.33.6.393"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Liddy AM, Grundy S, Sreenan S, et al. Impact of haemoglobin variants\n on the use of haemoglobin A1c for the diagnosis and monitoring of diabetes: a\n contextualised review. Ir J Med Sci. 2023; 192: 169-176.\n https:\/\/doi.org\/10.1007\/s11845-022-02967-2","DOI":"10.1007\/s11845-022-02967-2"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Miller L, Maddahi Y, Shelly M, et al. First reported case of\n hemoglobin Graz in the United States: implications for misleading hemoglobin A1c\n results. JCEM Case Rep. 2024; 3: luae242.\n https:\/\/doi.org\/10.1210\/jcemcr\/luae242","DOI":"10.1210\/jcemcr\/luae242"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Lorenzo-Medina M, De-La-Iglesia S, Ropero P, et al. Effects of\n hemoglobin variants on hemoglobin A1c values measured using a high-performance\n liquid chromatography method. J Diabetes Sci Technol. 2014; 8: 1168-1176.\n https:\/\/doi.org\/10.1177\/1932296814538774","DOI":"10.1177\/1932296814538774"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Liu L, Hood S, Wang Y, et al. Direct enzymatic assay for %HbA1c in\n human whole blood samples. Clin Biochem. 2008; 41: 576-583.\n https:\/\/doi.org\/10.1016\/j.clinbiochem.2008.01.013","DOI":"10.1016\/j.clinbiochem.2008.01.013"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Kohne E. Hemoglobinopathies: clinical manifestations, diagnosis, and\n treatment. Dtsch \u00c4rztebl Int. 2011; 108: 532-540.\n https:\/\/doi.org\/10.3238\/arztebl.2011.0532","DOI":"10.3238\/arztebl.2011.0532"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Thom CS, Dickson CF, Gell DA, et al. Hemoglobin variants:\n biochemical properties and clinical correlates. Cold Spring Harb Perspect Med.\n 2013; 3: a011858.\n https:\/\/doi.org\/10.1101\/cshperspect.a011858","DOI":"10.1101\/cshperspect.a011858"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Udvardy M. Sickle cell disease, 2025. [Sarl\u00f3sejtes anaemia, 2025.]\n Orv Hetil. 2025; 166: 1531-1537. [Hungarian]\n https:\/\/doi.org\/10.1556\/650.2025.33378","DOI":"10.1556\/650.2025.33378"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Schnedl WJ, Lahousen T, Lang T, et al. Determination of glycated\n hemoglobin in clinically silent hemoglobin variants. Diabetes Metab Res Rev.\n 2004; 20: 460-465. https:\/\/doi.org\/10.1002\/dmrr.483","DOI":"10.1002\/dmrr.483"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"V\u00e1s\u00e1rhelyi B, Dlovan AJ, Blaha B, et al. Relationship between red\n blood cell parameters and hemoglobin A1c levels based on a retrospective\n evaluation of 10 years of data. [V\u00f6r\u00f6sv\u00e9rsejt-param\u00e9terek \u00e9s a hemoglobin-A1c\n (HbA1c)-szint kapcsolata 10 \u00e9v adatainak retrospekt\u00edv \u00e9rt\u00e9kel\u00e9se alapj\u00e1n.] Orv\n Hetil. 2024; 165: 243-248. [Hungarian]\n https:\/\/doi.org\/10.1556\/650.2024.32982","DOI":"10.1556\/650.2024.32982"},{"key":"R16","unstructured":"Nitin S. HbA1c and factors other than diabetes mellitus affecting\n it. Singapore Med J. 2010; 51: 616-622."},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Arnold JG, McGowan HJ. Delay in diagnosis of diabetes mellitus due\n to inaccurate use of hemoglobin A1c levels. J Am Board Fam Med. 2007; 20: 93-96.\n Erratum: J Am Board Fam Med. 2007; 20: 326.\n https:\/\/doi.org\/10.3122\/jabfm.2007.01.060086","DOI":"10.3122\/jabfm.2007.01.060086"},{"key":"R18","doi-asserted-by":"crossref","unstructured":"Homa K, Majkowska L. Difficulties in interpreting HbA1c results. Pol\n Arch Med Wewn. 2010; 120: 148-154.\n https:\/\/doi.org\/10.20452\/pamw.913","DOI":"10.20452\/pamw.913"},{"key":"R19","doi-asserted-by":"crossref","unstructured":"Radin MS. Pitfalls in hemoglobin A1c measurement: when results may\n be misleading. J Gen Intern Med. 2014; 29: 388-394.\n https:\/\/doi.org\/10.1007\/s11606-013-2595-x","DOI":"10.1007\/s11606-013-2595-x"},{"key":"R20","doi-asserted-by":"crossref","unstructured":"Freedman BI, Shenoy RN, Planer JA, et al. Comparison of glycated\n albumin and hemoglobin A1c concentrations in diabetic subjects on peritoneal and\n hemodialysis. Perit Dial Int. 2010; 30: 72-79.\n https:\/\/doi.org\/10.3747\/pdi.2008.00243","DOI":"10.3747\/pdi.2008.00243"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Miller JC, Ward KM, Smith DA, et al. Less agreement among\n glycohemoglobin (gHb) results by six (6) different methods in the presence of\n hemoglobin (Hb) variants. Clin Chem. 1997; 43: 128.\n https:\/\/doi.org\/10.1016\/S0294-3506(97)82273-9","DOI":"10.1016\/S0294-3506(97)82273-9"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Weykamp CW, Penders TJ, Muskiet FA, et al. Influence of hemoglobin\n variants and derivatives on glycohemoglobin determinations, as investigated by\n 102 laboratories using 16 methods. Clin Chem. 1993; 39: 1717-1723.\n https:\/\/doi.org\/10.1093\/clinchem\/39.8.1717","DOI":"10.1093\/clinchem\/39.8.1717"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Weykamp CW, Martina WV, van der Diys FP, et al. Hemoglobin S and C:\n reference values for glycohemoglobin in heterozygous, double heterozygous and\n homozygous subjects, as established by 13 methods. Clin Chim Acta 1994; 23:\n 161-171.\n https:\/\/doi.org\/10.1016\/0009-8981(94)90200-3","DOI":"10.1016\/0009-8981(94)90200-3"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Liu JS, Molchanova TP, Gu LH, et al. Hb Graz or alpha 2 beta\n 2(2)(NA2)His\u2192Leu; a new beta chain variant observed in four families from\n Southern Austria. Hemoglobin 1992; 16: 493-501.\n https:\/\/doi.org\/10.3109\/03630269208993117","DOI":"10.3109\/03630269208993117"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"Schnedl WJ, Reisinger EC, Lipp RW, et al. Hemoglobin variants\n recently detected in Austria. Ann Hematol. 1995; 71: 185-187.\n https:\/\/doi.org\/10.1007\/BF01910316","DOI":"10.1007\/BF01910316"},{"key":"R26","doi-asserted-by":"crossref","unstructured":"Schnedl WJ, Lahousen T, Wallner SJ, et al. Silent hemoglobin\n variants and determination of HbA(1c) with the high-resolution program of the\n HPLC HA-8160 hemoglobin analyzer. Clin Biochem. 2005; 38: 88-91.\n https:\/\/doi.org\/10.1016\/j.clinbiochem.2004.09.016","DOI":"10.1016\/j.clinbiochem.2004.09.016"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"Adekanmbi J, Higgins T, Rodriguez-Capote K, et al Erroneous HbA1c\n results in a patient with elevated HbC and HbF. Clin Chim Acta 2016; 462:\n 153-157. https:\/\/doi.org\/10.1016\/j.cca.2016.09.017","DOI":"10.1016\/j.cca.2016.09.017"},{"key":"R28","doi-asserted-by":"crossref","unstructured":"Adamson JW, Parer JT, Stamatoyannopoulos G. Erythrocytosis\n associated with hemoglobin Rainier: oxygen equilibria and marrow regulation. J\n Clin Invest. 1969; 48: 1376-1386.\n https:\/\/doi.org\/10.1172\/JCI106103","DOI":"10.1172\/JCI106103"},{"key":"R29","doi-asserted-by":"crossref","unstructured":"Dingle B, Farguharson H, Williams D, et al. Hb Rainier or alpha 2\n beta 2 (145 (HC2) Tyr replaced by Cys) observed in members of a Canadian family\n of Greek origin. Hemoglobin 1979; 3: 209-213.\n https:\/\/doi.org\/10.3109\/03630267908998916","DOI":"10.3109\/03630267908998916"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Stamatoyannopoulos G, Yoshida A, Adamson J, et al. Hemoglobin\n Rainier (beta145 tyrosine rarr histidine): alkali-resistant hemoglobin with\n increased oxygen affinity. Science 1968; 159: 741-743.\n https:\/\/doi.org\/10.1126\/science.159.3816.741","DOI":"10.1126\/science.159.3816.741"},{"key":"R31","doi-asserted-by":"crossref","unstructured":"Ren Q, Lv X, Yang L, et al. Erythrocytosis and performance of HbA1c\n in detecting diabetes on an oxygen-deficient plateau: a population-based study.\n J Clin Endocrinol Metab. 2020; 105: dgaa001.\n https:\/\/doi.org\/10.1210\/clinem\/dgaa001","DOI":"10.1210\/clinem\/dgaa001"},{"key":"R32","doi-asserted-by":"crossref","unstructured":"Zhou L, Yang L, Zhou X, et al. A comparison of HbA1c concentration\n in people with Type 2 diabetes at sea level and high altitude in China: an\n observational study. Diabet Med. 2017; 34: 862-864.\n https:\/\/doi.org\/10.1111\/dme.13356","DOI":"10.1111\/dme.13356"},{"key":"R33","unstructured":"Koch D, Rhea-McManus J, Berte LM. Laboratory algorithm for HbA1c\n testing. Available from:\n http:\/\/www.captodayonline.com\/hundreds-of-variants-staying-alert-to-hba1c-method-interference\/?print=print\n [accessed: November 6, 2025]."}],"container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/167\/5\/article-p196.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/167\/5\/article-p196.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/167\/5\/article-p196.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:32:10Z","timestamp":1785508330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/167\/5\/article-p196.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":33,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1556\/650.2026.33478","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}