Unlocking precision: evaluating the impact of K2 and K3 EDTA anticoagulants on HbA1c analysis

Saitharani Arumugam; Suganya Subbarayalu; Sowmiya Subramani; Karpagavel Lakshmanan

Saitharani Arumugam Department of Biochemistry, Chettinad Academy of Research and Education (CHRI), Kelambakkam, Chengalpattu District, Tamil Nadu, India https://orcid.org/0009-0001-6010-478X
Suganya Subbarayalu Department of Biochemistry, Chettinad Academy of Research and Education (CHRI), Kelambakkam, Chengalpattu District, Tamil Nadu, India https://orcid.org/0000-0001-7656-875X
Sowmiya Subramani Department of Biochemistry, Chettinad Academy of Research and Education (CHRI), Kelambakkam, Chengalpattu District, Tamil Nadu, India https://orcid.org/0009-0008-9048-9511
Karpagavel Lakshmanan Department of Biochemistry, Chettinad Academy of Research and Education (CHRI), Kelambakkam, Chengalpattu District, Tamil Nadu, India https://orcid.org/0000-0001-9951-8667

Keywords: HbA1c, K2-EDTA, K3-EDTA, anticoagulant comparison, pre-analytical variability

Abstract

HbA1c plays a vital role in the diagnosis and monitoring of diabetes mellitus. The variety of blood collection tubes is a significant pre-analytical aspect that could affect test results. The influence of blood assortment devices on laboratory tests is often unnoticed. This study investigates whether K2-ethylenediaminetetraacetic acid (EDTA) and K3-EDTA vacuum tubes affect the analytical results of glycosylated haemoglobin, type A1C (HbA1c), measured via a Bio-Rad Analyser D10 HPLC analyser. This study was an analytical, observational, cross-sectional study, where we collected samples from 100 patients at Chettinad Hospital and Research Institute, Kelambakkam. Blood was taken simultaneously in both K2 RDTA and K3 EDTA tubes. The samples were analyzed immediately in a Bio-Rad analyzer D10 after collection. We employed the Wilcoxon test and passed the Bonferroni regression for comparing the two tubes. The information are represented as median and interquartile range. The standard deviations for K2 and K3 were 2.06 and 2.05, indicating the degree of variability in the data. Even though there is a very minor difference in the Wilcoxon test, there was no statistically significant p-value and passing the Bablok regression showed the Y=0.000+1.000x. This study showed very little noteworthy variance between K2 and K3 EDTA anticoagulant tubes. K2 and K3 tubes have a very slight difference, but it is not statistically significant and falls within the limit of agreement (LOA) range of 95%.