RESUMO
INTRODUCTION: Glycated hemoglobin (HbA1c) level reflects chronic glycemic status if reliable tests are used, however, in some regions worldwide high performing assays might not be readily available. This study aimed to asses two HbA1c immunoassays, comparing them with high-performance liquid chromatography (HPLC) assay, three methods available in Ecuador. MATERIAL AND METHODS: HbA1c were measured in 114 fresh whole blood-samples by DCA-Vantage point-of-care analyzer, I-Chroma portable fluorescent scanner immunoassay and BioRad Variant II Turbo HPLC. Normal and pathological HbA1c ranges were included. Blood samples with variants of hemoglobin were excluded. HbA1c values were expressed in National Glycohemoglobin Standardization Program percentages and mmol/mol, as mean±standard deviation. RESULTS: HbA1c results by HPLC and DCA-Vantage were similar: 6.3±1.7% (45±18.6mmol/mol) vs. 6.3±1.8% (45±19.7mmol/mol), respectively, P=0.057; while HbA1c values by I-Chroma were lower than HPLC, 5.8±1.9% (40±20.8mmol/mol), P<0.001. The coefficient of variation was below 2% for high and low HbA1c levels, in all methods studied. HbA1c values by HPLC and DCA-Vantage were highly correlated (Spearman's Rank Correlation [SRC]: 0.916), while the correlation among HPLC and I-Chroma was weak (SRC: 0.368). The mean bias between DCA-Vantage and HPLC was -0.02±0.29% (-0.2±3.2mmol/mol), while for I-Chroma and HPLC mean bias was -0.50±1.62% (-5.5±17.7mmol/mol). CONCLUSION: HbA1c immunoassays DCA-Vantage was comparable to HPLC assay, showing good correlation, appropriate precision and low bias, whereas I-Chroma assay was precise but inaccurate. Therefore, DCA-Vantage has better performance than I-Chroma. These findings suggest that is convenient to assess the HbA1c immunoassays commercially available in our country, Ecuador.
Assuntos
Cromatografia Líquida de Alta Pressão , Hemoglobinas Glicadas/análise , Imunoensaio , Adulto , Idoso , Equador , Feminino , Humanos , Imunoensaio/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
Consumption of fruit and vegetables has the potential to reduce non-transmissible diseases (NTD), such as cardiovascular diseases (CVD) and cancer, which are major public health concerns. Chile is a major apple producer and exporter in the world. Its production is concentrated in the sixth (O'Higgins) and seventh (Maule) regions of Central Chile. Phenolics and flavonoids are responsible for apple's high antioxidant activity. Many epidemiologic studies have shown that a diet rich in apples can reduce cardiovascular events (myocardial infarct and stroke) and some type of cancers. The mechanisms involved are not well understood. Nevertheless, antioxidants are key-players. Some of their in-vitro activities are inhibition of low-density lipoprotein (LDL) oxidation, cholesterol levels reduction, endothelium protection, reduction of neoplastic cells proliferation and apoptosis activation. Consequently, daily apple consumption campaigns in the country should be implemented, as well as funding research focused on molecular mechanisms involved in its antioxidant activity.
Las enfermedades no transmisibles (ENT), especialmente las cardiovasculares (ECV) y el cáncer, representan un grave problema de salud pública. Es conocido que el consumo de frutas y hortalizas disminuye el riesgo de sufrir dichas enfermedades. El manzano (Malus domestica Borkh.) se cultiva en Chile en una amplia zona geográfica, concentrándose principalmente en las regiones sexta y séptima. La actividad antioxidante de la manzana se debe principalmente a su contenido en fenoles y flavonoides. Varios estudios epidemiológicos han mostrado que el consumo de manzanas puede prevenir el desarrollo de ECV (infarto agudo de miocardio y enfermedad cerebro vascular) y ciertos tipos de cáncer. Los mecanismos por los cuales se producen dichos efectos, no están totalmente aclarados, sin embargo la participación de los antioxidantes es fundamental. Entre los principales hallazgos se han descrito, en relación a ECV: inhibición de la oxidación de low-density lipoprotein (LDL), disminución de colesterol total y protección de endotelio; y en relación a cáncer: disminución de la proliferación de células neoplásicas y activación de la apoptosis de las mismas. Debido al incuestionable efecto protector para la salud humana que presenta la ingesta de manzana, se deben impulsar estrategias que apunten a incentivar su consumo diario en el país. Asimismo, se deben seguir estudiando los principios activos y los mecanismos moleculares.