Volume 16, Issue 1 (volume 16, number 1 2024)                   IJDO 2024, 16(1): 25-31 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kashani S, Hesari Z, Koohsar F, Kalavi K, Hojjati M T. Evaluation of Anemia Effect on HbA1c Level Measurement in Type 2 Diabetic People. IJDO 2024; 16 (1) :25-31
URL: http://ijdo.ssu.ac.ir/article-1-852-en.html
Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Abstract:   (52 Views)
Objective: For many years HbA1c used as diagnostic criteria for diabetes, however, measurement of HbA1 has some limitations that cannot be accurately assess blood glucose levels in conditions such as changes in red blood cell life. in this study, we evaluated and compared the levels of HbA1C in diabetic, pre-diabetic and non-diabetic individuals to understand the role and relationship of different values of RBC`s indices in these conditions.
Materials and Methods: This study performed between august to December of year 2021, and the demographic information and hematologic indices of 706 individuals which referred to laboratories in Gorgan city were investigated. According to results of FBS and HbA1c, individuals categorized in three distinct healthy (H), pre-diabetic (PD), and diabetic (D) groups base on latest ADA criteria.
Results: Evaluation of HbA1c level based on the presence or absence of anemia showed that in diabetic group with anemia significantly had a lower level 8.4 (± 1.5) than people without anemia 8.6 (± 1.5) (P= 0.045).
Conclusion: In this study, it was shown that changes in RBC indices in anemia can lead to inaccurate measurement of HbA1c level.
 
Full-Text [PDF 223 kb]   (41 Downloads)    
Type of Study: Research | Subject: Special
Received: 2023/09/25 | Accepted: 2024/02/5 | Published: 2024/03/20

References
1. Suo M, Wen D, Wang W, Zhang T. Comparative study on hemoglobin A1c, glycated albumin and glycosylated serum protein in aplastic anemia patients with Type 2 diabetes mellitus. Bioscience Reports. 2020;40(5):BSR20192300. [DOI:10.1042/BSR20192300]
2. American Diabetes Association (2020). Standards of Medical Care in Diabetes-2020 Abridged for Primary Care Providers. Clinical diabetes : a publication of the American Diabetes Association, 38(1), 10-38. [DOI:10.2337/cd20-as01]
3. Committee TI. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes care. 2009;32(7):1327. [DOI:10.2337/dc09-9033]
4. Nakao T, Matsumoto H, Okada T, Han M, Hidaka H, YOSHINO M, et al. Influence of erythropoietin treatment on hemoglobin A1c levels in patients with chronic renal failure on hemodialysis. Internal medicine. 1998;37(10):826-30. [DOI:10.2169/internalmedicine.37.826]
5. Kim S, Min WK, Chun S, Lee W, Park HI. Glycated albumin may be a possible alternative to hemoglobin A1c in diabetic patients with anemia. Clinical chemistry and laboratory medicine. 2011;49(10):1743-7. [DOI:10.1515/CCLM.2011.646]
6. Hong JW, Ku CR, Noh JH, Ko KS, Rhee BD, Kim DJ. Association between the presence of iron deficiency anemia and hemoglobin A1c in Korean adults: the 2011-2012 Korea National Health and Nutrition Examination Survey. Medicine. 2015;94(20):e82. [DOI:10.1097/MD.0000000000000825]
7. Guo W, Zhou Q, Jia Y, Xu J. Increased levels of glycated hemoglobin A1c and iron deficiency anemia: a review. Medical science monitor: international medical journal of experimental and clinical research. 2019;25:8371-78. [DOI:10.12659/MSM.916719]
8. Rollborn N, Akerfeldt T, Nordin G, Xu XY, Mandic-Havelka A, Hansson LO, et al. Analysis of HbA1c on an automated multicapillary zone electrophoresis system. Scandinavian Journal of Clinical and Laboratory Investigation. 2017;77(1):15-8. [DOI:10.1080/00365513.2016.1238507]
9. Klingenberg O, Furuset T, Hestbråten CR, Hallberg MH, Steiro A, Orset IR, et al. HbA1c analysis by capillary electrophoresis-comparison with chromatography and an immunological method. Scandinavian journal of clinical and laboratory investigation. 2017;77(6):458-64. [DOI:10.1080/00365513.2017.1338747]
10. Freeman AM, Rai M, Morando DW. Anemia Screening. [Updated 2023 Jul 25]. In: StatPearls. Available from: https://pubmed.ncbi.nlm.nih.gov/ 29763080/
11. Figueiredo MS. The importance of hemoglobin A 2 determination. Revista Brasileira de hematologia e hemoterapia. 2015;37:287-9. [DOI:10.1016/j.bjhh.2015.06.002]
12. Masuch A, Friedrich N, Roth J, Nauck M, Müller UA, Petersmann A. Preventing misdiagnosis of diabetes in the elderly: age-dependent HbA1c reference intervals derived from two population-based study cohorts. BMC endocrine disorders. 2019;19:1-10. [DOI:10.1186/s12902-019-0338-7]
13. Huang SH, Huang PJ, Li JY, Su YD, Lu CC, Shih CL. Hemoglobin A1c levels associated with age and gender in Taiwanese adults without prior diagnosis with diabetes. International Journal of Environmental Research and Public Health. 2021;18(7):3390. [DOI:10.3390/ijerph18073390]
14. Wu L, Lin H, Gao J, Li X, Xia M, Wang D, et al. Effect of age on the diagnostic efficiency of HbA1c for diabetes in a Chinese middle-aged and elderly population: The Shanghai Changfeng Study. PloS one. 2017;12(9):e0184607. [DOI:10.1371/journal.pone.0184607]
15. Kwon E, Ahn C. Low hemoglobin concentration is associated with several diabetic profiles. The Korean journal of internal medicine. 2012;27(3):273-4. [DOI:10.3904/kjim.2012.27.3.273]
16. Chung JO, Cho DH, Chung DJ, Chung MY. Associations between hemoglobin concentrations and the clinical characteristics of patients with type 2 diabetes. The Korean journal of internal medicine. 2012;27(3):285. [DOI:10.3904/kjim.2012.27.3.285]
17. Bhutto AR, Abbasi A, Abro AH. Correlation of hemoglobin A1c with red cell width distribution and other parameters of red blood cells in type II diabetes mellitus. Cureus. 2019;11(8):e5533. [DOI:10.7759/cureus.5533]
18. Renuka P, Bag S. Hemorheological indices and glycated hemoglobin in type 2 diabetes mellitus. Biomedical and Pharmacology Journal. 2020;13(4):1899-902. [DOI:10.13005/bpj/2066]
19. A Alamri BN, Bahabri A, Aldereihim AA, Alabduljabbar M, Alsubaie MM, Alnaqeb D, et al. Hyperglycemia effect on red blood cells indices. European Review for Medical & Pharmacological Sciences. 2019;23(5):2139-50.

Add your comments about this article : Your username or Email:
CAPTCHA

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Diabetes and Obesity

Designed & Developed by : Yektaweb