The mean age of the anaemic and non-anaemic was 51.8 and 64.6 years respectively. Subsequent measures of HbA1c two months after correction of anaemia was also documented and compared to pre-treatment levels. The study reviewed electronic medical records of selected patients, extracting data on HbA1c, fasting blood glucose (FBG), 2-hour post-prandial serum glucose (2HPPG), 2-hour oral glucose tolerance test (OGTT), haemoglobin concentration and electrophoresis, and anaemia work-up results when available.
482 (229 anaemic and 253 non-anaemic) were selected. The study assumed a consistent HbA1c assay method at the study center over the study period. Blood loss or blood transfusion within two months of HbA1c assay.Kim et al (2010) stated that iron deficiency is associated with shifts in HbA1c distribution from 16g/dl. It makes logical sense to infer that HbA1c levels should at least in part reflect the average haemoglobin concentration (). There exists concern that because HbA1c is formed from the glycation of the terminal Valine unit of the β-chain of haemoglobin, it may not be an accurate surrogate to ascertain glycemic control in certain conditions that affect the concentration, structure and function of haemoglobin. Physicians have adopted HbA1c levels as a convenient way to screen for diabetes, as well as to monitor therapy. The American Diabetic Association (ADA) and the American College of Endocrinology (ACE) recommend HbA1c levels as diagnostic criteria for diabetes mellitus. Keywords: Anaemia, hemoglobin A1c, glycosylated hemoglobin, HbA1c reference range(s), HbA1c therapeutic goals,Ībbreviations: Hb hemoglobin, HbA1c: glycosylated hemoglobin, delta sin change Modest correction anaemia did not cause significant change in HbAIc, perhaps the increase in was too modest or persistence of correction was too short to be impactful.Ĭonclusion: It makes the case for defining HbA1c reference ranges for each anaemia subtype, as well as utilizing other surrogates for monitoring glycemic control in populations with anaemia. The variance and proposed reference ranges for anaemia group and its subtypes was greater than in non-anaemia group, perhaps due to homogenization of clinically heterogeneous entities. 5.7%), but a similar upper limit of reference range due to a higher variance. Non-diabetic, anaemic have a significantly lower mean HbA1c (5.3% vs. The linear relationship between and HbA1c holds true for anaemic and non-anaemia populations. Modest but statistically significant correction of anaemia did not result in significant changes in HbA1c.ĭiscussion: i. Computed ranges for anaemia group and its subgroups were significantly wider compared to non-anaemia population. Reference ranges of HbA1c for non-anaemic population and anaemia subtypes was computed.
Results: The study observed a statistically significant 0.4units (8%) difference in the mean HbA1c in anaemia vs. Study Design: Using a convenient sampling method and a set of inclusion and exclusion criteria, it examined (retrospectively) patterns in and HbA1c in non-diabetics with and without anemia. Study Objectives: The study attempts to discern clinical differences in HbA1c levels in patients with anaemia compared to patients without anemia, quantifying and showing the direction of such differences. There exists concern that other factors beyond serum glucose concentration may affect glycation rates and by extrapolation HbA1c levels. Segun Adeoye, Sherly Abraham, Irina Erlikh, Sylvester Sarfraz, Tomas Borda and Lap Yeung.Ĭite this article as: BJMP 2014 7(1):a706īackground: Hemoglobin A1c (HbA1c) has been adopted by physicians as a surrogate for monitoring glycemic control.
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