Iron Deficiency Anemia- Does it affect the Glycosylated Hemoglobin levels in Non- diabetic Patients?

Surya Aggarwal, Rajesh Kakkar, Rajeev M. Kaushik, R. Kaushik

Abstract


Background: Glycosylated hemo­globin (HbA1c) is used in diabetic patients as an index of glycemic control. Reports on the effects of iron deficien­cy anemia (IDA) on HbA1c levels have shown inconsistent results. This study investigated the effects of IDA on HbA1c levels in non- diabetic patients.

Methods: Fifty non- diabetic patients diagnosed as having IDA, and an equal number of age- and sex- matched healthy controls, were included in this study. Hematological and biochemical parameters, including HbA1c levels were measured, and compared between cases and controls.

Results: Mean baseline HbA1c (%) level in anemic patients (6.1 ± 0.2) was significantly higher than in control group (4.1 ± 0.3) (p < 0.0001, 95% CI1.89 to 2.1). A significant positive correlation of HbA1c was observed with total iron binding capacity (TIBC) (r = 0.36, p = 0.009, 95 % CI 0.09 to 0.58), but not with hemoglobin (r = −0.015, p = 0.915, 95% CI −0.29 to 0.26), MCV (r = −0.082, p = 0.571, 95 % CI −0.35 to 0.20), MCH (r = −0.11, p = 0.453, 95% CI −0.38 to 0.18), hematocrit (r = −0.0032, p = 0.982, 95% CI −0.28 to 0.28) and ferritin (r = −0.052 p = 0.721, 95% CI −0.33 to 0.23).

Conclusions: HbA1c levels were higher in patients with IDA than in controls and had a significant positive correlation with TIBC. This may have a practical application in diabetic individuals with IDA where HbA1c alone may give a false picture of poor glycemic control.


Keywords


Iron deficiency anemia, Glycosylated hemoglobin, HbA1c.

Full Text:

PDF

References


References

American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2012; 35: S4-S10.

American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2011; 34: S62-69.

Bunn HF, Haney DN, Kamin S et al. The biosynthesis of human hemoglobin A1c. J Clin Invest 1976; 57: 1652-59.

Kruiswijk T, Diaz DP, Holtkamp HC. Interference of hemoglobin H in the column-chromatographic assay of glycosylated hemoglobin A. Clin Chem 1981; 27: 641-42.

Saddi R, Wajcman H, Eschwege E et al. Glycosylated hemoglobin in patients on venesection therapy for haemochromatosis. Lancet 1980; 2: 141-42.

Dandona P, Freedman D, Moorehead JF. Glycosylated hemoglobin in chronic renal failure. Br Med J 1979; 1: 1183-84.

Nathan DM, Francis TB, Palmer JL. Effect of aspirin on determinations of glycosylated hemoglobin. Clin Chem 1983; 29: 466-69.

Gram-Hansen P, Eriksen J, Mourits-Andersen T et al. Glycosylated haemoglobin (HbA1c) in iron and vitamin B12 deficiency. J Intern Med 1990; 227: 133–36.

DeMaeyer EM, Adiels-Tegman M. The prevalence of anaemia in the world. World Health Statistics Quarterly 1985; 38: 302-16.

Brooks AP, Metcalfe J, Day JL et al. Iron deficiency and glycosylated hemoglobin A. Lancet 1980; 2: 141-45.

Sluiter WJ, van Essen LH, Reitsma WD et al. Glycosylated hae¬moglobin and iron deficiency. Lancet 1980; 2: 531-32.

El-Agouza I, Abu Shohla A, Sirdah M. The effect of iron deficiency ane¬mia on the levels of hemoglobin subtypes: possible consequences for clinical diagnosis. Clin Lab Haematol 2002; 24: 285-89.

Mitchell TR, Anderson D, Shepperd J. Iron deficiency, haemochroma¬tosis, and glycosylated haemoglobin. Lancet 1980; 2: 747-49.

van Heyningen C, Dalton RG. Glycosylated haemoglobin in iron-de¬ficiency anemia. Lancet 1985; 1: 874-8.

Sinha N, Mishra TK, Singh T et al. Effect of iron deficiency anemia on Hemoglobin A1c levels. Ann Lab Med 2012; 32: 17-22.

Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in non-diabetic patients. Acta Haematol 2004; 112: 126-28.

Kim C, Bullard KM, Herman WH et al. Association between iron deficiency and HbA1c levels among adults without diabetes in the National Health and Nutrition Examination Survey, 1999–2006. Diabetes Care 2010; 33: 780–5.

WHO. Iron deficiency anemia: assessment, prevention and control. WHO/NHD/01.3, Geneva: WHO, 2001.

Tarim O, Kucukerdogan A, Gunay U et al. Effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus. Pediatr Int 1999; 41: 357-62.

Ford ES, Cowie CC, Li C et al. Iron-deficiency anemia, non-iron-deficiency anemia and HbA1c among adults in the US. J Diabetes 2011; 3: 67-73.

Rai KB, Pattabiraman TN. Glycosylated haemoglobin levels in iron deficiency anemia. Indian J Med Res 1986; 83: 234–46.


Refbacks

  • There are currently no refbacks.


Copyright (c)