Diabetes Metab J.  2019 Aug;43(4):539-544. 10.4093/dmj.2018.0072.

Glycosylated Hemoglobin in Subjects Affected by Iron-Deficiency Anemia

• Intra J
• Limonta G
• Cappellini F
• Bertona M
• Brambilla

• KMID: 2455676
• DOI: http://doi.org/10.4093/dmj.2018.0072

Abstract

Previous studies have suggested that iron-deficiency anemia affects glycosylated hemoglobin (HbA1c) measurements, but the results were contradictory. We conducted a retrospective case-control study to determine the effects of iron deficiency on HbA1c levels. Starting with the large computerized database of the Italian Hospital of Desio, including data from 2000 to 2016, all non-pregnant individuals older than 12 years of age with at least one measurement of HbA1c, cell blood count, ferritin, and fasting blood glucose on the same date of blood collection were enrolled. A total of 2,831 patients met the study criteria. Eighty-six individuals were diagnosed with iron-deficiency anemia, while 2,745 had a normal iron state. The adjusted means of HbA1c were significantly higher in anemic subjects (5.59% [37.37 mmol/mol]), than those measured in individuals without anemia (5.34% [34.81 mmol/mol]) (P<0.0001). These results suggest that clinicians should be cautious about diagnosing prediabetes and diabetes in individuals with anemia.

Keyword

Anemia; Anemia, iron-deficiency; Diabetes complications; Glycated hemoglobin A

MeSH Terms

Anemia
Anemia, Iron-Deficiency*
Blood Glucose
Case-Control Studies
Diabetes Complications
Fasting
Ferritins
Hemoglobin A, Glycosylated*
Humans
Iron
Prediabetic State
Retrospective Studies
Blood Glucose
Ferritins
Iron

Figure

• 

  Fig. 1 Flow diagram of the study for final group selection. MCH, mean corpuscular hemoglobin. aIndividuals excluded from the analysis based on diagnoses, according to the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM).

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  Fig. 2 Box plots comparing cases and controls data of adjusted glycosylated hemoglobin (HbA1c) (A: HbA1c [%], B: HbA1c [mmol/mol]). Values shown are median (line within box), 25th and 75th percentiles (bottom and top of box, respectively), and mean (open diamond).

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