Effect of Microcytic Anemia on Glycosylated Hemoglobin A1c in non-diabetic adults

Gokhula Raj, B (2017) Effect of Microcytic Anemia on Glycosylated Hemoglobin A1c in non-diabetic adults. Masters thesis, Madras Medical College, Chennai.


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BACKGROUND: Glycosylated hemoglobin (HbA1c) is used as a gold standard for monitoring glycemic control of paatients and is used as a predictor of diabetes – related complications. Protein glycation is a spontaneous reaction that is believed to play a key role in the pathogenesis of many clinical disorders, including diabetes. The glycation of proteins is enhanced by elevated blood glucose concentrations. The major form of protein glycation of clinical importance is glycosylated haemoglobin (HbA1c). The HbA1c fraction is abnormally elevated in chronic hyperglycaemic states, including diabetes mellitus and it correlates positively with the glycaemic as well as metabolic control. Conditions that effect erythrocyte turnover affect HbA1c levels. However, increased glycatedhaemoglobin levels have been documented in microcytic anemias, the most common form of which is iron deficiency anaemia. AIMS AND OBJECTIVES: The aim of this study was to determine the effect of microcytic anemias on the HbA1c levels in non-diabetic patients, so as to consider microcytic anemia as an important factor which influences the HbA1c levels. MATERIALS AND METHODS: 100 non-diabetic, anaemic patients and 100 age-matched non – anaemic controls were involved in this study. The patients who had glucose toleranceabnormalities (impaired glucose tolerance or diabetes mellitus), blood loss, haemoglobinopathies, haemolytic anaemia, infestation, chronic alcohol ingestion and chronic liver or renal failure were excluded from the study. Haematologic investigations were done and the fasting and postprandial glucose and HbA1c levels were measured in all the subjects. There were no differences in the levels of fasting and postprandial glucose between those with microcytic anaemia and the control groups. RESULTS: The mean HbA1c (6.89 ± 0.55 %) level in the patients with microcytic anemia was higher than that in the control group (5.35 ± 0.28 %) (p < 0.001). CONCLUSION: HbA1c is not affected by the blood sugar levels alone, and there are various confounding factors when HbA1c is measured, especially that of iron content of the blood and RBC survival. It is hence important to rule out microcytic anemias before making any decision, based on the HbA1c levels.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Microcytic Anemia, Glycosylated Hemoglobin A1c, non-diabetic adults.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Feb 2020 10:21
Last Modified: 23 Feb 2020 10:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/12008

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