Highlights
- •The association between HgbA1c and anemia in elderly non-diabetics was evaluated.
- •HgbA1c was not correlated with hemoglobin or nutritional factors causing anemia.
- •Hemoglobin does not need to be considered when interpreting HgbA1c in elderly non diabetics.
Abstract
Background
Glycated hemoglobin (HgbA1C) is being increasingly used for the diagnosis of diabetes
mellitus due to its high availability and reproducibility. Several studies have shown
that HgbA1C levels may be affected by levels of hemoglobin and nutritional factors
associated with anemia, such as vitamin B12 and iron deficiency. However, none included
elderly subjects. The aim of the present study was to investigate these effects in
the older nondiabetic population.
Methods
A retrospective cohort study design was used. The computerized database of a large
health management organization was reviewed for all subjects without diabetes mellitus
who underwent at least one measurement of HgbA1C and other hemoglobin parameters in
2002 at age ≥ 65 years. HgbA1C levels were correlated with hemoglobin, hematocrit, ferritin, iron,
transferrin, vitamin B12, and folic acid levels.
Results
A total of 11,352 subjects met the study criteria. Those with HgbA1C levels in the
highest quintile (6.21–6.49%, 44.4–47.7 mmol/mol) had significantly lower levels of hemoglobin, hematocrit, and iron than
patients with HgbA1C levels in the lowest quintile (<5.4%, 36 mmol/mol), but no linear correlation was found. There was no correlation of HgbA1C level with
levels of ferritin, vitamin B12, and folic acid.
Conclusions
In elderly nondiabetic subjects, HgbA1C levels are not correlated with hemoglobin
level or nutritional factors associated with anemia and may be interpreted without
consideration of these factors.
Keywords
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Article info
Publication history
Published online: September 01, 2016
Accepted:
August 19,
2016
Received in revised form:
August 16,
2016
Received:
May 1,
2016
Footnotes
☆All authors had access to the data and a role in the writing of the manuscript.
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
