Hemoglobin A 1c Levels in Adults with Iron Deficiency Anemia
Abstract
Objective: Hemoglobin A1c levels which show the average level of blood glucose over the previous 3 months, have been used in the diagnosis and the follow-up of diabetes mellitus. Effect of iron deficiency anemia which is the most common anemia, on hemoglobin A1c levels is still controversial. In our study, we aimed to research that iron deficiency anemia whether effect or not on hemoglobin A1c levels in individuals whom have no diabetes history and whose fasting glucose levels and hemoglobin A1c levels are in the reference values.
Materials and Methods: Individuals who came to our hospital between the dates of February 2014- June 2014 were scanned from patient database of the hospital. The individuals who have no diabetes history, have fasting glucose and hemoglobin A1c levels (in the same specimen) are in the reference values and have existing serum iron, total iron binding capacity, ferritin and hemoglobin levels were selected. 222 individuals whose laboratory results pointing to iron deficiency anemia were formed as patient group and non-anemic 276 individuals were formed as control group. Hemoglobin A1c levels were measured by boronate affinity liquid chromatography. p value less than 0.05 was considered significant.
Results: Serum iron, ferritin and blood hemoglobin levels were significantly lower (for all of them, p<0,001); serum total iron binding capacity was significantly higher (p<0,001) in patient group compared as the control group. Hemoglobin A1c levels in patient group and control group were 5,53 %(±0,2) and 5,36 %(±0,2) respectively. Hemoglobin A1c was found significantly higher (p<0,001) in the patient group. No significant correlation was found between hemoglobin and hemoglobin A1c levels in both of groups.
Conclusion: Iron deficiency anemia has an effect on hemoglobin A1c levels which are in reference values as significant elevation. When interpretation of hemoglobin A1c levels in diabetes mellitus diagnosis and follow-up, presence of iron deficiency anemia and the other sources of error should be considered.