Original article / research
Correlation of Haemoglobin Percentage and Glycated Haemoglobin Level among Iron Deficient versus Non-iron Deficient Patients without Diabetes: An Observational Study in a Tertiary Care Centre of Bihar, India
Dr. Jiut Ram Keshari,
Department of Biochemistry, Indira Gandhi Institute of Medical Sciences, Sheikhpura-800014, Patna, Bihar, India
Introduction: Iron Deficiency Anaemia (IDA) and diabetes are extremely common in Indian settings. Glycated haemoglobin (HbA1c) indicates patient’s glycaemic status over past 8 to 12 weeks. Formation of HbA1c is irreversible and its concentration in the blood depends on life span of Red Blood Cell (RBC), blood glucose concentration, Haemoglobin (Hb) percentage (Hb%), serum iron etc. Some studies suggest that iron depletion is associated with increased glycation of Hb leading to falsely high values of HbA1c independent of glycaemia.
Aim: To compare and correlate Hb% and HbA1c level among iron deficient (non-diabetic) and non-iron deficient (non-diabetic) patients.
Materials and Methods: This was an observational, cross-sectional study conducted on 200 non-diabetic subjects which were divided into group A (n=100, IDA but non-diabetic) and group B (n=100, normal healthy subjects without IDA and without diabetes). Investigations like Complete Blood Count (CBC), Fasting and Postprandial (PP) blood sugar, HbA1c, blood urea and serum creatinine and iron profile were estimated. Data was analysed using Graph Pad Instat software by student’s t-test (unpaired t-test) and Hb% and HbA1c were correlated by using correlation coefficient (r).
Results: Mean Hb%, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), and Mean Corpuscular Haemoglobin Concentration (MCHC), serum iron and ferritin were significantly higher in group B in comparison with group A (p-value <0.0001). Mean serum Total Iron Binding Capacity (TIBC) was significantly higher in group A subjects in comparison to group B. Mean HbA1c in group A was significantly higher side as compared to group B. It showed that iron deficient patients had higher value of HbA1c as compared to non-iron deficient subjects. Value of Correlation Coefficient (r)= -0.4064 between Hb% and HbA1c in group A showed moderate strength of linear relationship in opposite direction (p-value <0.0001). Value of Correlation Coefficient (r)= 0.07228 between Hb% and HbA1c in group B shows no/extremely weak linear relationship in positive direction. Two tailed p-value was 0.4748, considered not significant.
Conclusion: This study concluded that iron deficiency (decreased Hb%) leads to increase in HbA1c.So,using HbA1c as a common diagnostic tool for diabetes one must keep in mind the IDA status for better endocrinological profile and medication of patients.
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