EXPLORING LABORATORY PARAMETERS THAT IMPACT HBA1C LEVELS
Dlovan Ali Jalal
Theoretical and Translational Medicine Division
Dr. Kellermayer Miklós
NET 16. emelet Könyvtár
2024-10-01 14:00:00
Clinical application of basic science results
Dr. Vásárhelyi Barna
Gyarmati Béla
Dr. Varga Marina
Dr. Shemirani Amir
Dr. Domján Gyula
Dr. Cseh Áron
Dr. Mácsai Emília
Background: Several observations suggest the presence of possible association between HbA1c levels and several demographic and clinical parameters.
Objectives: Several objectives were present in this work, we examined the possible correlation between HbA1c concentration and the concentrations of serum levels of uric acid, triglyceride, cholesterol, CRP, vitamin D, and the CBC indices. Moreover, we searched for the possible association between age and/or gender with HbA1c levels in single visit and in visit-to-visit.
Method: HbA1C results extracted from the electronic laboratory database of Semmelweis hospital, for patients consulting this hospital in Budapest/Hungary. The records of a total of 20,416 patients, consulting the Semmelweis hospital between 2008–2012 were recruited. The selected patients’ ages ranged between 20 – ≥ 90 years old. In addition to HbA1C, the results of laboratory parameters including CRP, vitamin D, CBC count, total cholesterol, LDL- and HDL, triglyceride, and uric acid were also extracted for the patients. Additional group of data were also analyzed, it was including 193,165 individuals included 92,700 males and 100,465 females, these data included HbA1c results for more than one visit for each patient with different ages and both genders.
Results: The developed formulas are as follow: HbA1c (estimated) in women = 0.752 + 0.237*log10(HDL/ cholesterol) + 0.156*log10 (cholesterol) + 0.077*log10 (triglyceride) + 0.025*log10(CRP) +0.001*log10 (age) − 0.026*log10(HDL/LDL) − 0.063*log10 (uric acid)-0.075*log10 (LDL)-0.199*log10(HDL); HbA1c (estimated) in men = 1.146 + 0.08*log10 (triglyceride) + 0.046*log10(CRP) + 0.01*log10 (cholesterol) + 0.001*log10 (age) − 0.014*log10(HDL)-0.018*log10(HDL/LDL)-0.025*log10(HDL/cholesterol) − 0.068*log10 (LDL)- 0.159*log10 (uric acid). MCV in both sexes, RDW in men negative, in women RBC showed a positive relationship with HbA1c. Based on the CE values, one of the tested parameters does not have a greater effect on HbA1c than age. Recorded in MCV, RDW, HB discrete ranges histogram is the same. The current study showed a weak negative correlation (R= – 0.14) between HbA1c and serum vitamin D levels among study group. Among all age groups, the females in age group 60-69 years old had the highest number of patients (n=2232) with HbA1c in diabetic range which also had the highest percentage of both not improved (20.8%) and improved (24.2%) HbA1c readings in the second visit; comparable values were also reported for the males.
Conclusion: HbA1c levels can be estimated almost exactly based on lipid profile, CRP and uric acid levels in female patients between 20 and 70 years. In routine clinical practice, apart from cases with severe hematopoietic organ abnormalities, it is not necessary to MCV value to be taken into account when evaluating HbA1c. vitamin D is negatively correlated with Hba1c in both males and females. The age group of 60–69 years old had the largest percentage of both males and females who were not improved in the next visit.
