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. 2008 Oct;31(10):1945-8.
doi: 10.2337/dc08-0352. Epub 2008 Jul 3.

A1C but not serum glycated albumin is elevated in late pregnancy owing to iron deficiency

Kunihiko Hashimoto  1 , Sanai Noguchi, Yasuhiko Morimoto, Shinichi Hamada, Kenshi Wasada, Shiro Imai, Yuji Murata, Soji Kasayama, Masafumi Koga
Affiliations

A1C but not serum glycated albumin is elevated in late pregnancy owing to iron deficiency

Kunihiko Hashimoto et al. Diabetes Care. 2008 Oct.

Abstract

Objective: A1C levels have been shown to be elevated in relation to glycemia in late pregnancy, although the precise mechanisms remain undetermined. We hypothesized that iron deficiency is involved in the A1C increase in late pregnancy.

Research design and methods: In study 1, A1C, serum glycated albumin, erythrocyte indexes, and iron metabolism indexes were determined in 47 nondiabetic pregnant women not receiving iron supplementation who were divided into four groups according to gestational period (group I, 21-24 weeks; group II, 25-28 weeks; group III, 29-32 weeks; and group IV, 33-36 weeks). In study 2, these determinants were obtained at two gestational periods (20-23 weeks and 32-33 weeks) in 17 nondiabetic pregnant women.

Results: In study 1, A1C levels were higher in groups III and IV than those in groups I and II, whereas serum glycated albumin levels were not different among these four groups. Hemoglobin, mean corpuscular hemoglobin (MCH), serum transferrin saturation, and serum ferritin were lower in groups III and IV. A1C levels were negatively correlated with MCH, serum transferrin saturation, and serum ferritin. In study 2, A1C levels were significantly increased at gestational weeks 32-33 from those at weeks 20-23, whereas serum glycated albumin levels did not differ between the two gestational periods. MCH, serum transferrin saturation, and serum ferritin were decreased at gestational weeks 32-33. A1C levels showed a negative correlation with MCH, serum transferrin saturation, and serum ferritin.

Conclusions: A1C levels were elevated in late pregnancy owing to iron deficiency. Serum glycated albumin may offer a better index for monitoring glycemic control in pregnancy.

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Figures

Figure 1
Figure 1
A1C (A) and serum glycated albumin (GA) (B) levels in 47 pregnant women (study 1) divided according to gestational period into group I (21–24 weeks; n = 20), group II (25–28 weeks; n = 9), group III (29–32 weeks; n = 11), and group IV (33–36 weeks; n = 7). *P < 0.001 versus group I; #P < 0.05 versus group II; ##P < 0.01 versus group II.
Figure 2
Figure 2
RBC counts (A), hemoglobin (B), MCH (C), serum transferrin (Tf) saturation (D), and serum ferritin (E) in 47 pregnant women (study 1) divided according to gestational period into group I (21–24 weeks; n = 20), group II (25–28 weeks; n = 9), group III (29–32 weeks; n = 11), and group IV (33–36 weeks; n = 7). *P < 0.05 versus group I; **P < 0.001 versus group I; #P < 0.05 versus group II.
Figure 3
Figure 3
Association of A1C levels with MCH (A), serum transferrin (Tf) saturation (B), and serum ferritin (C) in 47 pregnant women (study 1).
Figure 4
Figure 4
A1C (A) and serum glycated albumin (GA) (B) levels in 17 pregnant women (study 2) studied in middle pregnancy (20–23 weeks) and late pregnancy (32–33 weeks).
Figure 5
Figure 5
Association of A1C levels with MCH (A), serum transferrin (Tf) saturation (B), and serum ferritin (C) in 17 pregnant women (study 2). •, middle pregnancy (20–23 weeks); ○, late pregnancy (32–33 weeks).
See this image and copyright information in PMC

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