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. 2014 Feb 12;5(1):60-5.
doi: 10.1111/jdi.12123. Epub 2013 Aug 5.

Hemoglobin A1c values are affected by hemoglobin level and gender in non-anemic Koreans

Ji Cheol Bae  1 , Sunghwan Suh  2 , Sang-Man Jin  1 , Se Won Kim  1 , Kyu Yeon Hur  1 , Jae Hyeon Kim  1 , Yong-Ki Min  1 , Myung-Shik Lee  1 , Moon Kyu Lee  1 , Won Seon Jeon  3 , Won Young Lee  3 , Kwang-Won Kim  4
Affiliations

Hemoglobin A1c values are affected by hemoglobin level and gender in non-anemic Koreans

Ji Cheol Bae et al. J Diabetes Investig. .

Abstract

Aims/introduction: To evaluate whether hemoglobin A1c (HbA1c) levels are affected by hemoglobin level and gender.

Materials and methods: A cross-sectional analysis was carried out in a sample of 87,284 non-diabetic Koreans without anemia who participated in comprehensive health check-ups between January and December 2009 at the Kangbuk Samsung Hospital Total Healthcare Center in Seoul, Korea. We categorized men and women separately according to fasting plasma glucose and hemoglobin level to carry out the analysis.

Results: HbA1c increased steadily with increasing fasting plasma glucose level. Both men and women with lower hemoglobin had significantly higher HbA1c at a given fasting glucose level, and this result was consistent across the fasting glucose quintiles within the non-diabetic range. Women had a lower mean hemoglobin value compared with men, and women had higher HbA1c levels at a given fasting glucose level consistently across the fasting glucose deciles. There was also a gender-specific association between age and HbA1c (P < 0.001 for interaction).

Conclusions: HbA1c values were affected by hemoglobin level and gender in non-anemic Koreans. Thus, hemoglobin level and gender should be considered in the diagnosis of diabetes using HbA1c.

Keywords: Gender; Hemoglobin; Hemoglobin A1c.

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Figures

Figure 1
Figure 1
Glucose‐stratified comparison of hemoglobin A1c (HbA1c) between hemoglobin tertiles in (a) women (b) men. Adjusted for age. *,**P < 0.001 (Tukey's post‐hoc analysis of two way anova) between all three different combinations of hemoglobin (Hb) groups in women and men, respectively. CI, confidence interval.
Figure 2
Figure 2
Relationship between hemoglobin A1c (HbA1c) and hemoglobin deciles. (a) Adjusted for age, sex and fasting glucose. (b,c) Adjusted for age and fasting glucose. CI, confidence interval.
Figure 3
Figure 3
Fasting glucose‐stratified comparison of hemoglobin A1c (HbA1c) between genders. (a) Adjusted for age. (b) Adjusted for age and hemoglobin. CI, confidence interval.
Figure 4
Figure 4
Mean hemoglobin A1c (HbA1c) by gender and age categories. Adjusted for fasting glucose and hemoglobin. CI, confidence interval.
See this image and copyright information in PMC

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