Dijkstra Angelique, Lenters-Westra Erna, de Kort Wim, Bokhorst Arlinke G, Bilo Henk J G, Slingerland Robbert J, Vos Michel J
Sanquin Blood Bank Division, Zwolle, the Netherlands.
Department of Clinical Chemistry, Isala Hospital, Zwolle, the Netherlands.
PLoS One. 2017 Jan 24;12(1):e0170802. doi: 10.1371/journal.pone.0170802. eCollection 2017.
Several factors, including changed dynamics of erythrocyte formation and degradation, can influence the degree of hemoglobin A1c (HbA1c) formation thereby affecting its use in monitoring diabetes. This study determines the influence of whole blood donation on HbA1c in both non-diabetic blood donors and blood donors with type 2 diabetes.
In this observational study, 23 non-diabetic blood donors and 21 blood donors with type 2 diabetes donated 475 mL whole blood and were followed prospectively for nine weeks. Each week blood samples were collected and analyzed for changes in HbA1c using three secondary reference measurement procedures.
Twelve non-diabetic blood donors (52.2%) and 10 (58.8%) blood donors with type 2 diabetes had a significant reduction in HbA1c following blood donation (reduction >-4.28%, P < 0.05). All non-diabetic blood donors with a normal ferritin concentration predonation had a significant reduction in HbA1c. In the non-diabetic group the maximum reduction was -11.9%, in the type 2 diabetes group -12.0%. When eligible to donate again, 52.2% of the non-diabetic blood donors and 41.2% of the blood donors with type 2 diabetes had HbA1c concentrations significantly lower compared to their predonation concentration (reduction >-4.28%, P < 0.05).
Patients with type 2 diabetes contributing to whole blood donation programs can be at risk of falsely lowered HbA1c. This could lead to a wrong interpretation of their glycemic control by their general practitioner or internist.
包括红细胞生成和降解动态变化在内的多种因素，均可影响糖化血红蛋白A1c（HbA1c）的形成程度，进而影响其在糖尿病监测中的应用。本研究旨在确定全血捐献对非糖尿病献血者和2型糖尿病献血者HbA1c的影响。
在这项观察性研究中，23名非糖尿病献血者和21名2型糖尿病献血者捐献了475毫升全血，并进行了为期9周的前瞻性随访。每周采集血样，使用三种二级参考测量程序分析HbA1c的变化。
12名非糖尿病献血者（52.2%）和10名2型糖尿病献血者（58.8%）在献血后HbA1c显著降低（降低幅度>-4.28%，P<0.05）。所有献血前铁蛋白浓度正常的非糖尿病献血者HbA1c均显著降低。在非糖尿病组中，最大降低幅度为-11.9%，在2型糖尿病组中为-12.0%。当有资格再次献血时，52.2%的非糖尿病献血者和41.2%的2型糖尿病献血者的HbA1c浓度与献血前相比显著降低（降低幅度>-4.28%，P<0.05）。
参与全血捐献计划的2型糖尿病患者可能存在HbA1c被错误降低的风险。这可能导致其全科医生或内科医生对其血糖控制情况产生错误解读。
