Department of Laboratory Medicine, Desio Hospital, University of Milano-Bicocca, Desio, Italy.
Diabetes Metab J. 2019 Aug;43(4):539-544. doi: 10.4093/dmj.2018.0072. Epub 2018 Nov 28.
Previous studies have suggested that iron-deficiency anemia affects glycosylated hemoglobin (HbA1c) measurements, but the results were contradictory. We conducted a retrospective case-control study to determine the effects of iron deficiency on HbA1c levels. Starting with the large computerized database of the Italian Hospital of Desio, including data from 2000 to 2016, all non-pregnant individuals older than 12 years of age with at least one measurement of HbA1c, cell blood count, ferritin, and fasting blood glucose on the same date of blood collection were enrolled. A total of 2,831 patients met the study criteria. Eighty-six individuals were diagnosed with iron-deficiency anemia, while 2,745 had a normal iron state. The adjusted means of HbA1c were significantly higher in anemic subjects (5.59% [37.37 mmol/mol]), than those measured in individuals without anemia (5.34% [34.81 mmol/mol]) (<0.0001). These results suggest that clinicians should be cautious about diagnosing prediabetes and diabetes in individuals with anemia.
先前的研究表明，缺铁性贫血会影响糖化血红蛋白（HbA1c）的检测结果，但结果存在争议。我们进行了一项回顾性病例对照研究，以确定缺铁对 HbA1c 水平的影响。该研究从意大利德西奥医院的大型计算机数据库入手，纳入了 2000 年至 2016 年的数据，所有年龄在 12 岁以上、至少有一次 HbA1c、血细胞计数、铁蛋白和空腹血糖检测结果且采血日期相同的非妊娠个体均符合研究标准。共有 2831 名患者符合研究标准。86 名患者被诊断为缺铁性贫血，2745 名患者铁状态正常。贫血患者的 HbA1c 平均值明显高于无贫血患者（分别为 5.59% [37.37mmol/mol] 和 5.34% [34.81mmol/mol]）（<0.0001）。这些结果表明，临床医生在诊断贫血患者的糖尿病前期和糖尿病时应谨慎。
