Department of Blood Transfusion, Xiangya Second Hospital, Central South University, Changsha Province, China.
Department of Blood Quality Management, Yueyang Central Blood Bank, Yueyang City, Hunan Province, China.
Transfusion. 2022 Mar;62(3):663-674. doi: 10.1111/trf.16815. Epub 2022 Feb 9.
Glycosylated hemoglobin (HbA1c), not routinely screened in blood donors, is associated with morphological, biochemical, and functional abnormalities of red blood cells (RBCs) and with enhanced oxidative stress. We aimed to explore HbA1c levels in blood donors and their effect on RBC storage.
An analytical cross-sectional study was conducted on 875 eligible blood donors aged 18-60 years from May 1, 2021, to August 30, 2021. Two selected groups of donors (HbA1c <6.5%, n = 10; HbA1c ≥ 6.5%, n = 10) exhibiting as similar as possible baseline values (such as age, sex, and living habits, etc.) were recruited for blood donation in leukoreduced CPDA-1 units. RBC morphological, biochemical, structural, and oxidative stress states were measured during 5-35 days of storage.
Elevated HbA1c prevalence was 37%, including 31.7% (277/875) in the prediabetes range (HbA1c 5.7%-6.4%) and 5.4% (47/875) in the diabetes range (HbA1c ≥ 6.5%). Age, body mass index (BMI), smoking, and alcohol consumption were the main factors influencing the HbA1c levels. During storage, high-HbA1c group had abnormal RBC morphology, impaired membrane function, and ion imbalance (higher mean corpuscular volume, distribution width, hemolysis rate, potassium ion efflux, and phosphatidylserine exposure) as compared with low HbA1c group. Additionally, RBC oxidative stress was significantly increased in donors with high HbA1c levels during 21-35 days.
Blood donors proportion with abnormal HbA1c levels was relatively high, and donor HbA1c levels may be associated with stored RBCs capacity. Our study provides new insights into the different effects of donor HbA1c levels on RBC storage lesions.
糖化血红蛋白（HbA1c）通常不在献血者中筛查，它与红细胞（RBC）的形态、生化和功能异常以及氧化应激增强有关。我们旨在探索献血者的 HbA1c 水平及其对 RBC 储存的影响。
2021 年 5 月 1 日至 8 月 30 日，对 875 名年龄在 18-60 岁之间的合格献血者进行了一项分析性横断面研究。从这两组献血者中招募了两组（HbA1c<6.5%，n=10；HbA1c≥6.5%，n=10），他们的基线值（如年龄、性别和生活习惯等）尽可能相似，以捐献白细胞减少的 CPDA-1 单位。在 5-35 天的储存过程中测量 RBC 的形态、生化、结构和氧化应激状态。
HbA1c 升高的患病率为 37%，其中 31.7%（277/875）处于糖尿病前期范围（HbA1c 5.7%-6.4%），5.4%（47/875）处于糖尿病范围（HbA1c≥6.5%）。年龄、体重指数（BMI）、吸烟和饮酒是影响 HbA1c 水平的主要因素。在储存过程中，与低 HbA1c 组相比，高 HbA1c 组的 RBC 形态异常、膜功能受损和离子失衡（更高的平均红细胞体积、分布宽度、溶血率、钾离子外流和磷脂酰丝氨酸暴露）。此外，在 21-35 天期间，HbA1c 水平较高的献血者的 RBC 氧化应激显著增加。
具有异常 HbA1c 水平的献血者比例相对较高，献血者的 HbA1c 水平可能与储存 RBC 的能力有关。我们的研究为 HbA1c 水平对 RBC 储存损伤的不同影响提供了新的见解。
