Effect Of Iron Deficiency Anemia On Glycosylated Hemoglobin A1c In Diabetes Mellitus Patients

Objective:To analyze the influence of different degrees of iron deficiency anemia(IDA)on the content of glycosylated hemoglobin A1c(HbA1c)in diabetes mellitus(DM)patients,so as to provide a reference for the clinical application of HbA1c to evaluate the severity of DM complicated with IDA.Method:Seventy-one patients(group A)diagnosed as DM with IDA in our hospital from 2013 to 2019 and 50 DM patients without IDA admitted in the same period were selected as the control group(group B),clinical data,blood routine,fasting plasma glucose(FPG)and HbA1c test results of all patients were recorded;According to hemoglobin(Hb)concentration,group A was divided into 17 cases of DM with mild IDA(Group A1),32 cases of DM with moderate IDA(group A2)and 22 cases of DM with severe IDA(Group A3);according to different concentrations of FPG and mean corpuscular hemoglobin(MCH),group A and group B was divided into FPG<7mmol/L and MCH<27pg(Group C),FPG<7mmol/L and MCH≥27pg(group D),FPG≥7mmol/L and MCH<27pg(group E),FPG≥7mmol/L and MCH≥27pg(group F).The influence of different degrees IDA on HbA1c in DM patients in each group was analyzed,Pearson linear correlation analysis was conducted for HbA1c and other indicators.Results:1.There were no statistically significant differences in ethnicity and gender between group A and group B(P>0.05).2.FPG,HbA1c,Red blood cell(RBC),Hb,Hematocrit(HCT),Mean corpuscular hemoglobin(MCV),MCH and Mean corpuscular hemoglobin concentration(MCHC)in group A were all lower than those in group B,the result are all statistically differences(all P<0.05).3.HbA1c in group A1,A2 and A3 was all lower than that in group B(group Al:6.89±1.10%,group A2:6.85±2.03%,group A3:6.38±1.26%and group B:8.42±1.96%),the result are all statistically differences(all P<0.05).4.The HbA1c in group C was lower than that in group D(group C:6.07±1.14%and group D:6.86±1.63%),but there was no statistical significance between the two groups(P>0.05);The HbA1c of group E was lower than that of Group F(Group E:7.47±1.77%,group F:8.86±1.83%),and the difference between the two groups was statistically significant(P<0.05).5.There are linear relation between HbA1c and FPG,RBC,Hb,HCT,MCV,MCH and MCHC(P<0.05).Conclusion:1.IDA affects HbAlc in DM patients,and the concentration of HbAlc decreases with the severity of anemia.2.MCH should be referred when HbA1c was used to evaluate the severity of DM patients with FPG≥7mmol/L.