Investigation Of HbA1c And Its Correlation With RBC Storage Lesion In Blood Donors

Objective: The study aimed to investigate the influencing factors and distribution characteristics of Hb A1 c in qualified blood donors in Hunan province.To inquire into the effect of Hb A1 c on RBC storage in blood donors,and further explore the preliminary mechanism of Hb A1 c affecting RBC storage.Methods: This study recruited qualified unpaid blood donors from April 2021 to March 2022 at Yueyang Central Blood Station,Loudi Central Blood Station and Chenzhou Central Blood Station.After collecting baseline data and screening the Hb A1 c of blood donors,cross-sectional analysis and subgroup analysis were performed.Twenty of them were similar baseline characteristics(such as age,sex,lifestyle,etc.)but had different Hb A1 c levels(HbA1c<6.5%,n=10;HbA1c≥6.5%,n=10),to analyze the RBC storage lesion.Results: Among 1397 eligible blood donors,30.0%(419/1397)was in the prediabetes range(Hb A1 c 5.7%-6.4%)and 5.3%(74/1397)was in the diabetes range(HbA1c≥6.5%).Logistic regression analysis showed that age(OR=1.073,95%CI: 1.058-1.088,P<0.001),BMI(OR=1.096,95%CI: 1.060-1.133,P<0.001),gender(OR=2.392,95%CI: 1.482-3.303,P<0.001),smoking(OR=2.216,95%CI: 1.818-3.743,P=0.007),drinking(OR=3.615,95%CI: 2.240-4.990,P<0.001),and education level(OR=0.077,95%CI: 0.022-0.278,P<0.001)were the influencing factors of Hb A1 c in blood donors.Subgroup analysis of different genders,ages and regions showed that age,BMI,blood pressure,smoking,drinking and exercise of blood donors were statistically different among different Hb A1 c levels(P<0.05).Analysis of the storage condition of suspended erythrocytes showed that,high-Hb A1 c group had more serious storage lesions(abnormal morphology,impaired membrane function,ion imbalance,etc.)of suspension erythrocytes than low-Hb A1 c group,and the oxidative stress was significantly enhanced(GSH level and CAT activity decreased significantly,ROS level increased significantly).Conclusions: Among the blood donors in the three different regions of Hunan province,35.3% had abnormal HbA1c(diabetes and prediabetes).Age,sex(male),BMI,smoking and alcohol consumption were the risk factors for Hb A1 c elevation,while education level was the protective factor for Hb A1 c elevation in blood donors.Elevated Hb A1 c in blood donors increased the risk of RBC storage lesions,and the mechanism may be associated with the enhancement of RBC oxidative stress.The study results suggest that Hb A1 c can be used as an auxiliary reference index for blood donor screening in China.