A Population-Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-02-20 DOI:10.1111/1753-0407.70057

Tingyu Zhang, Tianyi Shi, Min Cao, Yunxi Ji, Yanbin Xue, Huayan Yao, Qiaomei Yin, Bin Cui, Zhen Xie, Ping He

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Abstract

Background

Glycated hemoglobin (HbA1c) is widely used to assess long-term glycemic control in individuals with diabetes. However, various conditions that affect hemoglobin levels or the lifespan of red blood cells can compromise the accuracy of HbA1c measurements. Despite extensive research, the relationship between HbA1c and hemoglobin remains unclear. This study aims to clarify this relationship by examining its correlation across diverse age and gender cohorts.

Methods

Data from 217,991 participants aged 20 to 69 years were collected from health examination centers in Southwest China. Standardized methodologies were used to measure HbA1c and hemoglobin levels. Generalized additive models (GAM) were utilized to analyze non-linear relationships and adjust for potential confounding variables. Gender-specific reference intervals (RIs) for hemoglobin were also established.

Results

A gender-specific association was observed between HbA1c and hemoglobin levels. In men, HbA1c levels decreased with increasing hemoglobin. Among women, a negative correlation was observed in premenopausal women (aged ≤ 45 years), whereas postmenopausal women (aged > 45 years) showed a positive correlation, with HbA1c levels increasing as hemoglobin levels rose. Additionally, HbA1c levels increased with age in both genders, with a more pronounced rise in women after the age of 45.

Conclusion

This study highlights significant gender- and age-related differences in the relationship between HbA1c and hemoglobin. The findings suggest that estrogen-related metabolic changes may influence HbA1c levels, with potential implications for diabetes management and hormone therapy in postmenopausal women.

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基于人群的糖化血红蛋白与血红蛋白水平的相关性分析

糖化血红蛋白（HbA1c）被广泛用于评估糖尿病患者的长期血糖控制。然而，各种影响血红蛋白水平或红细胞寿命的条件会损害HbA1c测量的准确性。尽管进行了广泛的研究，但HbA1c与血红蛋白之间的关系仍不清楚。本研究旨在通过检查其在不同年龄和性别队列中的相关性来澄清这种关系。方法收集西南地区健康检查中心年龄在20 ~ 69岁的217,991名参与者的资料。采用标准化方法测量HbA1c和血红蛋白水平。广义加性模型（GAM）用于分析非线性关系和调整潜在的混杂变量。还建立了血红蛋白的性别特异性参考区间（RIs）。结果HbA1c与血红蛋白水平存在性别特异性关联。在男性中，HbA1c水平随着血红蛋白的升高而降低。在女性中，绝经前妇女（年龄≤45岁）与HbA1c呈负相关，绝经后妇女（年龄≤45岁）与HbA1c呈正相关，且HbA1c水平随血红蛋白水平升高而升高。此外，HbA1c水平在男女中都随着年龄的增长而增加，45岁以后的女性上升更为明显。结论：本研究强调了HbA1c和血红蛋白之间存在显著的性别和年龄相关差异。研究结果表明，雌激素相关的代谢变化可能影响HbA1c水平，对绝经后妇女的糖尿病管理和激素治疗有潜在的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.