评估患有贫血和未患贫血的非糖尿病产前妇女 Hba1c 水平的比较研究

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
KanishkaS. Thakker , Swarnalatha Mohanapu , Maitrayee Sen
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引用次数: 0

摘要

背景糖基化血红蛋白(HbA1c)有一个葡萄糖残基连接到一条或两条 HbA beta 链的末端 NH2 基(缬氨酸残基)上。HbA1c 水平不会仅受血糖水平的影响。HbA1c 结果受多种因素影响,如贫血、结构性血红蛋白病和地中海贫血综合征。HbA1c 浓度会受到影响红细胞周转的条件的影响。缺铁性贫血是最常见的贫血形式。印度孕妇的贫血患病率超过 50%。虽然许多形式的贫血都与 HbA1c 降低有关,但事实证明缺铁会使 HbA1c 略微升高。对这一问题的研究结果多种多样。在一些研究中,没有观察到贫血与 HbA1c 水平之间的关联;而在另一些调查中,这一数字有升有降。因此,缺铁性贫血与 HbA1c 的关系仍不明确。因此,本研究旨在确定非糖尿病贫血孕妇中缺铁性贫血与 HbA1c 水平之间的相关性。方法:本前瞻性观察研究的对象是在坎奇普兰区 Chengalpattu 一家私立三级医院产前门诊 OPD 就诊的单胎孕妇。在对孕妇的产科记录进行全面审查后,用 5 毫升无菌注射器抽取孕妇的血液,并将其平均分送到两个含有乙烯-二胺-四乙酸(EDTA)抗凝剂的独立试管中,以测定红细胞指数和 HbA1c 水平。使用独立样本 t 检验确定两个独立样本(贫血和非贫血)之间的平均值差异,使用 z 检验计算两个独立比例之间的差异。采用双变量皮尔逊相关分析来判定红细胞指数与 HbA1c 水平之间的关系,并计算相关系数(r),P 值为 <0.05*,则认为具有统计学意义。结果采用双变量皮尔逊相关分析来确定贫血孕妇的 HbA1c 水平与红细胞之间的关系。HbA1c 水平与血红蛋白(r = -0.875,p <0.01*)、PCV(r = -0.732,p = <0.01*)和转铁蛋白饱和度(r = 0.224,p <0.01*)呈负相关,且具有统计学意义。结论本研究表明,Hba1c 诊断缺铁性贫血孕妇糖尿病的可靠性存在误导性,可在治疗后再考虑。此外,我们还需要更多的研究来加深对这一主题的理解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A comparative study to assess Hba1c levels in antenatal non diabetic women with anemia and without anemia

Background

Glycosylated hemoglobin (HbA1c) has a glucose residue attached to the terminal NH2 group (valine residue) of one or both HbA beta chains. HbA1c levels are not affected by blood glucose levels alone. HbA1c results are affected by several factors, such as anemia, structural hemoglobinopathies and thalassemia syndromes. HbA1c concentrations are affected by conditions that affect erythrocyte turnover. Iron deficiency anemia is the most common form of anemia. The prevalence of anemia among pregnant women in India is above 50 %. Although many forms of anemia are associated with the lowering of HbA1c, iron deficiency has been shown to shift HbA1c slightly upward. Research on this topic has yielded a variety of findings. In some research, there was no association observed between anemia and HbA1c levels; in other investigations, there was a rise or fall in this number. Iron deficiency anemia and HbA1c′s relationship is therefore still unclear. Therefore, this study aims to determine the correlation between Iron deficiency anemia and HbA1c levels among non diabetic pregnant women with anemia.

Methodology

This prospective observational study was conducted among singleton pregnant women attending antenatal clinic OPD in a private tertiary hospital in Chengalpattu, Kanchipuram district. After the complete review of their obstetric record, blood was collected in 5 ml sterile syringes and transferred equally to the two separate test tubes containing ethylene-diamine-tetra acetic acid (EDTA) anticoagulant for determining RBC indices and HbA1c levels. The difference in mean between two independent samples (between Anemia and Non-anemia) was determined using an independent sample t-test, and the difference between two independent proportions was calculated using a z-test. Bivariate Pearson's correlation analysis was used to adjudicate the relationship between red blood cell indices and HbA1c level, and correlation coefficient (r)was calculated, and the p-value of <0.05* was considered statistically significant.

Results

Bivariate Pearson's correlation analysis was done to determine the relationship between HbA1c levels and red blood cells in anemic pregnant women. HbA1c levels negatively correlated with Hemoglobin (r = −0.875, p < 0.01*), PCV (r = −0.732, p =<0.01*) and transferrin saturation (r = 0.224, p < 0.01*) and it was statistically significant. Other indices, such as serum iron concentration and TIBC, demonstrated no correlation with HbA1c level.

Conclusion

This study shows that the reliability of Hba1c in diagnosing diabetes among pregnant women with iron deficiency anemia is misguiding and can be considered after treating the condition. Also, more studies are needed to improve our understanding of this topic.

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来源期刊
Clinical Epidemiology and Global Health
Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.60
自引率
7.70%
发文量
218
审稿时长
66 days
期刊介绍: Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.
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