Open AccessAssociations of anemia and hemoglobin with hemoglobin A1c among non‐diabetic workers in Japan
Author(s) -
Sakamoto Nobuaki,
Hu Huanhuan,
Nanri Akiko,
Mizoue Tetsuya,
Eguchi Masafumi,
Kochi Takeshi,
Nakagawa Tohru,
Honda Toru,
Yamamoto Shuichiro,
Ogasawara Takayuki,
Sasaki Naoko,
Nishihara Akiko,
Imai Teppei,
Miyamoto Toshiaki,
Yamamoto Makoto,
Okazaki Hiroko,
Tomita Kentaro,
Uehara Akihiko,
Hori Ai,
Shimizu Makiko,
Murakami Taizo,
Kuwahara Keisuke,
Fukunaga Ami,
Kabe Isamu,
Sone Tomofumi,
Dohi Seitaro
Publication year - 2020
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13159
Subject(s) - medicine , hemoglobin , anemia , mean corpuscular volume , diabetes mellitus , mean corpuscular hemoglobin concentration , confidence interval , gastroenterology , mean corpuscular hemoglobin , endocrinology
Aims/Introduction We examined the association between hemoglobin A1c (HbA1c) and anemia, which was categorized into three groups according to mean corpuscular volume (MCV), as well as the association between hemoglobin in the non‐anemic range and HbA1c. Materials and Methods We used the 2016 health checkup data from 36,422 workers without diabetes. Anemic people were divided into three groups based on MCV: <80, 80–90 and >90 fL. Non‐anemic people were divided into four groups based on their hemoglobin levels. We carried out multiple linear regression models to estimate the means and 95% confidence intervals (CIs) of HbA1c. Results For men, 0.2% had anemia with MCV <80 fL, 0.5% had anemia with MCV 80–90 fL, 0.9% had anemia with MCV >90 fL and 98.4% had no anemia. For women, the corresponding values were 6.1, 6.4, 2.8 and 84.7%, respectively. The adjusted mean HbA1c (%) values for men with anemia with MCV <80, 80–90 and >90 fL were 5.67 (95% CI 5.60–5.74), 5.58 (95% CI 5.54–5.62) and 5.41 (95% CI 5.37–5.44), respectively. Among men without anemia, HbA1c (%) increased from 5.36 (95% CI 5.34–5.39) in those with hemoglobin ≥17.5 mg/dL to 5.45 (95% CI 5.45–5.46) in those with hemoglobin 13.0 to <14.5 mg/dL ( P for trend <0.001). The HbA1c values were higher in men with anemia with MCV <80 fL or MCV 80–90 fL, but lower in men with MCV >90 fL, compared with non‐anemic men with hemoglobin 13.0 to <14.5 mg/dL (All P < 0.001). Similar findings were observed in women. Conclusions We observed elevated HbA1c among anemic people with MCV <80 fL or MCV 80–90 fL, and decreased HbA1c among anemic people with MCV >90 fL, suggesting that different types of anemia might influence HbA1c differently. In addition, non‐anemic people with lower hemoglobin levels had higher HbA1c levels, suggesting that hemoglobin levels are in need of consideration when interpreting HbA1c values among non‐anemic people.