The Relationship Between Hemoglobin A1c and Hemogram-derived Novel Inflammatory Indices

Objective: An increasing number of studies are investigating the importance of new inflammatory markers derived from hemogram in the clinical management of diabetes, which is a chronic inflammatory condition.In this study, we aimed to assess the relation between HbA1c, Systemic Inflammatory Index (SII), Systemic Inflammation Response Index (SIRI), and Systemic Inflammation Aggregate Index (SIAI).Methods: A total of 22,183 participants, including the control group (n=9100), prediabetes group (n=7087), and diabetes group (n=5996), were divided into 3 groups according to their HbA1c levels.In these 3 groups, hemogram-derived new inflammatory markers SII, SIRI, and SIAI values, as well as C-reactive protein, sedimentation, and leukocyte values, were evaluated. Results:The median values of all 3 indices were found to be higher in the diabetes group compared to the other groups [SII=515(380-716), SIRI=0.93(0.66-1.35),SIAI=248(164-374), p<0.001].In the control group, HbA1c and glucose values were not significantly correlated with inflammation indices (p>0.05).However, in the prediabetes group, significant correlations were detected between SII and SIRI values and glucose (r=0.033,p=0.006; r=0.040, p=0.001) and HbA1c levels (r=0.038,p=0.001; r=0.069, p<0.001). Conclusion:Hemogram-derived inflammatory indices showed a gradual increase in patient groups based on HbA1c levels, but weak correlations were found between HbA1c levels and inflammatory markers as indicators of glucotoxicity.Hemogram is an easily accessible and widely used test in clinical practice.Therefore, hemogram-derived indices may be an alternative to traditional inflammatory markers in assessing glycotoxicity-induced inflammation.The detection of inflammation, which positively correlated with HbA1c levels through new indices, may help in predicting diabetic complications.