Impact of sickle cell trait on glycated hemoglobin levels in Abidjan

Glycated hemoglobin (HbA1c) is a marker for glycemic control and diagnosis in diabetic patients. Sickle cell trait (SCT), characterized by the presence of hemoglobin S (HbS), may interfere with HbA1c formation. This study aimed to determine the impact of sickle cell trait (AS) on HbA1c levels. This cross-sectional analytical study included 94 patients and 76 control subjects over a 12-month period. HbA1c was measured using a chromatographic method, and additional biological parameters were assessed after obtaining informed consent. Statistical analyses included the Student’s t-test, Spearman’s rank correlation, Chi-square (χ²) test, and ANOVA, all applied at a 5% significance level. The mean age of the control and sickle cell trait groups was 35.17 ± 11.35 years and 34.22 ± 11.54 years, respectively. Most participants were female, with a sex ratio of 0.46 in controls and 0.56 in patients. The prevalence of anemia was significantly higher in the sickle cell trait group than in the controls (26.6 vs. 10.5%, P=0.008). HbA1c levels were lower in subjects with sickle cell trait (AS) (4.99 ± 0.65) than in controls (5.56 ± 0.30) among those with normal blood glucose, independent of BMI and hemoglobin levels. Similarly, in individuals with moderate hyperglycemia, HbA1c values followed a similar trend (5.7 ± 0.67 in AA vs. 5.68 ± 0.59 in AS), showing a significant difference (p? 0.0001). HbA1c may underestimate average blood glucose levels in heterozygous Black patients with sickle cell trait, suggesting the need for alternative tests, such as fructosamine levels.   Key words: Abidjan, glycated hemoglobin (HbA1c), sickle cell disease.