Key result
HbH disease (one functional α-gene) was associated with significantly lower HbA1c levels compared to controls (P<0.01), whereas having two or three functional α-genes did not affect HbA1c.
Why the study?
Does α-thalassemia genotype affect HbA1c measurement in nondiabetic patients?
Observational (n=189)
Does α-thalassemia genotype affect HbA1c measurement in nondiabetic patients?
p-value: p=<0.01
HbA1c values do not accurately reflect mean blood glucose levels in patients with HbH disease (one functional α-gene), highlighting a limitation of HbA1c testing in this population.
α-Thalassemia may bias HbA1c across assays; leaves open optimal method selection for glycemic monitoring.
Background α‐Thalassemia is a benign condition that is often present in patients with diabetes mellitus. Here, we evaluated the effects of different genotypes α‐thalassemia on HbA1c measurement. Methods A total of 189 samples from nondiabetic patients were analyzed. HbA1c analysis was performed by ion‐exchange high‐performance liquid chromatography, boronate affinity HPLC, immunoassay, and capillary electrophoresis. Fasting glucose, fructosamin, and HbA2 were also performed. All samples were confirmed by genotyping for thalassemia. Results In patients with two or three functional α‐genes, HbA1c values were not significantly different from those of controls (P > 0.05); however, in individuals with α‐thalassemia with one functional α‐gene (i.e., HbH disease), HbA1c levels were significantly different from those of controls (P < 0.01). HbA1c values were significantly lower in individuals with HbH disease than in control individuals and patients in the other two α‐thalassemia groups. For patients with HbH disease, there were no significant differences in the four HbA1c measurement systems (P > 0.05). Conclusions In this study, HbA1c values in samples from individuals with two or three functional α‐genes basically reflected the normal mean blood glucose level, while those in samples from individuals with one functional α‐gene did not.
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Xu et al. (2016) conducted an observational in α-Thalassemia (n=189). α-Thalassemia genotypes (HbH disease / one functional α-gene) vs. Controls and patients with two or three functional α-genes was evaluated on HbA1c levels (p=<0.01). HbH disease (one functional α-gene) was associated with significantly lower HbA1c levels compared to controls (P<0.01), whereas having two or three functional α-genes did not affect HbA1c.
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