Unit:
Κατεύθυνση Σακχαρώδης Διαβήτης και ΠαχυσαρκίαLibrary of the School of Health Sciences
Author:
Tsilingiris Dimitrios
Dissertation committee:
Πέτρος Π. Σφηκάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Τεντολούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Μακρυλάκης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αλέξανδρος Κόκκινος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βάια Λαμπαδιάρη, Αναπληρώτρια Καθηγήτρια , Ιατρική Σχολή, ΕΚΠΑ
Μαριάννα Νταλαμάγκα, Αναπληρώτρια Καθηγήτρια , Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Ράπτης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Διερεύνηση της επίδρασης της ετεροζύγου β-μεσογειακής αναιμίας στα επίπεδα της HbA1c σε άτομα με και χωρίς σακχαρώδη διαβήτη
Translated title:
Effect of heterozygous beta thalassemia on HbA1c levels among individuals with and without diabetes mellitus
Summary:
Background and Aims: To investigate the effect of heterozygous β-thalassemia on glycated hemoglobin (HbA1c) among individuals with and without diabetes mellitus (DM).
Μaterials and Methods: Using a cross-sectional design, HbA1c levels were studied in two populations as follows: (a) between two subgroups of individuals without DM (100 consecutive carriers of β-thalassemia trait and 100 healthy controls) matched for age, gender and BMI, taking into account fasting serum glucose and fructosamine levels. The effect of hemoglobin concentration and HbF% on HbA1c was also examined. (b) between two subgroups of individuals with DM (77 consecutive carriers of β-thalassemia trait and 71 healthy controls) matched for age, gender, BMI, diabetes type and duration, and presence of complications, considering fasting serum glucose and fructosamine levels. The glycation gap (GG) was calculated. The effect of hemoglobin and bilirubin concentration, HbF(%) and relative reticulocyte count was examined.
Results: In population (a), mean HbA1c level was almost identical in the two groups. Within the group of β-thalassemia, there was a positive correlation between HbA1c and hemoglobin concentration (r=0.455, p<0.001), which was not observed in controls. β-thalassemia carriers without anemia had slightly higher HbA1c levels compared to those with anemia (5.35% vs. 5.12% p<0.001, absolute difference (0.23%). In multivariable analysis, hemoglobin concentration, BMI and 1st degree family history of T2DM were significant predictors of HbA1c, while β-thalassemia carrier state was non-significant (p=0.07) but a positive correlation became significant after adjustment for HbF(%). In population (b) no significant effects of β-thalassemia carrier state was ascertained on either HbA1c level or GG despite the considerable effects of erythrocyte turnover-related parameters.
Conclusions: The effect of heterozygous β-thalassemia and β-thalassemia trait-associated anemia on HbA1c among individuals without DM is of negligible clinical significance while no effect of heterozygous β-thalassemia on HbA1c values is observed among individuals with DM. These findings advocate for the clinical use of HbA1c as a diagnostic criterion for diabetes mellitus and for long-tern therapeutic monitoring among β-thalassemia carriers.
Main subject category:
Health Sciences
Keywords:
ΗbA1c, Glycated hemoglobin, Heterozegous beta thalassemia, Diabetes mellitus, Diabetes diagnosis
Number of references:
199
