Correlation of Hemoglobin A1c with Red Cell Width Distribution and Other Parameters of Red Blood Cells in Type II Diabetes Mellitus

Abdul Rabb Bhutto, Amanullah Abbasi, Ali Hassan Abro, Abdul Rabb Bhutto, Amanullah Abbasi, Ali Hassan Abro

Abstract

Objective To determine the correlation of glycated hemoglobin (HbA1c) with red cell width (RDW) and other analytic parameters of red blood cells (RBCs) in type II diabetic patients. Design Cross-sectional analytical study. Place and duration of the study Al-Tibri Medical College and Hospital Karachi; from July 2017 to January 2018. Patients and methods This cross-sectional study was conducted on diagnosed type II diabetic patients visiting the outpatient department of medicine at Al-Tibri Medical College Hospital from July 2017 to January 2018. Diabetes mellitus was diagnosed according to American Diabetes Association (ADA) guidelines. After taking consent and conducting a clinical assessment (include history and physical examination), laboratory tests, such as fasting blood glucose, random blood glucose, complete blood count (CBC), and HbA1c, were collected on proforma. Results A total of 119 patients were eligible for the study with a mean age of 48.63±12.462 (range 24-76) years; among those, males were 74 (62.2%) and females were 45 (37.8%). The mean duration of diabetes mellitus (DM) was 6.735±3.759 (range 1-20) years. The mean hemoglobin of patients was 11.59±1.315 gm/dl. The mean corpuscular volume (MCV) was 76.65±11.121 fl and the mean RDW was found to be 18.287±4.352, with the highest value of 30.20. The mean MCH was 30.223±23.873 pg, with the highest value of 38.4 pg. The mean cell hemoglobin concentration (MCHC) was 28.214±4.7498 mg/dl. The HbA1c of the study population was found to be moderately uncontrolled and the mean HbA1c was 8.278±5.015%, with the highest value of 16.2%. The mean fasting blood sugar was 158±39.50 mg/dl while the mean random blood sugar was 236±57.390 mg/dl. The correlation of HbA1c with RDW turned out to be significant statistically (p-0.035) while other RBCs and/or hematological parameters, such as MCV, hemoglobin, and platelets, revealed no significant correlation. Conclusion The study highlighted that RDW has a significant correlation with HbA1c and is an inexpensive and freely available test so it may be used as a marker of glycemic status.

Keywords: diabetes mellitus; hba1c; rdw.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2019, Bhutto et al.

References

    1. Global estimates of diabetes prevalence for 2013 and projections for 2035. Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Diabetes Res Clin Pract. 2013:103–137.
    1. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Nathan DM. Diabetes Care. 2009;32:1327–1334.
    1. Impairment of erythrocyte viscoelasticity is correlated with levels of glycosylated haemoglobin in diabetic patients. Symeonidis A, Athanassiou G, Psiroyannis A, Kyriazopoulou V, Kapatais‐Zoumbos K, Missirlis Y, Zoumbos N. Clin Lab Haematol. 2001;23:103–109.
    1. Effect of short-term hyperglycemia on protein kinase C alpha activation in human erythrocytes. Livshits L, Srulevich A, Raz I, Cahn A, Barshtein G, Yedgar S, Eldor R. Rev Diabet Stud. 2012;9:94–103.
    1. Red cell distribution width is associated with all-cause and cardiovascular mortality in patients with diabetes. Al-Kindi SG, Refaat M, Jayyousi A, Asaad N, Al Suwaidi J, Abi Khalil C. Biomed Res Int. 2017;2017:1–7.
    1. Is there a real correlation between red cell distribution width and peripheral arterial disease? Enes D, Sevsen K, Egemen C, Mehmet O. J Med Biochem. 2017;36:309–313.
    1. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Montagnana M, Cervellin G, Meschi T, Lippi G. Clin Chem Lab Med. 2011;50:635–641.
    1. Red cell distribution width and acute coronary syndromes. Yaman H, Celik T, Akgul EO, Cayci T, Kurt Y. Int J Cardiol. 2010;145:353.
    1. The red blood cell distribution width. Evans TC, Jehle D. J Emerg Med. 1991;9:71–74.
    1. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Arch Intern Med. 2009;169:588–594.
    1. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM program and the Duke Databank. Felker GM, Allen LA, Pocock SJ, et al. J Am Coll Cardiol. 2007;50:40–47.
    1. for the CARE Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. . Circulation. 2008;117:163–168.
    1. Red cell distribution width and risk for first hospitalization due to heart failure: a population-based cohort study. Borne Y, Smith JG, Melander O, Hedblad B, Engstrom G. Eur J Heart Fail. 2011;13:1355–1361.
    1. Red blood cell distribution width is associated with incidence of atrial fibrillation. Eryd SA, Borné Y, Melander O, Persson M, Smith JG, Hedblad B, Engström G. J Intern Med. 2014;275:84–92.
    1. Association of increased levels of glycated hemoglobin with variations in red blood cell parameters in diabetes mellitus. Suryavanshi C, Manjula SD, Bekur R, Rao RK. Int J Adv Res (Indore) 2015;3:31–37.
    1. Correlation of red blood cell distribution width (RDW) and hemoglobin A1C (HbA1C) levels in diabetic individuals. Salimon AH, Patil HA. Int J Innov Res Sci Eng Technol. 2017;6:8227–8239.
    1. Red cell distribution width as a marker of inflammation in type 2 diabetes mellitus. Sherif H, Ramadan N, Radwan M, Hamdy E, Reda R. Life Sci J. 2013;10:1501–1507.
    1. Increased red blood cell distribution width (RDW) is associated with higher glycosylated hemoglobin (HbA1C) in the elderly. Lippi G, Targher G, Salvagno GL, Guidi GC. Clin Lab. 2014;60:2095–2098.
    1. Spuriously high prevalence of prediabetes diagnosed by HbA1c in young Indians partly explained by hematological factors and iron deficiency anemia. Hardikar P, Joshi S, Bhat D, et al. Diabetes Care. 2012;35:797–802.
    1. Association of erythrocyte indices with glycated haemoglobin in pre-menopausal women. Koga M, Morita S, Saito H, Mukai M, Kasayama S. Diabet Med. 2007;24:843–847.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren