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Published on: April 6, 2014
HbA1c: High in acute cerebral infarction and low in brain trauma
Zhifeng Jiang1, Jigang Wang2, Peng Zhao3
1Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China; Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University, Qingdao, China.
Insights
Elevated hemoglobin A1c (HbA1c) levels, commonly used for diabetes diagnosis, are frequently observed in many non-diabetic diseases. This study analyzed 48,183 results, finding increased HbA1c in 29 of 36 diseases, suggesting a common link beyond diabetes.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Pathophysiology
Background:
- Hemoglobin A1c (HbA1c) is a key biomarker for diabetes diagnosis and management.
- Elevated HbA1c levels are known in some non-diabetic conditions, but a comprehensive comparison across diseases is lacking.
Purpose of the Study:
- To systematically compare HbA1c levels in healthy individuals and patients with various non-diabetic diseases.
- To investigate the association of elevated HbA1c with aging and age-related conditions.
Main Methods:
- Retrospective analysis of 48,183 clinical laboratory test results for HbA1c.
- Inclusion of data from healthy individuals and patients with 36 different disease types over five years.
- Statistical analysis using mean, median, and p-values (-Log10p) to determine significance.
Main Results:
- Significantly increased HbA1c levels were found in type 2 diabetes, acute cerebral infarction, nephrotic syndrome, endometrial cancer, cerebral ischemia, leukemia, bladder cancer, COPD, and 27 other diseases.
- Brain trauma patients showed significantly decreased HbA1c levels compared to healthy controls.
- Highest significance for increased HbA1c was observed in type 2 diabetes, acute cerebral infarction, coronary heart disease, cerebrovascular disease, older healthy adults (>65), and diabetic nephropathy, linking elevated HbA1c to aging.
- Unexpectedly, 29 out of 36 diseases exhibited mean and median HbA1c levels of ≥6.5%.
Conclusions:
- Elevated HbA1c levels are a common finding in numerous non-diabetic diseases, not solely indicative of diabetes.
- The association of increased HbA1c with aging and age-related diseases warrants further investigation.
- Understanding the molecular mechanisms behind these elevated HbA1c levels in non-diabetic conditions may refine the interpretation of glycemic control markers.
Abstract:
HbA1c is a glycated hemoglobin. The ≥6.5% HbA1c in total hemoglobins has been used in diagnosing and guiding therapy for patients with diabetes since 1970s. Increased HbA1c levels are observed in other nondiabetic conditions, such as cancers, uremia, macro- and microvascular diseases. However, a systematic comparison of the HbA1c levels in different types of human diseases has not been reported. In current study, 48,183 clinical lab test results of HbA1c levels from healthy individuals and patients with 36 different types of diseases during the past 5 years in our hospital were retrieved and analyzed. Based on the mean (SD), median, and p (-Log10p) values, we found that patients suffering type 2 diabetes, acute cerebral infarction, nephrotic syndrome, endometrial cancer, cerebral ischemia, leukemia, bladder cancer, chronic obstructive pulmonary disease plus other 27 diseases had significantly (p<0.05, -Log10p>1.30) increased HbA1c levels, whereas patients suffering brain trauma had significantly decreased HbA1c levels compared to that of healthy controls. Moreover, the highest -Log10p values were observed in type 2 diabetes, acute cerebral infarction, coronary heart disease, cerebrovascular disease, healthy controls >65 years old, and diabetic nephropathy, indicating the increased HbA1c levels were associated with aging and aging-related diseases. Unexpectedly, 29/36 diseases had both mean and median HbA1c levels ≥6.5%. These data suggested that the increased HbA1c levels were a common feature of nondiabetic diseases. Revealing the molecular mechanisms underlying the data presented in current study might help better understand the meaning of glycemic control.
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