High HbA1C in anemic patients: Is hypovitaminosis D that link?

Abstract

Context: Glycated hemoglobin is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time, formed due to non-enzymatic glycation. Previous studies have suggested increased glycated hemoglobin levels in anemic patients despite the shortened life span of the erythrocytes. Several reports have suggested an active role of vitamin D in the functional regulation of pancreatic β-cells. Hypovitaminosis D may be an independent risk factor for type 2 diabetes mellitus (T2DM) with higher HbA1c levels. Studies have also demonstrate association of vitamin D deficiency and greater risk of anemia in children. Aims: The aim of this study is to estimate and analyse hemoglobin A1c, vitamin D and hemoglobin levels in non diabetic anemic adults and assess the relationship between above mentioned parameters. Materials and Methods: The study was conducted at Kasturba Medical College, Manipal. Serum vitamin D, hemoglobin and HbA1c measured in 187 non-diabetic anemic adults of 25-55 years of age, glycated hemoglobin measured in BIORAD variant turbo II using ion exchange HPLC method, and vitamin D by Eletrochemiluminescene method. Hemoglobin estimation was done by Drabkin's method. Results and Conclusion: The study found negative correlation between vitamin D and HbA1c in both males and females (r = -0.5, r = -0.4 P ≤ 0.001), HbA1c and hemoglobin (r = -0.4, r = -0.3 P ≤ 0.002). Also, there was significant positive correlation between the vit D and hemoglobin (r = 0.4, r = 0.3 P ≤ 0.001) values in the study population. Thus, there could be a role of vitamin D in the management of anemia. Since the sample size was small further study is recommended with larger sample size for reliable results.