January - March 2018, Volume 14, Issue 1

Li Q, Yang LZ

Hemoglobin A1c Level Higher Than 9.05% Causes a Significant Impairment of Erythrocyte Deformability in Diabetes Mellitus

Acta Endo (Buc) 2018, 14 (1): 66-75
doi: 10.4183/aeb.2018.66

Context. Clinical studies demonstrated erythrocyte deformability (ED) is impaired in diabetic patients and described the correlations between HbA1c and ED. Few studies further investigated what an exact elevated HbA1c level linked to the impairment of ED in diabetes. Objective. This study was to determine a cut-off point of HbA1c level leading to the impairment of ED in patients with diabetes. Design. This was a retrospective observational study. ROC curve analysis was used to determine an optimal cut-off value of HbA1c for the increasing HSRV. Subjects and Methods. In this study, 300 type 2 diabetic patients were enrolled. The whole blood viscosity was measured. High shear reductive viscosity (HSRV) was used to indirectly estimate ED. Based on the obtained cut-off value and glycemic control criteria for HbA1c, we divided all the cases into different groups to further confirm the accuracy of the cut-off value. Results. In 300 patients, ROC curve illustrated that 9.05% was the optimal cut-off value as a predictor of the increasing HSRV. And higher odds ratio (OR) for significant decrease in ED was seen in the patients with HbA1c >9.05% compared to those with HbA1c≤9.05% (OR: 3.78, 95% CI: 2.08-6.87). HSRV increased significantly in patients with HbA1c level >9.05% in comparison to patients with HbA1c levels <6.5% between 6.5 and 8.0% and between 8.0 and 9.05%. Conclusion. ED decreased significantly in diabetic patients as soon as HbA1c level was higher than 9.05%.

Keywords: Erythrocyte deformability, Type 2 diabetes mellitus, High shear reductive viscosity, HbA1c.

Correspondence: Li-Zhen Yang MD, Shanghai Ninth People’s Hospital affiliated Shanghai Jiaotong University School of Medicine, Division of Endocrinology and Metabolism, 639 Zhizaoju Road, Shanghai, 200011, China, E-mail: dryanginsh@yahoo.com