ABSTRACT
Hemoglobin A1c (HbA1c) level represents an established tool to monitor glycemic control in diabetic patients, but the previous commonly used tests of HbA1c in patients with end-stage renal disease (ESRD) may not be reliable because of the presence of anemia, assay interference from uremia, and decreased red blood cell (RBC) life span. HbA1c level measured by turbidimetric immunoassay method is not affected by the above factors. We enrolled 40 non-diabetic ESRD patients receiving hemodialysis and 55 non-diabetic patients without ESRD for this study. HbA1c was analyzed by turbidimetric immunoassays with Synchron CX system. We found that the average HbA1c level in non-diabetic ESRD patients receiving hemodialysis was 5.99% and in the control group was 5.45% (p<0.05). There was no significant difference in fasting glucose levels and Hct % between the two groups (p>0.05). Our limited data indicate that HbA1c levels are elevated in nondiabetic ESRD patients receiving hemodialysis. We propose that the elevated HbA1c level may be due to the repetitive exposure of patients' RBCs to the high glucose level in dialysate (200 mg/dl) or may reflect true glucose intolerance in non-diabetic patients with ESRD.
Subject(s)
Glycated Hemoglobin/metabolism , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/therapy , Renal Dialysis , Adult , Black or African American , Blood Glucose/metabolism , Female , Humans , Immunoassay , Male , Middle Aged , Nephelometry and Turbidimetry , New York CityABSTRACT
OBJECTIVE: To assess the potential effect of serum leptin levels in human immunodeficiency virus (HIV)-related wasting. METHODS: Morning serum leptin levels of 94 randomly chosen HIV-infected patients were measured and correlated with age, sex, weight, height, body mass index (BMI), routine blood chemistries (SMA 18), complete blood cell count, HIV viral load, and CD4/CD8 ratio. RESULTS: The mean serum leptin level was 7.0 +/- 6.9 ng/mL. Leptin levels were significantly higher in the 38 female patients than in the 56 male patients (10.0 +/- 8.4 ng/mL versus 5.0 +/- 4.9 ng/mL; P<0.001). Leptin levels were positively correlated with BMI (r = 0.71; P<0.05). The correlation of leptin levels with BMI was improved when the results were analyzed stratified by the sex of the patients (r = 0.74 for female patients; r = 0.81 for male patients). CONCLUSION: This study showed that the serum leptin levels in HIV-infected patients with BMI between 18 and 25 kg/m 2 were comparable to leptin levels in lean, healthy subjects. Leptin distribution was positively correlated with BMI, as expected. These data do not support the hypothesis for a major role of serum leptin in HIV-related wasting.
