Clinical features and laboratory data analysis of decreased glycosylated hemoglobin related to hemolytic disease / 中华血液学杂志

ABSTRACT

Objective@#To compare the effects of different hemolytic diseases on the level of glycosylated hemoglobin (HbA1c) to further explore the relationship between HbA1c and laboratory indexes to disclose implications of HbA1c in hemolytic diseases.@*Methods@#The distribution of 192 decreased HbA1c cases in 4 categories of hemolytic diseases was analyzed. Laboratory indexes related to hemolysis were tested and analyzed in each kind of disease, and relationship between laboratory indexes and HbA1c was statistically explored.@*Results@#Diagnoses of decreased HbA1c cases mainly included erythrocyte membranopathies (88 cases), immunohemolytic anemia (72 cases), hemoglobinopathy (4 cases) and erythrocyte enzymopathy (5 cases). The distribution of HbA2 and normal HbF subjects in immunohemolytic anemia and hemoglobinopathy was significantly different from those of HbA2 and / or abnormal HbF subjects (41.7% vs 22.0%, χ2=5.574, P=0.018; 0.7% vs 7.3%, P=0.031). Compared with non-hemolytic disease patients, those who suffered from 4 categories of hemolytic diseases showed lower HbA1c level and higher reticulocyte percentage (Ret), indirect bilirubin (IBIL) and free hemoglobin (F-Hb). Different levels of Ret, reticulocyte hemoglobin content (Ret-He), mean corpuscular volume (MCV), IBIL and F-Hb among the 4 kinds of diseases were observed, but the causes of the differences were not the same. HbA1c was negatively correlated with other laboratory indexes in erythrocyte membranopathies and immunohemolytic anemia.@*Conclusions@#Hemolytic disease resulted in false lower HbA1c, but impact of difference on HbA1c between different diseases was not significant. HbA1c was closely connected to laboratory indexes related to hemolysis, which might have potential implications for hemolytic diseases such as erythrocyte membranopathies and immunohemolytic anemia.