PMID- 27679433 OWN - NLM STAT- MEDLINE DCOM- 20170601 LR - 20221207 IS - 1530-8561 (Electronic) IS - 0009-9147 (Linking) VI - 62 IP - 12 DP - 2016 Dec TI - Impact of Mean Cell Hemoglobin on Hb A1c-Defined Glycemia Status. PG - 1570-1578 AB - BACKGROUND: Several hematological alterations are associated with altered hemoglobin A(1c) (Hb A(1c)). However, there have been no reports of their influence on the rates of exceeding standard Hb A(1c) thresholds by patients for whom Hb A(1c) determination is requested in clinical practice. METHODS: The initial data set included the first profiles (complete blood counts, Hb A(1c), fasting glucose, and renal and hepatic parameters) of all adult patients for whom such a profile was requested between 2008 and 2013 inclusive. After appropriate exclusions, 21844 patients remained in the study. Linear and logistic regression models were adjusted for demographic, hematological, and biochemical variables excluded from the predictors. RESULTS: Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) correlated negatively with Hb A(1c). Fasting glucose, MCH, and age emerged as predictors of Hb A(1c) in a stepwise regression that discarded sex, hemoglobin, MCV, mean corpuscular hemoglobin concentration (MCHC), serum creatinine, and liver disease. Mean Hb A(1c) in MCH interdecile intervals fell from 6.8% (51 mmol/mol) in the lowest (32.5 pg), with similar results for MCV. After adjustment for fasting glucose and other correlates of Hb A(1c), a 1 pg increase in MCH reduced the odds of Hb A(1c)-defined dysglycemia, diabetes and poor glycemia control by 10%-14%. CONCLUSIONS: For at least 25% of patients, low or high MCH or MCV levels are associated with increased risk of an erroneous Hb A(1c)-based identification of glycemia status. Although causality has not been demonstrated, these parameters should be taken into account in interpreting Hb A(1c) levels in clinical practice. CI - (c) 2016 American Association for Clinical Chemistry. FAU - Rodriguez-Segade, Santiago AU - Rodriguez-Segade S AD - Department of Biochemistry and Molecular Biology, ssegade@telefonica.net. AD - University Hospital Clinical Biochemistry Laboratory. FAU - Garcia, Javier Rodriguez AU - Garcia JR AD - University Hospital Clinical Biochemistry Laboratory. FAU - Garcia-Lopez, Jose M AU - Garcia-Lopez JM AD - Division of Endocrinology. FAU - Gude, Francisco AU - Gude F AD - Clinical Epidemiology Unit, Universidade de Santiago de Compostela, 15782-Santiago de Compostela, A Coruna, Spain. FAU - Casanueva, Felipe F AU - Casanueva FF AD - Division of Endocrinology. AD - Physiopathology of Obesity and Nutrition Biomedical Research Network Consortium; and. FAU - Rs-Alonso, Santiago AU - Rs-Alonso S AD - the Division of Pneumology, University Hospital Clinical Complex (CHUAC), A Coruna, Spain. FAU - Camina, Felix AU - Camina F AD - Department of Biochemistry and Molecular Biology. LA - eng PT - Journal Article DEP - 20160927 PL - England TA - Clin Chem JT - Clinical chemistry JID - 9421549 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) RN - 0 (Hemoglobins) SB - IM CIN - Clin Chem. 2016 Dec;62(12):1551-1553. PMID: 27694390 MH - Adult MH - Aged MH - Aged, 80 and over MH - Blood Glucose/*analysis MH - Diabetes Mellitus/*blood/*diagnosis MH - Erythrocytes/*chemistry MH - Fasting MH - Female MH - Glycated Hemoglobin/*analysis MH - Hemoglobins/*analysis MH - Humans MH - Linear Models MH - Logistic Models MH - Male MH - Middle Aged EDAT- 2016/09/30 06:00 MHDA- 2017/06/02 06:00 CRDT- 2016/09/29 06:00 PHST- 2016/03/18 00:00 [received] PHST- 2016/07/27 00:00 [accepted] PHST- 2016/09/30 06:00 [pubmed] PHST- 2017/06/02 06:00 [medline] PHST- 2016/09/29 06:00 [entrez] AID - clinchem.2016.257659 [pii] AID - 10.1373/clinchem.2016.257659 [doi] PST - ppublish SO - Clin Chem. 2016 Dec;62(12):1570-1578. doi: 10.1373/clinchem.2016.257659. Epub 2016 Sep 27.