Elevation of HbA1c in hyperglycemic women with decreased iron involves increased osmotic stability and volume variability (RDW) of red cells

Abstract

Background: Glycated hemoglobin (HbA1c) concentrations are associated not only with glucose, but also with iron levels, and this requires careful clinical attention, especially in hyperglycemic individuals. Objective: This study aimed to analyze the associations of anthropometric, inflammatory, regulatory, metabolic, and hematologic variables with iron status and HbA1c levels in hyperglycemic women. Methods: A total of 143 (68 normoglycemic and 75 hyperglycemic) women participated in this prospective cross-sectional study. Comparisons between groups used the Mann-Whitney test, and the search for associations between pairs of variables used the Spearman correlation method. Results: In hyperglycemic women, decreased iron associates with increased HbA1c, and these changes are both associated with inflammatory status and involve decreased intracellular hemoglobin concentration (MCHC), which in turn, involves enhanced osmotic stability (dX) and volume variability (RDW) of erythrocytes, as well as decreased hemoglobin catabolism. This decreased hemoglobin catabolism does not seem to be solely a process associated with diminished intracellular concentrations of this protein since it is associated with inflammatory status and decreased LDL-cholesterol. Conclusion: In hyperglycemic women, the elevation of HbA1c with decreased iron is linked with obesity-associated inflammation and involves changes associated with increased osmotic stability and distribution width (RDW) in red cells.