Influence of red blood cell indices on HbA1c performance in detecting dysglycaemia in a Singapore preconception cohort study

See Ling Loy, Jinjie Lin, Yin Bun Cheung, Aravind Venkatesh Sreedharan, Xinyi Chin, Keith M. Godfrey, Kok Hian Tan, Lynette Pei Chi Shek, Yap Seng Chong, Melvin Khee Shing Leow, Chin Meng Khoo, Yung Seng Lee, Shiao Yng Chan, Ngee Lek, Jerry Kok Yen Chan, Fabian Yap

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Abstract

Abnormalities of red blood cell (RBC) indices may affect glycated haemoglobin (HbA1c) levels. We assessed the influence of haemoglobin (Hb) and mean corpuscular volume (MCV) on the performance of HbA1c in detecting dysglycaemia among reproductive aged women planning to conceive. Women aged 18–45 years (n = 985) were classified as normal (12 ≤ Hb ≤ 16 g/dL and 80 ≤ MCV ≤ 100 fL) and abnormal (Hb < 12 g/dL and/or MCV < 80 fL). The Area Under the Receiver Operating Characteristic (AUROC) curve was used to determine the performance of HbA1c in detecting dysglycaemic status (prediabetes and diabetes). There were 771 (78.3%) women with normal RBC indices. The AUROCs for the normal and abnormal groups were 0.75 (95% confidence interval 0.69, 0.81) and 0.80 (0.70, 0.90), respectively, and were not statistically different from one another [difference 0.04 (− 0.16, 0.08)]. Further stratification by ethnicity showed no difference between the two groups among Chinese and Indian women. However, Malay women with normal RBC indices displayed lower AUROC compared to those with abnormal RBC indices (0.71 (0.55, 0.87) vs. 0.98 (0.93, 1.00), p = 0.002). The results suggest that the performance of HbA1c in detecting dysglycaemia was not influenced by abnormal RBC indices based on low Hb and/or low MCV. However, there may be ethnic variations among them.

Original languageEnglish
Article number20850
JournalScientific Reports
Volume11
DOIs
Publication statusPublished - Oct 2021
Publication typeA1 Journal article-refereed

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • General

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