A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels

ABSTRACT Background Glycated hemoglobin (HbA1c) is widely used to assess long‐term glycemic control in individuals with diabetes. However, various conditions that affect hemoglobin levels or the lifespan of red blood cells can compromise the accuracy of HbA1c measurements. Despite extensive research...

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Main Authors: Tingyu Zhang, Tianyi Shi, Min Cao, Yunxi Ji, Yanbin Xue, Huayan Yao, Qiaomei Yin, Bin Cui, Zhen Xie, Ping He
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Journal of Diabetes
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Online Access:https://doi.org/10.1111/1753-0407.70057
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author Tingyu Zhang
Tianyi Shi
Min Cao
Yunxi Ji
Yanbin Xue
Huayan Yao
Qiaomei Yin
Bin Cui
Zhen Xie
Ping He
author_facet Tingyu Zhang
Tianyi Shi
Min Cao
Yunxi Ji
Yanbin Xue
Huayan Yao
Qiaomei Yin
Bin Cui
Zhen Xie
Ping He
author_sort Tingyu Zhang
collection DOAJ
description ABSTRACT Background Glycated hemoglobin (HbA1c) is widely used to assess long‐term glycemic control in individuals with diabetes. However, various conditions that affect hemoglobin levels or the lifespan of red blood cells can compromise the accuracy of HbA1c measurements. Despite extensive research, the relationship between HbA1c and hemoglobin remains unclear. This study aims to clarify this relationship by examining its correlation across diverse age and gender cohorts. Methods Data from 217,991 participants aged 20 to 69 years were collected from health examination centers in Southwest China. Standardized methodologies were used to measure HbA1c and hemoglobin levels. Generalized additive models (GAM) were utilized to analyze non‐linear relationships and adjust for potential confounding variables. Gender‐specific reference intervals (RIs) for hemoglobin were also established. Results A gender‐specific association was observed between HbA1c and hemoglobin levels. In men, HbA1c levels decreased with increasing hemoglobin. Among women, a negative correlation was observed in premenopausal women (aged ≤ 45 years), whereas postmenopausal women (aged > 45 years) showed a positive correlation, with HbA1c levels increasing as hemoglobin levels rose. Additionally, HbA1c levels increased with age in both genders, with a more pronounced rise in women after the age of 45. Conclusion This study highlights significant gender‐ and age‐related differences in the relationship between HbA1c and hemoglobin. The findings suggest that estrogen‐related metabolic changes may influence HbA1c levels, with potential implications for diabetes management and hormone therapy in postmenopausal women.
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spelling doaj-art-c67ff9360ef84d4ca6d69e9f10129a8e2025-08-20T02:45:43ZengWileyJournal of Diabetes1753-03931753-04072025-02-01172n/an/a10.1111/1753-0407.70057A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin LevelsTingyu Zhang0Tianyi Shi1Min Cao2Yunxi Ji3Yanbin Xue4Huayan Yao5Qiaomei Yin6Bin Cui7Zhen Xie8Ping He9Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaFaculty of Medical and Health Sciences University of Auckland Auckland New ZealandDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaComputer Net Center, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaComputer Net Center, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaKunming First People's Hospital Yunnan ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Dermatology, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu ChinaLink Healthcare Engineering and Information Department Shanghai Hospital Development Center Shanghai ChinaABSTRACT Background Glycated hemoglobin (HbA1c) is widely used to assess long‐term glycemic control in individuals with diabetes. However, various conditions that affect hemoglobin levels or the lifespan of red blood cells can compromise the accuracy of HbA1c measurements. Despite extensive research, the relationship between HbA1c and hemoglobin remains unclear. This study aims to clarify this relationship by examining its correlation across diverse age and gender cohorts. Methods Data from 217,991 participants aged 20 to 69 years were collected from health examination centers in Southwest China. Standardized methodologies were used to measure HbA1c and hemoglobin levels. Generalized additive models (GAM) were utilized to analyze non‐linear relationships and adjust for potential confounding variables. Gender‐specific reference intervals (RIs) for hemoglobin were also established. Results A gender‐specific association was observed between HbA1c and hemoglobin levels. In men, HbA1c levels decreased with increasing hemoglobin. Among women, a negative correlation was observed in premenopausal women (aged ≤ 45 years), whereas postmenopausal women (aged > 45 years) showed a positive correlation, with HbA1c levels increasing as hemoglobin levels rose. Additionally, HbA1c levels increased with age in both genders, with a more pronounced rise in women after the age of 45. Conclusion This study highlights significant gender‐ and age‐related differences in the relationship between HbA1c and hemoglobin. The findings suggest that estrogen‐related metabolic changes may influence HbA1c levels, with potential implications for diabetes management and hormone therapy in postmenopausal women.https://doi.org/10.1111/1753-0407.70057estrogenhemoglobinhemoglobin A1c
spellingShingle Tingyu Zhang
Tianyi Shi
Min Cao
Yunxi Ji
Yanbin Xue
Huayan Yao
Qiaomei Yin
Bin Cui
Zhen Xie
Ping He
A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
Journal of Diabetes
estrogen
hemoglobin
hemoglobin A1c
title A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
title_full A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
title_fullStr A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
title_full_unstemmed A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
title_short A Population‐Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels
title_sort population based correlation analysis between hemoglobin a1c and hemoglobin levels
topic estrogen
hemoglobin
hemoglobin A1c
url https://doi.org/10.1111/1753-0407.70057
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