Hemoglobin A1c values are affected by hemoglobin level and gender in non-anemic Koreans.
OBJECTIVE
To evaluate whether hemoglobin A1c (HbA1c) levels are affected by hemoglobin level and gender.


METHODS
A cross-sectional analysis was carried out in a sample of 87,284 non-diabetic Koreans without anemia who participated in comprehensive health check-ups between January and December 2009 at the Kangbuk Samsung Hospital Total Healthcare Center in Seoul, Korea. We categorized men and women separately according to fasting plasma glucose and hemoglobin level to carry out the analysis.


RESULTS
HbA1c increased steadily with increasing fasting plasma glucose level. Both men and women with lower hemoglobin had significantly higher HbA1c at a given fasting glucose level, and this result was consistent across the fasting glucose quintiles within the non-diabetic range. Women had a lower mean hemoglobin value compared with men, and women had higher HbA1c levels at a given fasting glucose level consistently across the fasting glucose deciles. There was also a gender-specific association between age and HbA1c (P < 0.001 for interaction).


CONCLUSIONS
HbA1c values were affected by hemoglobin level and gender in non-anemic Koreans. Thus, hemoglobin level and gender should be considered in the diagnosis of diabetes using HbA1c.
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Ji Cheol
JC
Bae
Division of Endocrinology and Metabolism Department of Internal Medicine Dong-A University Medical Center Busan Korea.
Sunghwan
S
Suh
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Sang-Man
SM
Jin
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Se Won
SW
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Kyu Yeon
KY
Hur
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Jae Hyeon
JH
Kim
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Yong-Ki
YK
Min
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Myung-Shik
MS
Lee
Division of Endocrinology and Metabolism Department of Internal Medicine Samsung Medical Center Seoul Korea.
Moon Kyu
MK
Lee
Division of Endocrinology and Metabolism Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Korea.
Won Seon
WS
Jeon
Division of Endocrinology and Metabolism Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Korea.
Won Young
WY
Lee
Division of Endocrinology and Metabolism Department of Internal Medicine Gil Medical Center Gachon University School of Medicine Incheon Korea.
Kwang-Won
KW
Kim
Gender; Hemoglobin; Hemoglobin A1c