In 2009, the Department of Laboratory Medicine of China-Japan Friendship Hospital, Ministry of Health joined this project as the lead agency for the collection, storage and analysis of biospecimens. The CHNS is an ongoing, open, population-based study conducted by the National Institute for Nutrition and Food Safety at the Chinese Center for Disease Control and Prevention (CCDC) and the Carolina Population Center at the University of North Carolina at Chapel Hill (UNC), designed to examine the health and nutrition status of the Chinese population. Therefore, our aim in this study was to evaluate the association between Hb levels within the normal range and HbA1c levels among Chinese non-diabetes adults using cross-sectional data from the China Health and Nutrition Survey (CHNS). Moreover, the association between Hb levels within the normal range and HbA1c levels remains to be clarified. However, previous studies that focused on the relationship between Hb and HbA1c in patients with anemia yielded inconsistent findings. As a measure of blood glucose, HbA1c has several advantages over fasting plasma glucose generally used in practice: greater convenience as no fasting is required greater pre-analytical stability and less day-to-day variability due to stress, diet, or illness. The HbA1c level reflects the average level of blood glucose over the past 90 days. Hemoglobin A1c (HbA1c) is the product of a non-enzymatic chemical reaction between Hb and glucose. As the extent of Hb glycation is influenced by the amount of blood glucose, increased blood glucose levels are reflected on the surface of the Hb protein. Hemoglobin (Hb), a protein only found in red blood cells, becomes glycated or coated with glucose from the bloodstream. Accordingly, ongoing studies are assessing the utility of novel and less studied biomarkers of diabetes. As early interventions might delay or even prevent full-blown diabetes, it is important to identify individuals at high risk of diabetes. If left untreated, diabetes is associated with devastating short- and long-term complications. Moreover, although the prevalence of diabetes is high, nearly half of the individuals living with diabetes are unaware of their disease status. Almost 10% of the world’s adult population (nearly 500 million individuals) live with diabetes, with the prevalence expected to increase to 700 million by 2045. Confounding factors, such as red blood cell counts can affect the association between Hb and HbA1c levels.ĭiabetes is one of the most prevalent diseases globally. Our findings revealed that Hb levels within the normal range were negatively associated with HbA1c levels among Chinese non-diabetes adults. However, this association did not remain significant when the regression model was minimally adjusted for age and sex (β =0.006, 95% CI: − 0.014, 0.024) this association became negative when the model was further adjusted for covariates whose effect estimates of HbA1c levels more than 10% (β = − 0.042, 95% CI: − 0.064, − 0.020). The association between Hb and HbA1c levels was positive in the unadjusted model (β =0.020, 95% CI: 0.008, 0.032). Subgroup analyses stratified by age and sex were also performed. Multivariable linear models were applied to examine the association between Hb and HbA1c levels. Our analysis was based on the data of 1659 non-diabete adults 20–49 years of age. Therefore, our aim in this study was to evaluate the association between Hb levels within the normal range and HbA1c levels among Chinese non-diabetes adults using cross-sectional data from the China Health and Nutrition Survey 2009. However, the association between Hb and HbA1c remains to be fully elucidated in view of the controversial findings reported to date. Hemoglobin A1c (HbA1c) is the product of a non-enzymatic chemical reaction between hemoglobin (Hb) and glucose.
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