The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.
Iron-deficiency anemia, non-iron-deficiency anemia and HbA1c among adults in the US
Open accessAbstract
BACKGROUND: Conditions that affect erythrocyte turnover affect HbA1c concentrations. Although many forms of anemia are associated with lowering of HbA1c, iron deficiency tends to increase HbA1c. We examined the effect of iron and hemoglobin (Hb) status on HbA1c and on the relationship between concentrations of fasting glucose and HbA1c in a national sample of adults in the US. METHODS: Cross-sectional data from 8296 adults aged ≥ 20 years who participated in NHANES 1999-2002 were used. RESULTS: The prevalence of low Hb (defined as <120 and < 118 g/L in women aged 20-69 and ≥ 70 years, respectively, and <137, <133, and < 124 g/L in men aged 20-49, 50-69, and ≥ 70 years, respectively) was 5.5%. There was a significant positive correlation between Hb concentrations and HbA1c concentrations after adjusting for age, gender, and race or ethnicity, with HbA1c rising from a mean of 5.28% among participants with Hb < 100 g/L to 5.72% among participants with Hb ≥ 170 g/L. The adjusted mean concentrations of HbA1c were 5.56% and 5.46% among participants with and without iron deficiency, respectively (P = 0.095). However, there was no evidence of differences in the relationship between fasting glucose and HbA1c when groups of anemic and non-anemic individuals with and without iron deficiency were examined individually. CONCLUSIONS: Caution should be used when diagnosing diabetes and prediabetes among people with high or low Hb when the HbA1c level is near 6.5% or 5.7%, respectively, as changes in erythrocyte turnover may alter the test result. However, the trend for HbA1c to increase with iron deficiency does not appear to require screening for iron deficiency in ascertaining the reliability of HbA1c in the diagnosis of diabetes and prediabetes in a given individual.
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Cites
A New Equation to Estimate Glomerular Filtration Rate
Levey, A. S., Stevens, L. A., Schmid, C. H., Zhang, Y. (., Castro, A. F., Feldman, H. I., Kusek, J. W., Eggers, P., Van Lente, F., Greene, T., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-9-200905050-00006 · Cited by 25,603
Diagnosis and classification of diabetes mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc10-s062 · Cited by 5,491
International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes
The International Expert Committee (2009) · Diabetes Care · doi:10.2337/dc09-9033 · Cited by 3,185
Prevalence of Iron Deficiency in the United States
Looker, A. C. (1997) · JAMA · doi:10.1001/jama.1997.03540360041028 · Cited by 1,137
A new look at screening and diagnosing diabetes mellitus
Saudek, C. D., Herman, W. H., Sacks, D. B., Bergenstal, R. M., Edelman, D., & Davidson, M. B. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2174 · Cited by 432
Review of hemoglobin A1c in the management of diabetes
Gallagher, E. J., Roith, D. L., & Bloomgarden, Z. T. (2009) · Journal of Diabetes · doi:10.1111/j.1753-0407.2009.00009.x · Cited by 318
Effect of Iron Deficiency Anemia on the Levels of Hemoglobin A1c in Nondiabetic Patients
Çoban, E., Özdoğan, M., & Timurağaoğlu, A. (2004) · Acta Haematologica · doi:10.1159/000079722 · Cited by 308
Prevalence of iron deficiency in the United States
Looker, A. C. (1997) · JAMA · doi:10.1001/jama.277.12.973 · Cited by 242
IRON DEFICIENCY AND GLYCOSYLATED HÆMOGLOBIN A1
Brooks, A. P., Metcalfe, J., Day, J. L., & Edwards, M. (1980) · The Lancet · doi:10.1016/s0140-6736(80)90019-7 · Cited by 235
Kim, C., Bullard, K. M., Herman, W. H., & Beckles, G. L. (2010) · Diabetes Care · doi:10.2337/dc09-0836 · Cited by 216
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International consensus on use of continuous glucose monitoring
Danne, T., Nimri, R., Battelino, T., Bergenstal, R. M., Close, K. L., DeVries, J. H., Garg, S., Heinemann, L., Hirsch, I., Amiel, S. A., et al. (2017) · Diabetes Care · doi:10.2337/dc17-1600 · Cited by 2,069
Grunberger, G., Sherr, J., Allende, M., Blevins, T., Bode, B., Handelsman, Y., Hellman, R., Lajara, R., Roberts, V. L., Rodbard, D., et al. (2021) · Endocrine Practice · doi:10.1016/j.eprac.2021.04.008 · Cited by 288
English, E., IDRIS, I. R., Smith, G., Dhatariya, K., Kilpatrick, E. S., & John, W. G. (2015) · Diabetologia · doi:10.1007/s00125-015-3599-3 · Cited by 248
“Ford et al [13] showed that in patients without diabetes, with low Hb but normal iron levels had significantly lower HbA1c values than those with normal iron and normal Hb (see Table 2).”
BackgroundMethodInfluentialWelsh, K. J., Kirkman, M. S., & Sacks, D. B. (2016) · Diabetes Care · doi:10.2337/dc15-2727 · Cited by 212
“56% in the presence of iron deficiency (26).”
Background
Metadata
- Authors
- FORD, E. S., COWIE, C. C., LI, C., HANDELSMAN, Y., & BLOOMGARDEN, Z. T.
- Affiliations
- Centers for Disease Control and Prevention (US)
- National Institutes of Health (US)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- FORD, Earl S.
- Venue
- Journal of Diabetes
- Publisher
- Wiley
- Published
- 2011-03
- Volume
- 3
- Issue
- 1
- Pages
- 67-73
- ISSN
- 1753-0393 (ISSN-L)
- OpenAlex
- W1629736006
- Cited by
- 165
- References
- 19
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 18 · 2020: 21 · 2019: 10 · 2018: 16 · 2017: 16 · 2016: 7 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 3
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Genetics (clinical) › Hemoglobinopathies and Related Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- iron deficiency anemia, HbA1c, hemoglobin, erythrocyte turnover, fasting blood glucose, diabetes diagnosis, prediabetes, anemia prevalence, NHANES
- MeSH terms
- Adult, Aged, Anemia, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Female, Glycated Hemoglobin, Hemoglobins, Humans, Iron, Male, Middle Aged, Nutrition Surveys, Sensitivity and Specificity, United States, Anemia, Iron-Deficiency, Young Adult
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