Dr.Vad
18.05.2015, 20:42
Публикация от британцев в Диабетологии попала в новостные ленты и доступна для свободного прочтения - как анемия и железодефицит влияют на гликированный гемоглобин:
The effect of anaemia and abnormalities of erythrocyte indices on HbA1c analysis: a systematic review.
[Ссылки могут видеть только зарегистрированные и активированные пользователи]
Квинтэссенция оттуда:
1. During monitoring of people with diabetes, when glucose and HbA1c are discordant, consider abnormalities of erythrocyte indices.
2. When HbA1c is normal/elevated but Hb is low, do not assume that HbA1c is falsely elevated—check erythrocyte indices, in particular MCV and MCH; if low, consider iron deficiency by TSAT or ferritin. If MCV and MCH are not low then consider other forms of anaemia—HbA1c may be falsely decreased in these cases.
3. Iron deficiency, as well as IDA, may be sufficient to cause a change in HbA1c values; this is highly relevant in women of childbearing age.
4. If abnormalities of erythrocyte indices or anaemia are identified, consider correction of the abnormality before using HbA1c for diagnosis or monitoring. The studies included in this review suggest that it may take up to 6 months after treatment is initiated to normalise erythrocyte indices. RDW will provide an additional indicator of normalisation of the erythrocyte population and erythrocyte lifespan.
The effect of anaemia and abnormalities of erythrocyte indices on HbA1c analysis: a systematic review.
[Ссылки могут видеть только зарегистрированные и активированные пользователи]
Квинтэссенция оттуда:
1. During monitoring of people with diabetes, when glucose and HbA1c are discordant, consider abnormalities of erythrocyte indices.
2. When HbA1c is normal/elevated but Hb is low, do not assume that HbA1c is falsely elevated—check erythrocyte indices, in particular MCV and MCH; if low, consider iron deficiency by TSAT or ferritin. If MCV and MCH are not low then consider other forms of anaemia—HbA1c may be falsely decreased in these cases.
3. Iron deficiency, as well as IDA, may be sufficient to cause a change in HbA1c values; this is highly relevant in women of childbearing age.
4. If abnormalities of erythrocyte indices or anaemia are identified, consider correction of the abnormality before using HbA1c for diagnosis or monitoring. The studies included in this review suggest that it may take up to 6 months after treatment is initiated to normalise erythrocyte indices. RDW will provide an additional indicator of normalisation of the erythrocyte population and erythrocyte lifespan.