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Title: Influence of red blood cell indices on HbA1c performance in detecting dysglycaemia in a Singapore preconception cohort study
Authors: Loy, See Ling
Lin, Jinjie
Cheung, Yin Bun
Sreedharan, Aravind Venkatesh
Chin, Xinyi
Godfrey, Keith M.
Tan, Kok Hian
Shek, Lynette Pei-Chi
Chong, Yap Seng
Leow, Melvin Khee-Shing
Khoo, Chin Meng
Lee, Yung Seng
Chan, Shiao-Yng
Lek, Ngee
Chan, Jerry Kok Yen
Yap, Fabian
Keywords: Science::Medicine
Issue Date: 2021
Source: Loy, S. L., Lin, J., Cheung, Y. B., Sreedharan, A. V., Chin, X., Godfrey, K. M., Tan, K. H., Shek, L. P., Chong, Y. S., Leow, M. K., Khoo, C. M., Lee, Y. S., Chan, S., Lek, N., Chan, J. K. Y. & Yap, F. (2021). Influence of red blood cell indices on HbA1c performance in detecting dysglycaemia in a Singapore preconception cohort study. Scientific Reports, 11(1), 20850-.
Project: NMRC/TCR/004-NUS/2008
Journal: Scientific Reports
Abstract: Abnormalities of red blood cell (RBC) indices may affect glycated haemoglobin (HbA1c) levels. We assessed the influence of haemoglobin (Hb) and mean corpuscular volume (MCV) on the performance of HbA1c in detecting dysglycaemia among reproductive aged women planning to conceive. Women aged 18-45 years (n = 985) were classified as normal (12 ≤ Hb ≤ 16 g/dL and 80 ≤ MCV ≤ 100 fL) and abnormal (Hb < 12 g/dL and/or MCV < 80 fL). The Area Under the Receiver Operating Characteristic (AUROC) curve was used to determine the performance of HbA1c in detecting dysglycaemic status (prediabetes and diabetes). There were 771 (78.3%) women with normal RBC indices. The AUROCs for the normal and abnormal groups were 0.75 (95% confidence interval 0.69, 0.81) and 0.80 (0.70, 0.90), respectively, and were not statistically different from one another [difference 0.04 (- 0.16, 0.08)]. Further stratification by ethnicity showed no difference between the two groups among Chinese and Indian women. However, Malay women with normal RBC indices displayed lower AUROC compared to those with abnormal RBC indices (0.71 (0.55, 0.87) vs. 0.98 (0.93, 1.00), p = 0.002). The results suggest that the performance of HbA1c in detecting dysglycaemia was not influenced by abnormal RBC indices based on low Hb and/or low MCV. However, there may be ethnic variations among them.
ISSN: 2045-2322
DOI: 10.1038/s41598-021-00445-w
Rights: © 2021 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Fulltext Permission: open
Fulltext Availability: With Fulltext
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