(08-06-15) Association Between Inflammation and Biological Variation in Hemoglobin A1c in U.S. Non-diabetic Adults.

Liu S1, Hempe JM, McCarter RJ, Li S, Fonseca VA.
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Abstract
CONTEXT:
Inflammation is associated with higher glycated hemoglobin (HbA1c) levels. Whether the relationship is independent of blood glucose concentration remains unclear.
OBJECTIVE:
The hemoglobin glycation index (HGI) was used to test the hypothesis that inter-individual variation in HbA1c is associated with inflammation.
PARTICIPANTS:
This study used non-diabetic adults from the National Health and Nutrition Examination Survey (1999-2008).
MAIN OUTCOME MEASURES:
A subsample of participants was used to estimate the linear regression relationship between HbA1c and fasting plasma glucose (FPG). Predicted HbA1c were calculated for 7,323 non-diabetic participants by inserting FPG into the equation (HbA1c= 0.017× FPG (mg/dl) + 3.7). HGI was calculated as the difference between the observed and predicted HbA1c and the population was divided into low, moderate and high HGI subgroups. Polymorphonuclear leukocytes (PMNL), monocytes, and C-reactive protein (CRP) were used as biomarkers of inflammation.
RESULTS:
Mean HbA1c, CRP, monocyte and PMNL levels, but not FPG, progressively increased in the low, moderate and high HGI subgroups. There were disproportionately more blacks than whites in the high HGI subgroup. CRP (ß: 0.009, 95% CI 0.0001, 0.017), PMNL (ß: 0.036, 95% CI: 0.010, 0.062), and monocyte count (ß: 0.072, 95% CI: 0.041, 0.104) were each independent predictors of HGI after adjustment for age, gender, race, triglycerides, hemoglobin level, mean corpuscular volume, red cell distribution width, and obesity status.
CONCLUSIONS:
HGI reflects the effects of inflammation on HbA1c in a non-diabetic population of U.S. adults and may be a marker of risk associated with inflammation independent of FPG, race and obesity.


SOURCE: J Clin Endocrinol Metab. 2015 Apr 13:jc20144454. [Epub ahead of print]

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