당화혈색소에 영향을 미치는 인자

<Erythropoiesis>

1. Decreased erythropoiesis (old RBC증가) → ↑ HbA1c : iron, vit B12 deficiency, lack of EPO(CKD), bone marrow suppression (pregnancy, alcoholism)

2. Increased erythropoiesis (reticulocytosis, old RBC감소) → ↓ HbA1c : hemolytic anemia, iron, vit B12 보충, EPO보충(in CKD), chronic liver disease

 

<Altered Hb>

Hb의 유전적, 화학적 변화 – hemoglobinopathies, methaemoglobin → ↑ HbA1c or ↓ HbA1c

 

<Glycation>

• alcohol, chronic kidney disease → ↑ HbA1c

• aspirin, vitamins C and E → ↓ HbA1c

 

<Erythrocyte destruction>

• splenectomy → increased RBC survival → ↑ HbA1c

• Hemoglobinopathies, splenomegaly, rheumatoid arthritis or drugs such as antiretrovirals, ribavirin and dapsone → hemolysis →  ↓ HbA1c

 

<Assays>

•alcohol → acetaldehyde → ↑ HbA1c

•very high TG → ↓ HbA1c

•elevated bilirubin → ↑ HbA1c