The usefulness of glycosylated hemoglobin (HbA1C) in discriminating between iron deficiency and thalassemia

This study assessed whether glycosylated hemoglobin could be used as an index to distinguish between iron-deficiency anemia and thalassemia minor. Glycosylated hemoglobin was measured by high- pressure liquid chromatography in 40 beta-thalassemia minor patients, 20 iron-deficiency anemia patients, and 38 healthy controls, all nondiabetic. Median glycosylated hemoglobin was lower in thalassemia minor than in the iron-deficiency and control groups (p =. 000). There was no difference between iron-deficiency patients and healthy controls (p =.095). Glycosylated hemoglobin was not different in iron- replete and iron- deficient traits (p > .05). A cutoff value of 5% has provided a sensitivity of 95% and specificity of 75.7% for distinguishing between these two entities. Positive and negative predictive value were 96.6 and 67.9%. These values were superior to the traditional discriminants' values calculated on the same individuals. Glycosylated hemoglobin could be useful in discriminating between iron- deficiency anemia and thalassemia minor. Further studies are needed, but the point that it can also be used when both conditions exist simultaneously seems to be clinically important.