Association Between Iron Deficiency and A1C Levels Among Adults Without Diabetes in the National Health and Nutrition Examination Survey, 1999-2006

被引:152
作者
Kim, Catherine [1 ,2 ]
Bullard, Kai McKeever [3 ]
Herman, William H. [1 ,4 ]
Beckles, Gloria L. [3 ]
机构
[1] Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Dept Obstet & Gynecol, Ann Arbor, MI 48109 USA
[3] Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA
[4] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA
关键词
PREVALENCE; WOMEN; HEMOGLOBIN; ANEMIA; GLUCOSE; TRENDS; RISK;
D O I
10.2337/dc09-0836
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE Iron deficiency has been reported to elevate A1C levels apart from glycemia. We examined the influence of iron deficiency on A1C distribution among adults without diabetes. RESEARCH DESIGN AND METHODS Participants included adults without self-reported diabetes or chronic kidney disease in the National Health and Nutrition Examination Survey 1999-2006 who were aged >= 18 years of age and had complete blood counts, iron studies, and A1C levels. Iron deficiency was defined as at least two abnormalities including free erythrocyte protoporphyrin >70 mu g/dl erythrocytes, transferrin saturation <16%, or serum ferritin <= 15 mu g/l. Anemia was defined as hemoglobin <13.5 g/dl in men and <12.0 g/dl in women. RESULTS Among women = 6,666), 13.7% had iron deficiency and 4.0% had iron deficiency anemia. Whereas 316 women with iron deficiency had A1C >= 5.5%, only 32 women with iron deficiency had A1C >= 6.5%. Among men (n = 3,869), only 13 had iron deficiency and A1C >= 5.5%, and only I had iron deficiency and A1C >= 6.5%. Among women, iron deficiency was associated with a greater odds of A1C >= 5.5% (odds ratio 1.39 [95% CI 1.11-1.73]) after adjustment for age, race/ethnicity, and waist circumference but not with a greater odds of A1C >= 6.5% (0.79 [0.33-1.85]). CONCLUSIONS Iron deficiency is common among women and is associated with shifts in A1C distribution from <5.5 to >= 5.5%. Further research is needed to examine whether iron deficiency is associated with shifts at higher A1C levels.
引用
收藏
页码:780 / 785
页数:6
相关论文
共 25 条
[1]  
[Anonymous], NAT HLTH NUTR EX SUR
[2]   Association of kidney function with anemia - The Third National Health and Nutrition Examination Survey (1988-1994) [J].
Astor, BC ;
Muntner, P ;
Levin, A ;
Eustace, JA ;
Coresh, J .
ARCHIVES OF INTERNAL MEDICINE, 2002, 162 (12) :1401-1408
[3]  
BROOKS AP, 1980, LANCET, V2, P141
[4]   Serum iron and body fat distribution in a multiethnic cohort of adults living in New York City [J].
Chambers, EC ;
Heshka, S ;
Gallagher, D ;
Wang, J ;
Pi-Slinyer, FX ;
Pierson, RN .
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION, 2006, 106 (05) :680-684
[5]   Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients [J].
Coban, E ;
Ozdogan, M ;
Timuragaoglu, A .
ACTA HAEMATOLOGICA, 2004, 112 (03) :126-128
[6]   Prevalence of chronic kidney disease in the United States [J].
Coresh, Josef ;
Selvin, Elizabeth ;
Stevens, Lesley A. ;
Manzi, Jane ;
Kusek, John W. ;
Eggers, Paul ;
Van Lente, Frederick ;
Levey, Andrew S. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (17) :2038-2047
[7]   Unexplained decline in the prevalence of anemia among US children and women between 1988-1994 and 1999-2002 [J].
Cusick, Sarah E. ;
Mei, Zuguo ;
Freedman, David S. ;
Looker, Anne C. ;
Ogden, Cynthia L. ;
Gunter, Elaine ;
Cogswell, Mary E. .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2008, 88 (06) :1611-1617
[8]  
Dabelea D, 2007, JAMA-J AM MED ASSOC, V297, P2716, DOI 10.1001/jama.297.24.2716
[9]   Trends in the prevalence and ratio of diagnosed to undiagnosed diabetes according to obesity levels in the U.S [J].
Gregg, EW ;
Cadwell, BL ;
Cheng, YJ ;
Cowie, CC ;
Williams, DE ;
Geiss, L ;
Engelgau, MM ;
Vinicor, F .
DIABETES CARE, 2004, 27 (12) :2806-2812
[10]   A1C but Not Serum Glycated Albumin Is Elevated in Late Pregnancy Owing to Iron Deficiency [J].
Hashimoto, Kunihiko ;
Noguchi, Sanai ;
Morimoto, Yasuhiko ;
Hamada, Shinichi ;
Wasada, Kenshi ;
Imai, Shiro ;
Murata, Yuji ;
Kasayama, Soji ;
Koga, Masafumi .
DIABETES CARE, 2008, 31 (10) :1945-1948