HEMOGLOBIN Alc LEVEL HIGHER THAN 9.05% CAUSES A SIGNIFICANT IMPAIRMENT OF ERYTHROCYTE DEFORMABILITY IN DIABETES MELLITUS

Context. Clinical studies demonstrated erythrocyte deformability (ED) is impaired in diabetic patients and described the correlations between HbAlc and ED. Few studies further investigated what an exact elevated HbAlc level linked to the impairment of ED in diabetes. Objective. This study was to determine a cut-off point of HbAlc level leading to the impairment of ED in patients with diabetes. Design. This was a retrospective observational study. ROC curve analysis was used to determine an optimal cut-off value of HbAlc for the increasing HSRV. Subjects and Methods. In this study, 300 type 2 diabetic patients were enrolled. The whole blood viscosity was measured. High shear reductive viscosity (HSRV) was used to indirectly estimate ED. Based on the obtained cut-off value and glycemic control criteria for HbAlc, we divided all the cases into different groups to further confirm the accuracy of the cut-off value. Results. In 300 patients, ROC curve illustrated that 9.05% was the optimal cut-off value as a predictor of the increasing HSRV. And higher odds ratio (OR) for significant decrease in ED was seen in the patients with HbAlc >9.05% compared to those with HbA1c <= 9.05% (OR: 3.78, 95% CI: 2.08-6.87). HSRV increased significantly in patients with HbAlc level >9.05% in comparison to patients with HbAlc levels <6.5% between 6.5 and 8.0% and between 8.0 and 9.05%. Conclusion. ED decreased significantly in diabetic patients as soon as HbAlc level was higher than 9.05%.