Glycosylated Hemoglobin in Young Healthy Kashmiri Adults for Reference Epidemiological Purposes and Prediction of the Risk of Future Diabetes

Background Accumulation of glycated hemoglobin in the red cell reflects the average level of glucose to which the cell has been exposed during its life-cycle. Increased levels of glucose in the Hb contribute to more binding and consequently higher levels of glycosylated Hb. Glycated- Hb is also associated with a risk of diabetes and more strongly with the risk of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of glycated- Hb as a diagnostic test for diabetes. Aims and objectives Assessing the normal levels of HbA1c in young healthy adult Kashmiri population for reference and epidemiological purposes and prediction of the risk of future diabetes. Materials and MethodsThis was a prospective study which was conducted in the department of physiology and department of Biochemistry, GMC Srinagar for a period of two years. The sample size included 500 normal, healthy adult Kashmiris of both sexes. Besides history, physical examination and routine investigations, HbA1c testing was done in these individuals by using an autoanalyser (ROCHE, HITACHI 912). Exclusion criteria included pregnant women, diabetics, individuals having any bleeding disorder and on any drugs like aspirin, steroids or dapsone. Statistical analysis was done by Two-sample t-test. Results In our study males were more as compared to females (M=264, F= 236). The age group ranged from 20-60 years and the predominant age-group assessed was 20-30 years. The average HbA1c value obtained was more in males as compared to females, however less than the diabetic value, in the predominant age group assessed. There was a significant difference in the HbA1c values between males and females (p value 0.008). Conclusion HbA1c is a more comprehensive measure of total glucose exposure than fasting plasma glucose due to the representation of blood glucose in the post- prandial state in addition to the fasting state. HbA1c testing is a simple and effective investigation which can provide a baseline assessment of glycated hemoglobin in an individual and to reduce the delay in the diagnosis and treatment of hyperglycemic conditions with their complications.