Reference Ranges for Glycosylated Haemoglobin And The Correlation Between Glycosylated Haemoglobin Levels And Random Blood Glucose, Hemoglobin And It’s Related Red Blood Cell Indices
Kimani, Lucy Nyokabi
Njagi, Eliud N. M
Waithaka, Stanley King’e
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Abstract: A reference value for glycosylated haemoglobin in the Kenyan population in Kiambu County was developed. 600 normal adult individuals were recruited in the study, 7 (1.2%) of their sample were not analysed as they were positive for HIV (5) and HbsAg (2). The remaining 593 study participants had representation of male 325 (54.8%) and female 268 (45.2%).Six millitres of blood was obtained from the participants three millitres put in EDTA vacuitainer for analysis of glycosylated haemoglobin and three millilitres put in a plain vacuitainer for screening of HIV, HbsAg and VDRL.Statistical package for the social sciences (SPSS) programme (version 21) was used for data analysis. T-test was used to compare the levels of the measured parameters between sexes, ANOVA and post ANOVA was used to compare the value of each parameter across the various age groups. P<0.05 was considered significant.Means difference between male and female for analysed glycosylated haemoglobin parameter was statistically significant (p < .003.) and therefore separate reference ranges were established for adult population in Kiambu county. Mean and standard deviation (SD) for the studied male population was 4.57 and 0.90 respectively. Using the formula; Mean +/- 1.96 SD lower reference value was found to be 2.8 % and the high reference value to be 6.4. Mean and standard deviation (SD) for the studied female population was 4.34 and 0.92 respectively. Using the formula; Mean +/- 1.96 SD hence lower reference value was found to be 2.5 % and the high reference value to be 6.2 %. 323 diabetic patients attending diabetic clinic at Thika level five hospital were recruited to assess the correlation of glycosylated hemoglobin with random blood sugar, hemoglobin, packed cell volume, mean cell haemoglobin, mean cell haemoglobin concentration and mean cell volume. For the diabetic patients all the recruited study populations were included in the study. Four millitres of blood sample was obtained from the patients and was put in EDTA vacuitainer. The sample was used for analysis of glycosylated haemoglobin and the full haemoglobin. Pearson’s product moment correlation matrix with the dependent and independent variables was performed to assess the strength and direction of the associations between the variables of interest. Four factors especially correlated with the dependent variable glycosylated hemoglobin: hemoglobin (r = .467, ρ = .000), packed cell volume (r = .435, ρ = .000), mean cell hemoglobin (r = -.165, ρ = .003), and random blood glucose (r = .626, ρ = .006). This meant that an increase in random blood glucose, hemoglobin, packed cell volume, and mean cell hemoglobin, increases glycosylated hemoglobin. Mean cell haemoglobin concentration and mean cell volume had no significant correlation with glycosylated haemoglobin. A multiple linear regression analysis was applied to explain the direction and strength of relationships between the dependent variable glycosylated hemoglobin and independent variables, random blood glucose, haemoglobin, packed cell volume, mean cell haemoglobin, mean cell hemoglobin concentration, and mean cell volume. The coefficient of determination R2 in this model equation was found to be .552, which meant that the six independent variables explained 55.2% of the variation of glycosylated hemoglobin. The other 44.8% of the variation being accounted for by factors other than those included in this study. Key words: correlation, glycosylated haemoglobin, reference ranges, Kiambu County.