Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification
AimsTo determine the effect of red blood cell (RBC) lifespan variability on glycosylated hemoglobin (HbA1c) measurements in type 2 diabetes mellitus (T2DM) individuals and develop a mathematical model for adjusting HbA1c values.MethodsWe tracked glucose levels in 516 T2DM patients from Chu Hsien-I M...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1500660/full |
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| author | Li Zhang Li Zhang Ximan Gao Ximan Gao Xuying Meng Xuying Meng Guangyang Ma Guangyang Ma Jing Li Jing Li Weilin Wang Weilin Wang Sisi Chen Sisi Chen Yongjian Ma Pei Yu Pei Yu Saijun Zhou Saijun Zhou |
| author_facet | Li Zhang Li Zhang Ximan Gao Ximan Gao Xuying Meng Xuying Meng Guangyang Ma Guangyang Ma Jing Li Jing Li Weilin Wang Weilin Wang Sisi Chen Sisi Chen Yongjian Ma Pei Yu Pei Yu Saijun Zhou Saijun Zhou |
| author_sort | Li Zhang |
| collection | DOAJ |
| description | AimsTo determine the effect of red blood cell (RBC) lifespan variability on glycosylated hemoglobin (HbA1c) measurements in type 2 diabetes mellitus (T2DM) individuals and develop a mathematical model for adjusting HbA1c values.MethodsWe tracked glucose levels in 516 T2DM patients from Chu Hsien-I Memorial Hospital, categorized into Construction (n = 416) and Internal (n = 100) cohorts. Additionally, 165 participants from Tianjin diabetic retinopathy screening cohort, serving as the Independent cohort. RBC lifespan was determined using the CO breath test, and Hemoglobin glycation variation index (HGI) was calculated from the difference between measured and estimated HbA1c (eHbA1c). Model efficacy was evaluated using AUC, accuracy, sensitivity, and specificity.ResultsAn inflection in the HGI-RBC lifespan model occurred at 66 days, with HbA1c underestimation when RBC lifespan was below 90 days, notably in the ≤ 66 days group. This underestimation increased the risk of cardiovascular and peripheral neuropathy complications. To rectify the impact of the shorter RBC lifespan in T2DM patients, the correction formula was established as HbA1c(c) = -0.05629×RBC lifespan + 1.127×HbA1c + 3.178 (R = 0.7360) in the ≤ 66 day lifespan group and HbA1c(c) = -0.004772 × RBC lifespan + 0.7569 × HbA1c + 2.394 (R = 0.7344) in the 67 to 89 day group. The corrected HbA1c models exhibited satisfactory predictive performance in all cohorts.ConclusionsAccurate adjustment for the effects of RBC lifespan on HbA1c values in T2DM patients is expected to enhance blood glucose management and the efficacious prevention and treatment of diabetes-associated complications.Clinical Trial RegistrationChu Hsien-I Memorial Hospital of Tianjin Medical University, identifier ChiCTR2100046557. |
| format | Article |
| id | doaj-art-0bee2b3ba0694de09f4f5c1a0b21d11e |
| institution | OA Journals |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-0bee2b3ba0694de09f4f5c1a0b21d11e2025-08-20T02:12:15ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15006601500660Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verificationLi Zhang0Li Zhang1Ximan Gao2Ximan Gao3Xuying Meng4Xuying Meng5Guangyang Ma6Guangyang Ma7Jing Li8Jing Li9Weilin Wang10Weilin Wang11Sisi Chen12Sisi Chen13Yongjian Ma14Pei Yu15Pei Yu16Saijun Zhou17Saijun Zhou18NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaDepartment of Endocrinology, The Second Hospital of Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaGuangdong Breath Test Engineering and Technology Research Center, Shenzhen University, Shenzhen, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaNHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, ChinaAimsTo determine the effect of red blood cell (RBC) lifespan variability on glycosylated hemoglobin (HbA1c) measurements in type 2 diabetes mellitus (T2DM) individuals and develop a mathematical model for adjusting HbA1c values.MethodsWe tracked glucose levels in 516 T2DM patients from Chu Hsien-I Memorial Hospital, categorized into Construction (n = 416) and Internal (n = 100) cohorts. Additionally, 165 participants from Tianjin diabetic retinopathy screening cohort, serving as the Independent cohort. RBC lifespan was determined using the CO breath test, and Hemoglobin glycation variation index (HGI) was calculated from the difference between measured and estimated HbA1c (eHbA1c). Model efficacy was evaluated using AUC, accuracy, sensitivity, and specificity.ResultsAn inflection in the HGI-RBC lifespan model occurred at 66 days, with HbA1c underestimation when RBC lifespan was below 90 days, notably in the ≤ 66 days group. This underestimation increased the risk of cardiovascular and peripheral neuropathy complications. To rectify the impact of the shorter RBC lifespan in T2DM patients, the correction formula was established as HbA1c(c) = -0.05629×RBC lifespan + 1.127×HbA1c + 3.178 (R = 0.7360) in the ≤ 66 day lifespan group and HbA1c(c) = -0.004772 × RBC lifespan + 0.7569 × HbA1c + 2.394 (R = 0.7344) in the 67 to 89 day group. The corrected HbA1c models exhibited satisfactory predictive performance in all cohorts.ConclusionsAccurate adjustment for the effects of RBC lifespan on HbA1c values in T2DM patients is expected to enhance blood glucose management and the efficacious prevention and treatment of diabetes-associated complications.Clinical Trial RegistrationChu Hsien-I Memorial Hospital of Tianjin Medical University, identifier ChiCTR2100046557.https://www.frontiersin.org/articles/10.3389/fendo.2025.1500660/fullglycosylated hemoglobin (HbA1c)hemoglobin glycation index (HGI)red blood cell lifespantype 2 diabetes mellituscorrection model |
| spellingShingle | Li Zhang Li Zhang Ximan Gao Ximan Gao Xuying Meng Xuying Meng Guangyang Ma Guangyang Ma Jing Li Jing Li Weilin Wang Weilin Wang Sisi Chen Sisi Chen Yongjian Ma Pei Yu Pei Yu Saijun Zhou Saijun Zhou Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification Frontiers in Endocrinology glycosylated hemoglobin (HbA1c) hemoglobin glycation index (HGI) red blood cell lifespan type 2 diabetes mellitus correction model |
| title | Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification |
| title_full | Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification |
| title_fullStr | Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification |
| title_full_unstemmed | Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification |
| title_short | Rectify the impact of shorter red blood cell lifespan upon HbA1c detection values in T2DM patients: modeling and internal-external verification |
| title_sort | rectify the impact of shorter red blood cell lifespan upon hba1c detection values in t2dm patients modeling and internal external verification |
| topic | glycosylated hemoglobin (HbA1c) hemoglobin glycation index (HGI) red blood cell lifespan type 2 diabetes mellitus correction model |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1500660/full |
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