Glycosylated Haemoglobin In Non- Diabetic End-Stage Renal Disease Patients Undergoing Haemodialysis
3191-3195
Correspondence
Dr Sangeeta Kapoor (M.D.Biochemistry)
Assistant Professor
Department of Biochemistry
Teerthanker Mahaveer Medical College and Research Centre
Moradabad (U.P.) INDIA
Phone No. 09411874572
E-mail address - drsangeeta2000@yahoo.com
Background: Glycosylated haemoglobin is widely used as a measure for glycaemic control in patients with diabetes mellitus. The significance of the increased levels of glycosylated haemoglobin in non-diabetic patients with end-stage renal disease, receiving maintenance haemodialysis remains unclear at the present time. It is known that the attainment of glycaemic control is important in these patients. Objectives: In this study, an attempt has been made to study glycosylated haemoglobin levels, which may serve as a reliable indicator of integrated glycaemia in these patients. Material and Methods: We enrolled 65 non-diabetic end-stage renal disease patients who received haemodialysis and 30 non-diabetic patients without end-stage renal disease for this study. Glycosylated haemoglobin was analysed by a turbidimetric immunoassay by using a Synchron CX system in order to avoid assay interference from uraemia and anaemia in end-stage renal disease patients. Results: We found that the average glycosylated haemoglobin levels in non-diabetic end - stage renal disease patients on haemodialysis was 5.23% +1.16 and that in the control group was 4.56% + 0.52 (p < 0.001). There was no significant difference in the random blood glucose levels between the two groups. Our data indicated that glycosylated haemoglobin levels are elevated in non - diabetic end-stage renal disease patients undergoing haemodialysis. Conclusions: We conclude that the elevation in glycosylated haemoglobin level cannot be solely explained by glucose reabsorption from the dialysates and that it reflects true glucose intolerance, which is consistent with increased cardiovascular risk in such patients. Moreover, correlations between glycosylated haemoglobin and the duration of dialysis and the lipid profile of the patient were made, thus indicating the cumulative effect of these factors in regulating the glycaemic status of such patients. Cardiac risk ratio (TC / HDLc) and Freidwald’s ratio (LDLc / HDLc ), the indicators of coronary heart disease ( CHD), were also computed . It was found that these ratios varied significantly with the increase in HbA1c levels in ESRD patients.