Age sex ethnicity education level marital status smoking behavior BMI levels of blood glucose, uric acid, total protein, alanine aminotransferase, cholesterol, and serum creatinine platelet count and white blood cell and RBC counts were acquired from questionnaires. The multivariate model contained variables that may confuse the association between the HbA1c and Hb. The HbA1c whole blood sample was processed, stockpiled, and transferred to the University of Kansas, Columbia, Missouri. The outcome variable was the HbA1c level. The method used to derive the complete blood count (CBC) parameters was based on the Beckmann Kurt counting and grading method, combined with an automatic dilution and hybrid device used for sample treatment and a single beam photometer for the determination of the Hb level. Hence, our study aimed to reveal the relationship between the normal level of Hb and GHb in a nondiabetic American population aged ≥ 16 years through cross-sectional investigation data obtained from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). However, the relationship between the Hb and HbA1c levels remains unclear. The higher the primary environmental level of blood glucose, the higher the HbA1c level. Glycemic control has been assessed using GHb. The GHb (HbA1c) level represents the percentage of Hb proteins bound to glucose. Hemoglobin A1c (HbA1c) acts as glycosylated hemoglobin (GHb) constructed by the nonenzymatic binding of glucose to valine at the N-terminus of the Hb β chain, which is the most abundant and common Hb in human erythrocytes. Hemoglobin (Hb) is a protein molecule that only exists in red blood cells (RBCs) that can bind oxygen. Therefore, many prospective ongoing clinical studies are evaluating the efficacy of new and rarely studied diabetes biomarkers. It is well known that controlling high blood glucose levels could reduce and postpone the appearance and progression of DM-related complications. Chronic prediabetes and diabetes often cause a series of complications, including renal, ophthalmological, neurological, and vascular complications. Diabetes status can be classified into three categories: nondiabetes, prediabetes, and diabetes (T2DM). Obesity may serve as a major inducement factor for diabetes, and the prevalence of diabetes and obesity are increasing. Over 30 million and 86 million Americans suffer from diabetes and prediabetes, respectively, which could increase the occurrence rate of many chronic diseases, especially type 2 DM (T2DM). DM is a major cause of global morbidity and mortality, and was one of the major causes of death in the United States in 2015. The prevalence and incidence of DM continue to increase annually. Diabetes mellitus (DM) has a high global incidence.
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