HbA1c: High in acute cerebral infarction and low in brain trauma.

HbA1c is a glycated hemoglobin. The ≥6.5% HbA1c in total hemoglobins has been used in diagnosing and guiding therapy for patients with diabetes since 1970s. Increased HbA1c levels are observed in other nondiabetic conditions, such as cancers, uremia, macro- and microvascular diseases. However, a systematic comparison of the HbA1c levels in different types of human diseases has not been reported. In current study, 48,183 clinical lab test results of HbA1c levels from healthy individuals and patients with 36 different types of diseases during the past 5 years in our hospital were retrieved and analyzed. Based on the mean (SD), median, and p (-Log10p) values, we found that patients suffering type 2 diabetes, acute cerebral infarction, nephrotic syndrome, endometrial cancer, cerebral ischemia, leukemia, bladder cancer, chronic obstructive pulmonary disease plus other 27 diseases had significantly (p<0.05, -Log10p>1.30) increased HbA1c levels, whereas patients suffering brain trauma had significantly decreased HbA1c levels compared to that of healthy controls. Moreover, the highest -Log10p values were observed in type 2 diabetes, acute cerebral infarction, coronary heart disease, cerebrovascular disease, healthy controls >65 years old, and diabetic nephropathy, indicating the increased HbA1c levels were associated with aging and aging-related diseases. Unexpectedly, 29/36 diseases had both mean and median HbA1c levels ≥6.5%. These data suggested that the increased HbA1c levels were a common feature of nondiabetic diseases. Revealing the molecular mechanisms underlying the data presented in current study might help better understand the meaning of glycemic control.