(1) Erythropoiesis:
Increased HbA1c levels: iron/vitamin B12 deficiency, decreased erythropoiesis;
Decreased HbA1c levels: history of erythropoietin, iron, vitamin B12, reticulocytosis, chronic liver disease;
(2) Changes in the structure of hemoglobin:
Genetic or chemical changes in hemoglobin such as hemoglobinopathies, HbF, methylhemoglobin can increase or decrease glycated hemoglobin;
(3) Saccharification process:
Increased HbA1c levels: alcoholism, chronic renal failure, decreased pH in red blood cells;
Decreased HbA1c levels: aspirin, vitamin C and vitamin E, elevated pH in red blood cells, certain hemoglobinopathies;
(4) Destruction of red blood cells:
Increased HbA1c levels: extended red blood cell lifespan, splenectomy;
Decreased HbA1c levels: shortened red blood cell lifespan, splenomegaly, rheumatoid arthritis, antiretroviral drugs, certain hemoglobin disorders;
(5) Inspection process:
Increased HbA1c levels: hyperbilirubinemia, aminoglycated hemoglobin, alcoholism, high-dose aspirin, long-term opioid use;
(6) It should be noted that HbA1c is not affected by daily blood sugar fluctuations, nor is it affected by exercise or food, but hyperlipidemia specimens can make the results higher; laboratory temperature, ionic strength of reagents, pH and other factors can affect the determination of HbA1c. The results have some impact.