ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a f...BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.展开更多
Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a...Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.展开更多
Flooding can lead to oxygen deprivation in rapeseed,negatively affecting its growth and development and ul-timately reducing yields.Vitreoscilla hemoglobin(VHb),a bacterial hemoglobin with a high oxygen-binding affini...Flooding can lead to oxygen deprivation in rapeseed,negatively affecting its growth and development and ul-timately reducing yields.Vitreoscilla hemoglobin(VHb),a bacterial hemoglobin with a high oxygen-binding affinity,plays a key role in enhancing oxygen uptake and metabolic efficiency under low-oxygen conditions.Through genetic transformation,we overexpressed the VHb gene in rapeseed,which resulted in significant im-provements in survival rate,root length,and biomass under submerged conditions.Additionally,we observed that transgenic plants developed adventitious roots in response to submergence stress.These transgenic plants also exhibited increased activities of ethanol dehydrogenase and pyruvate decarboxylase-enzymes associated with anaerobic respiration.Our findings indicate that VHb enhances flooding tolerance in rapeseed by promoting adventitious root formation and strengthening the plant's capacity for fermentation metabolism under anaerobic conditions.展开更多
BACKGROUND Objective and accurate assessment of blood loss during pancreaticoduodenectomy(PD)is crucial for ensuring the safety and efficacy of the procedure.While the visual method remains the most common clinical me...BACKGROUND Objective and accurate assessment of blood loss during pancreaticoduodenectomy(PD)is crucial for ensuring the safety and efficacy of the procedure.While the visual method remains the most common clinical metric,many scholars argue that it significantly differs from actual blood loss and is inherently subjective.AIM To assess blood loss in PD via delta hemoglobin(ΔHb)and compare it with the visual method to predict bleeding-related risk factors.METHODS In this retrospective analysis,1722 patients who underwent PD from 2017 to 2022 at Shandong Provincial Hospital were divided into three groups:Open PD(OPD),laparoscopic PD(LPD),and conversion to OPD(CTOPD).IntraoperativeΔHb(IΔHb)was calculated via preoperative and 72-hour-postoperative hemoglobin concentrations,and its association with visually obtained estimated blood loss(EBL)was analyzed.PerioperativeΔHb(PΔHb)was calculated via preoperative and predischarge hemoglobin concentrations.We compared the differences in IΔHb and PΔHb among the three groups,and performed univariate and multi-variate regression analyses of IΔHb and PΔHb.RESULTS The preoperative general information of patients showed no statistically si-gnificant difference among the three groups(P>0.05).The IΔHb in the OPD,LPD,and CTOPD groups were 22.00(12.00,36.00),21.00(10.00,33.00),and 33.00(18.12,52.24)g/L,respectively;And the PΔHb in the OPD,LPD,and CTOPD groups were 25.87(13.51,42.00),25.00(14.00,45.00),and 37.48(21.64,59.65)g/L,respectively,values significantly differed(P<0.05).IΔHb and EBL were significantly correlated(r=0.337,P<0.001).The results of univariate and multivariate regression analyses indicated that American Society of Anesthesiologists(ASA)classification IV[95%confidence interval(CI):2.330-37.811,P=0.049]and preoperative total bilirubin>200μmol/L(95%CI:2.805-8.673,P<0.001)were independent risk factors for IΔHb(P<0.05),and ASA classification IV(95%CI:45.934-105.485,P<0.001),body mass index>24 kg/m2(95%CI:1.285-9.890,P=0.011),and preoperative total bilirubin>200μmol/L(95%CI:6.948-16.797,P<0.001)were independent risk factors for PΔHb(P<0.05).CONCLUSION There is a correlation between IΔHb and EBL in PD,so we can assess the patients’intraoperative blood loss by theΔHb method.ASA classification IV,body mass index>24 kg/m²,and preoperative total bilirubin>200μmol/L increased perioperative bleeding risk.展开更多
AIM:To evaluate retinal hemoglobin oxygen saturation in myopic eyes by scanning laser ophthalmoscope(SLO)and to assess its correlations with different severity of myopia.METHODS:Sixty-one eyes from 61 patients were in...AIM:To evaluate retinal hemoglobin oxygen saturation in myopic eyes by scanning laser ophthalmoscope(SLO)and to assess its correlations with different severity of myopia.METHODS:Sixty-one eyes from 61 patients were included and subdivided into three groups according to their refractive errors:high myopia group[20 eyes,spherical equivalent(SE)≤-6 D];low and moderate myopia(22 eyes,-6.0<SE≤-0.5 D);normal(19 eyes,-0.5<SE<+0.5 D).All subjects underwent SLO imaging with dual lasers(532 nm and 633 nm).The oxygen saturations of hemoglobin in arteries(SO_(2)A)and veins(SO_(2)V),and their differences(SO_(2)AV)were estimated from the optical densities of the vessels on the images at the two wavelengths.Pearson’s or Spearman’s rank correlation coefficient were calculated to assess the correlation between retinal hemoglobin oxygen saturation and refractive error/axial length(AL).RESULTS:For the retinal oxygen saturation,the SO_(2)V in high myopia group(73.21%±21.42%)was significantly higher than that in normal group(55.81%±21.69%)and low and moderate myopia group(56.88%±13.83%,P<0.05).The SE was significantly correlated with SO_(2)A(r=-0.30)and SO_(2)V(r=-0.36;P<0.05),and AL was also significantly correlated with SO_(2)A(r=0.27)and SO_(2)V(r=0.30;P<0.05).No significant correlations were found between SO_(2)AV and SE and AL(P>0.05).CONCLUSION:SO_(2)A and SO_(2)V increased in more myopic eye based on SLO measurements.Further studies are warranted to investigate the changes of retinal hemoglobin oxygen saturation in myopia with different methods.展开更多
Bariatric surgery significantly improves glycemic control and can lead to type 2 diabetes remission.However,the reliability of glycated hemoglobin(HbA1c)as a type 2 diabetes biomarker post-surgery can be confounded by...Bariatric surgery significantly improves glycemic control and can lead to type 2 diabetes remission.However,the reliability of glycated hemoglobin(HbA1c)as a type 2 diabetes biomarker post-surgery can be confounded by conditions such as anemia and gastrointestinal complications.Hence,we explored the use of alter-native biomarkers such as glycated albumin(GA),1,5-anhydroglucitol(1,5-AG),and insulin-like growth factor binding protein-1(IGFBP-1)to monitor glycemic control more effectively in post-bariatric surgery patients.Measuring GA and 1,5-AG levels can detect glycemic variability more sensitively than HbA1c,especially under non-fasting conditions.GA shows promise for short-term monitoring post-surgery while 1,5-AG could be useful for real-time glucose monitoring.IGFBP-1 can be used to monitor metabolic improvement and to predict HbA1c normal-ization.However,challenges in assay standardization and cost remain significant barriers to their clinical adoption.Although these biomarkers could offer a more personalized approach to glucose monitoring(thereby addressing the limitations of utilizing HbA1c in this endeavor in post-bariatric surgery patients),this would require overcoming technical,logistical,and cost-related challenges.While using GA,1,5-AG,and IGFBP-1 shows promise for glycemic monitoring,further research and validation are crucial for their routine clinical implementation,espe-cially in the context of diabetes management post-bariatric surgery.展开更多
This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with pa...This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.展开更多
BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains unce...BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains uncertain.AIM To evaluate the association between glycated hemoglobin(HbA1c)target achievement and long-term cardiovascular outcomes in patients receiving standard of care(SoC)or multifactorial intensive therapy(MT).METHODS This post-hoc analysis of the nephropathy in diabetes type 2 cluster-randomized trial included 323 patients with T2D,albuminuria,and retinopathy(SoC:n=139;MT:n=184),who underwent a 4-year intervention phase.Outcomes were major adverse cardiovascular events(MACE)and all-cause mortality.Associations with HbA1c target achievement(≤7%vs>7%)were assessed using Kaplan-Meier curves and shared frailty Cox regression models.RESULTS During a median follow-up of 12.1 years,190 MACEs and 139 deaths occurred.Achievement of the HbA1c target was not associated with reduced mortality in either group.However,a significant reduction in MACEs was observed only among SoC patients achieving HbA1c≤7%(P=0.031),whereas no benefit was seen in the MT group(P=0.645).In multivariable Cox regression models adjusted for cluster effect,in the MT group age[hazard ratio(HR)=1.07,P<0.001]and female sex(HR=0.38,P<0.001)were independent predictors of MACE,while in the SoC group only age(HR=1.04,P=0.009).For all-cause mortality,age(HR=1.11,P<0.001)and blood pressure control(HR=0.55,P=0.041)were significant predictors in the MT group,whereas age(HR=1.06,P=0.002)was independently associated with increased mortality in the SoC group.CONCLUSION In high-risk patients with T2D receiving standard care,achieving an HbA1c≤7%was associated with fewer cardiovascular events only under standard care,but not with reduced mortality.This association was not observed in patients managed with a multifactorial strategy.These findings suggest that the prognostic value of glycemic control depends on the broader treatment context and highlight the central role of comprehensive risk factor management in microvascularcomplicated T2D.展开更多
BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary int...BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary intervention(PCI)remains uncertain.This systematic review and meta-analysis evaluates the association between elevated HbA1c levels in the prediabetic range(≥5.7%)and adverse cardiovascular outcomes in this population.AIM To investigate the association between elevated HbA1c levels in the prediabetic range and adverse outcomes in patients without diagnosed diabetes undergoing PCI.METHODS We systematically searched PubMed,EMBASE,and Cochrane Central through April 2025 for studies comparing clinical outcomes in coronary artery disease(CAD)patients without a prior diabetes diagnosis,stratified by HbA1c levels(≥5.7% vs<5.7%).Risk ratios(RR)with 95%confidence intervals(CI)were pooled using a random-effects model.Statistical analysis was performed using R software(version 4.3.2).Primary outcomes were long-term allcause mortality and major adverse cardiovascular events(MACE);secondary outcomes included short-term mortality and cardiac death.RESULTS Ten studies involving 32403 patients(mean age:60 years;29% female)were included.Elevated HbA1c levels in patients without diagnosed diabetes were significantly associated with increased risk of long-term all-cause mortality(RR:1.30;95% CI:1.10-1.54;P<0.01;I2=41%)and MACEs(RR:1.31;95% CI:1.01-1.69;P=0.04;I2=61%).Although the risks of short-term all-cause mortality(RR:1.16;95% CI:0.88-1.53;P=0.29;I2=1%)and cardiac mortality(RR:1.76;95% CI:0.85-3.67;P=0.13;I2=94%)were elevated,they did not reach statistical significance.Sensitivity analyses confirmed the robustness of the findings despite moderate to high heterogeneity in some outcomes.CONCLUSION Among CAD patients without diagnosed diabetes,elevated HbA1c levels in the prediabetic range(≥5.7%)are independently associated with worse long-term outcomes following PCI.HbA1c may serve as a valuable biomarker for post-PCI risk stratification in this metabolically at-risk group.展开更多
Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abn...Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abnormal hemoglobin levels can indicate significant health issues.Traditional methods for hemoglobin measurement are invasive,causing pain,risk of infection,and are less convenient for frequent monitoring.PPG is a transformative technology in wearable healthcare for noninvasive monitoring and widely explored for blood pressure,sleep,blood glucose,and stress analysis.In this work,we propose a hemoglobin estimation method using an adaptive lightweight convolutional neural network(HMALCNN)from PPG.The HMALCNN is designed to capture both fine-grained local waveform characteristics and global contextual patterns,ensuring robust performance across acquisition settings.We validated our approach on two multi-regional datasets containing 152 and 68 subjects,respectively,employing a subjectindependent 5-fold cross-validation strategy.The proposed method achieved root mean square errors(RMSE)of 0.90 and 1.20 g/dL for the two datasets,with strong Pearson correlations of 0.82 and 0.72.We conducted extensive posthoc analyses to assess clinical utility and interpretability.A±1 g/dL clinical error tolerance evaluation revealed that 91.3%and 86.7%of predictions for the two datasets fell within the acceptable clinical range.Hemoglobin range-wise analysis demonstrated consistently high accuracy in the normal and low hemoglobin categories.Statistical significance testing using the Wilcoxon signed-rank test confirmed the stability of performance across validation folds(p>0.05 for both RMSE and correlation).Furthermore,model interpretability was enhanced using Gradient-weighted Class Activation Mapping(Grad-CAM),supporting the model’s clinical trustworthiness.The proposed HMALCNN offers a computationally efficient,clinically interpretable,and generalizable framework for noninvasive hemoglobin monitoring,with strong potential for integration into wearable healthcare systems as a practical alternative to invasive measurement techniques.展开更多
BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients wi...BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.展开更多
BACKGROUND Apolipoprotein E epsilon 4(APOE4)is recognized as a genetic risk factor for cognitive decline and neurodegeneration in both type 2 diabetes mellitus(T2DM)and Alzheimer’s disease,while glycated hemoglobin(H...BACKGROUND Apolipoprotein E epsilon 4(APOE4)is recognized as a genetic risk factor for cognitive decline and neurodegeneration in both type 2 diabetes mellitus(T2DM)and Alzheimer’s disease,while glycated hemoglobin(HbA1c)reflects persistent hyperglycemia and serves as a key indicator of long-term glycemic control in T2DM.Although both factors have been individually linked to neurobehavioral deficits,it remains uncertain whether HbA1c contributes to APOE4-related cognitive and olfactory impairment in individuals with T2DM.AIM To investigate the role of HbA1c in APOE4-associated cognitive and olfactory dysfunction in patients with T2DM.METHODS Of 636 T2DM patients were recruited from five medical centers in Wuhan,Hubei Province,China.APOE genotyping was evaluated by polymerase chain reaction using Gerard’s method.Cognitive and olfactory functions were assessed by mini-mental state examination and Connecticut chemosensory clinical research center test,respectively.Regression analysis was employed to assess the independent and interactive effects of HbA1c on APOE4-associated cognitive and olfactory function.RESULTS APOE4 was associated with increased risks of cognitive impairment[odds ratios(OR)=1.815,P=0.021]and olfactory dysfunction(OR=2.588,P<0.001).Higher HbA1c levels were also related to worse cognitive(OR=1.189,P<0.001)and olfactory performance(OR=1.149,P=0.011).HbA1c exerted a moderating effect,yet not a mediating effect,between APOE4 and its impacts on cognition and olfaction.Specifically,a higher level of HbA1c exacerbated the damaging effect of APOE4,as shown by significant interaction effects on both cognitive impairment(OR=2.687,P<0.001)and olfactory dysfunction(OR=1.440,P=0.027).CONCLUSION Elevated HbA1c levels are associated with increased risks of cognitive and olfactory impairments in patients with T2DM and may exacerbate the detrimental effects of APOE4.These findings underscore the need for early preventive strategies targeting individuals with both poor glycemic control and APOE4 carriage to mitigate neurodegenerative risk.展开更多
Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design...Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.展开更多
BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced i...BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for th...BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.展开更多
BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and inaccurate.Currently,there is...BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and inaccurate.Currently,there is no accurate,objective me-thod to evaluate the amount of blood loss in PD patients.We retrospectively analyzed the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019.According to different surgical methods,they were divided into an open PD(OPD)group and a laparoscopic PD(LPD)group.The differences and correlations between the in-traoperative estimation of blood loss(IEBL)obtained by visual inspection and the intraoperative calculation of blood loss(ICBL)obtained using the Hb loss method were analyzed.ICBL,IEBL and perioperative calculation of blood loss(PCBL)were compared between the two groups,and single-factor regression analysis was performed.RESULTS There was no statistically significant difference in the preoperative general patient information between the two groups(P>0.05).PD had an ICBL of 743.2(393.0,1173.1)mL and an IEBL of 100.0(50.0,300.0)mL(P<0.001).There was also a certain correlation between the two(r=0.312,P<0.001).Single-factor analysis of ICBL showed that a history of diabetes[95%confidence interval(CI):53.82-549.62;P=0.017]was an independent risk factor for ICBL.In addition,the single-factor analysis of PCBL showed that body mass index(BMI)(95%CI:0.62-76.75;P=0.046)and preoperative total bilirubin>200μmol/L(95%CI:7.09-644.26;P=0.045)were independent risk factors for PCBL.The ICBLs of the LPD group and OPD group were 767.7(435.4,1249.0)mL and 663.8(347.7,1138.2)mL,respectively(P>0.05).The IEBL of the LPD group 200.0(50.0,200.0)mL was slightly greater than that of the OPD group 100.0(50.0,300.0)mL(P>0.05).PCBL was greater in the LPD group than the OPD group[1061.6(612.3,1632.3)mL vs 806.1(375.9,1347.6)mL](P<0.05).CONCLUSION The ICBL in patients who underwent PD was greater than the IEBL,but there is a certain correlation between the two.The Hb loss method can be used to evaluate intraoperative blood loss.A history of diabetes,preoperative bilirubin>200μmol/L and high BMI increase the patient's risk of bleeding.展开更多
BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean...BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.展开更多
BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predictin...BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.展开更多
Subsequent studies have demonstrated the reversed activity of the aqueous extract of Ceiba pentandra on the deformity of sickled red blood cells in hypoxia conditions. The observation which related to an in vitro stud...Subsequent studies have demonstrated the reversed activity of the aqueous extract of Ceiba pentandra on the deformity of sickled red blood cells in hypoxia conditions. The observation which related to an in vitro study had given rise to hopes as to the management of sickle cell disease (SCD) by the use of this plant species. In this paper, the authors aimed to investigate the effect of the aqueous extract of C. pentandra on the production of fetal hemoglobin in SCD patients. The work carried out hemoglobin electrophoresis, for a period of six months, on blood samples from SCD patients who voluntarily undergone routine treatment, based on the medicinal recipe prepared from the bark of the trunk and branches of C. pentandra, in a hospital center of herbal medicines located in Kinshasa. The medicinal recipe called BEAT-SS is a patented product of the hospital center named Centre de Phytothérapie Moderne NIECA. Blood samples from patients under treatment were taken to evaluate the behavior of different forms of hemoglobin (hemoglobin S, hemoglobin F and hemoglobin A2). Agarose gel electrophoresis with integrated reading was used for the separation of the different forms of hemoglobin, as well as their dosage on each sample of sickle blood. A reduction in the proportion of hemoglobin S and an increase in the proportion of fetal hemoglobin were found in all sickle cell patients during the treatment period. This observation could affirm that the management of sickle cell patients using the recipe prepared from the aqueous extract of C. pentandra could increase the level of fetal hemoglobin in these patients.展开更多
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
文摘BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.
基金supported by the 90th Anniversary of Chulalong-korn University Scholarship(Ratchadaphiseksomphot Endowment Fund)。
文摘Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.
基金supported by National Key Research and Development Program of China(2023YFD1201403)The Science and Technology Innovation Program of Hunan Province(2023RC1077)+2 种基金Key Research and Development Projects of Hunan Provincial(2023NK2012)Hunan Provincial Science and Technology Talent Promotion Project(2023 TJ-Z09)The Hunan Agricultural Science and Technology Innovation Fund Project(2024CX096).
文摘Flooding can lead to oxygen deprivation in rapeseed,negatively affecting its growth and development and ul-timately reducing yields.Vitreoscilla hemoglobin(VHb),a bacterial hemoglobin with a high oxygen-binding affinity,plays a key role in enhancing oxygen uptake and metabolic efficiency under low-oxygen conditions.Through genetic transformation,we overexpressed the VHb gene in rapeseed,which resulted in significant im-provements in survival rate,root length,and biomass under submerged conditions.Additionally,we observed that transgenic plants developed adventitious roots in response to submergence stress.These transgenic plants also exhibited increased activities of ethanol dehydrogenase and pyruvate decarboxylase-enzymes associated with anaerobic respiration.Our findings indicate that VHb enhances flooding tolerance in rapeseed by promoting adventitious root formation and strengthening the plant's capacity for fermentation metabolism under anaerobic conditions.
基金Supported by the Shandong Provincial Natural Science Foundation General Project,No.ZR2020MH248.
文摘BACKGROUND Objective and accurate assessment of blood loss during pancreaticoduodenectomy(PD)is crucial for ensuring the safety and efficacy of the procedure.While the visual method remains the most common clinical metric,many scholars argue that it significantly differs from actual blood loss and is inherently subjective.AIM To assess blood loss in PD via delta hemoglobin(ΔHb)and compare it with the visual method to predict bleeding-related risk factors.METHODS In this retrospective analysis,1722 patients who underwent PD from 2017 to 2022 at Shandong Provincial Hospital were divided into three groups:Open PD(OPD),laparoscopic PD(LPD),and conversion to OPD(CTOPD).IntraoperativeΔHb(IΔHb)was calculated via preoperative and 72-hour-postoperative hemoglobin concentrations,and its association with visually obtained estimated blood loss(EBL)was analyzed.PerioperativeΔHb(PΔHb)was calculated via preoperative and predischarge hemoglobin concentrations.We compared the differences in IΔHb and PΔHb among the three groups,and performed univariate and multi-variate regression analyses of IΔHb and PΔHb.RESULTS The preoperative general information of patients showed no statistically si-gnificant difference among the three groups(P>0.05).The IΔHb in the OPD,LPD,and CTOPD groups were 22.00(12.00,36.00),21.00(10.00,33.00),and 33.00(18.12,52.24)g/L,respectively;And the PΔHb in the OPD,LPD,and CTOPD groups were 25.87(13.51,42.00),25.00(14.00,45.00),and 37.48(21.64,59.65)g/L,respectively,values significantly differed(P<0.05).IΔHb and EBL were significantly correlated(r=0.337,P<0.001).The results of univariate and multivariate regression analyses indicated that American Society of Anesthesiologists(ASA)classification IV[95%confidence interval(CI):2.330-37.811,P=0.049]and preoperative total bilirubin>200μmol/L(95%CI:2.805-8.673,P<0.001)were independent risk factors for IΔHb(P<0.05),and ASA classification IV(95%CI:45.934-105.485,P<0.001),body mass index>24 kg/m2(95%CI:1.285-9.890,P=0.011),and preoperative total bilirubin>200μmol/L(95%CI:6.948-16.797,P<0.001)were independent risk factors for PΔHb(P<0.05).CONCLUSION There is a correlation between IΔHb and EBL in PD,so we can assess the patients’intraoperative blood loss by theΔHb method.ASA classification IV,body mass index>24 kg/m²,and preoperative total bilirubin>200μmol/L increased perioperative bleeding risk.
基金Supported by Shantou Science and Technology Project(No.190917155269927)2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant(No.2020LKSFG06B).
文摘AIM:To evaluate retinal hemoglobin oxygen saturation in myopic eyes by scanning laser ophthalmoscope(SLO)and to assess its correlations with different severity of myopia.METHODS:Sixty-one eyes from 61 patients were included and subdivided into three groups according to their refractive errors:high myopia group[20 eyes,spherical equivalent(SE)≤-6 D];low and moderate myopia(22 eyes,-6.0<SE≤-0.5 D);normal(19 eyes,-0.5<SE<+0.5 D).All subjects underwent SLO imaging with dual lasers(532 nm and 633 nm).The oxygen saturations of hemoglobin in arteries(SO_(2)A)and veins(SO_(2)V),and their differences(SO_(2)AV)were estimated from the optical densities of the vessels on the images at the two wavelengths.Pearson’s or Spearman’s rank correlation coefficient were calculated to assess the correlation between retinal hemoglobin oxygen saturation and refractive error/axial length(AL).RESULTS:For the retinal oxygen saturation,the SO_(2)V in high myopia group(73.21%±21.42%)was significantly higher than that in normal group(55.81%±21.69%)and low and moderate myopia group(56.88%±13.83%,P<0.05).The SE was significantly correlated with SO_(2)A(r=-0.30)and SO_(2)V(r=-0.36;P<0.05),and AL was also significantly correlated with SO_(2)A(r=0.27)and SO_(2)V(r=0.30;P<0.05).No significant correlations were found between SO_(2)AV and SE and AL(P>0.05).CONCLUSION:SO_(2)A and SO_(2)V increased in more myopic eye based on SLO measurements.Further studies are warranted to investigate the changes of retinal hemoglobin oxygen saturation in myopia with different methods.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.NRF-RS 2023-00237287.
文摘Bariatric surgery significantly improves glycemic control and can lead to type 2 diabetes remission.However,the reliability of glycated hemoglobin(HbA1c)as a type 2 diabetes biomarker post-surgery can be confounded by conditions such as anemia and gastrointestinal complications.Hence,we explored the use of alter-native biomarkers such as glycated albumin(GA),1,5-anhydroglucitol(1,5-AG),and insulin-like growth factor binding protein-1(IGFBP-1)to monitor glycemic control more effectively in post-bariatric surgery patients.Measuring GA and 1,5-AG levels can detect glycemic variability more sensitively than HbA1c,especially under non-fasting conditions.GA shows promise for short-term monitoring post-surgery while 1,5-AG could be useful for real-time glucose monitoring.IGFBP-1 can be used to monitor metabolic improvement and to predict HbA1c normal-ization.However,challenges in assay standardization and cost remain significant barriers to their clinical adoption.Although these biomarkers could offer a more personalized approach to glucose monitoring(thereby addressing the limitations of utilizing HbA1c in this endeavor in post-bariatric surgery patients),this would require overcoming technical,logistical,and cost-related challenges.While using GA,1,5-AG,and IGFBP-1 shows promise for glycemic monitoring,further research and validation are crucial for their routine clinical implementation,espe-cially in the context of diabetes management post-bariatric surgery.
文摘This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.
基金Supported by the Ministero dell’Universitàe della Ricerca(Italian Ministry of University and Research),No.2007PSYLRX.
文摘BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains uncertain.AIM To evaluate the association between glycated hemoglobin(HbA1c)target achievement and long-term cardiovascular outcomes in patients receiving standard of care(SoC)or multifactorial intensive therapy(MT).METHODS This post-hoc analysis of the nephropathy in diabetes type 2 cluster-randomized trial included 323 patients with T2D,albuminuria,and retinopathy(SoC:n=139;MT:n=184),who underwent a 4-year intervention phase.Outcomes were major adverse cardiovascular events(MACE)and all-cause mortality.Associations with HbA1c target achievement(≤7%vs>7%)were assessed using Kaplan-Meier curves and shared frailty Cox regression models.RESULTS During a median follow-up of 12.1 years,190 MACEs and 139 deaths occurred.Achievement of the HbA1c target was not associated with reduced mortality in either group.However,a significant reduction in MACEs was observed only among SoC patients achieving HbA1c≤7%(P=0.031),whereas no benefit was seen in the MT group(P=0.645).In multivariable Cox regression models adjusted for cluster effect,in the MT group age[hazard ratio(HR)=1.07,P<0.001]and female sex(HR=0.38,P<0.001)were independent predictors of MACE,while in the SoC group only age(HR=1.04,P=0.009).For all-cause mortality,age(HR=1.11,P<0.001)and blood pressure control(HR=0.55,P=0.041)were significant predictors in the MT group,whereas age(HR=1.06,P=0.002)was independently associated with increased mortality in the SoC group.CONCLUSION In high-risk patients with T2D receiving standard care,achieving an HbA1c≤7%was associated with fewer cardiovascular events only under standard care,but not with reduced mortality.This association was not observed in patients managed with a multifactorial strategy.These findings suggest that the prognostic value of glycemic control depends on the broader treatment context and highlight the central role of comprehensive risk factor management in microvascularcomplicated T2D.
文摘BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary intervention(PCI)remains uncertain.This systematic review and meta-analysis evaluates the association between elevated HbA1c levels in the prediabetic range(≥5.7%)and adverse cardiovascular outcomes in this population.AIM To investigate the association between elevated HbA1c levels in the prediabetic range and adverse outcomes in patients without diagnosed diabetes undergoing PCI.METHODS We systematically searched PubMed,EMBASE,and Cochrane Central through April 2025 for studies comparing clinical outcomes in coronary artery disease(CAD)patients without a prior diabetes diagnosis,stratified by HbA1c levels(≥5.7% vs<5.7%).Risk ratios(RR)with 95%confidence intervals(CI)were pooled using a random-effects model.Statistical analysis was performed using R software(version 4.3.2).Primary outcomes were long-term allcause mortality and major adverse cardiovascular events(MACE);secondary outcomes included short-term mortality and cardiac death.RESULTS Ten studies involving 32403 patients(mean age:60 years;29% female)were included.Elevated HbA1c levels in patients without diagnosed diabetes were significantly associated with increased risk of long-term all-cause mortality(RR:1.30;95% CI:1.10-1.54;P<0.01;I2=41%)and MACEs(RR:1.31;95% CI:1.01-1.69;P=0.04;I2=61%).Although the risks of short-term all-cause mortality(RR:1.16;95% CI:0.88-1.53;P=0.29;I2=1%)and cardiac mortality(RR:1.76;95% CI:0.85-3.67;P=0.13;I2=94%)were elevated,they did not reach statistical significance.Sensitivity analyses confirmed the robustness of the findings despite moderate to high heterogeneity in some outcomes.CONCLUSION Among CAD patients without diagnosed diabetes,elevated HbA1c levels in the prediabetic range(≥5.7%)are independently associated with worse long-term outcomes following PCI.HbA1c may serve as a valuable biomarker for post-PCI risk stratification in this metabolically at-risk group.
基金funded by the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2025).
文摘Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abnormal hemoglobin levels can indicate significant health issues.Traditional methods for hemoglobin measurement are invasive,causing pain,risk of infection,and are less convenient for frequent monitoring.PPG is a transformative technology in wearable healthcare for noninvasive monitoring and widely explored for blood pressure,sleep,blood glucose,and stress analysis.In this work,we propose a hemoglobin estimation method using an adaptive lightweight convolutional neural network(HMALCNN)from PPG.The HMALCNN is designed to capture both fine-grained local waveform characteristics and global contextual patterns,ensuring robust performance across acquisition settings.We validated our approach on two multi-regional datasets containing 152 and 68 subjects,respectively,employing a subjectindependent 5-fold cross-validation strategy.The proposed method achieved root mean square errors(RMSE)of 0.90 and 1.20 g/dL for the two datasets,with strong Pearson correlations of 0.82 and 0.72.We conducted extensive posthoc analyses to assess clinical utility and interpretability.A±1 g/dL clinical error tolerance evaluation revealed that 91.3%and 86.7%of predictions for the two datasets fell within the acceptable clinical range.Hemoglobin range-wise analysis demonstrated consistently high accuracy in the normal and low hemoglobin categories.Statistical significance testing using the Wilcoxon signed-rank test confirmed the stability of performance across validation folds(p>0.05 for both RMSE and correlation).Furthermore,model interpretability was enhanced using Gradient-weighted Class Activation Mapping(Grad-CAM),supporting the model’s clinical trustworthiness.The proposed HMALCNN offers a computationally efficient,clinically interpretable,and generalizable framework for noninvasive hemoglobin monitoring,with strong potential for integration into wearable healthcare systems as a practical alternative to invasive measurement techniques.
基金Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0508201the National Key R and D Program of China,No.2022YFC2010100+3 种基金the National Natural Science Foundation of China,No.82070812the Natural Science Foundation of Hunan Province,No.2024JJ9049,No.2023JJ30762 and No.2021JC0003Sinocare Diabetes Foundation,No.2020SD08the National Clinical Research Center for Metabolic Diseases Clinical Diagnosis and Treatment Capacity Enhancement Program,No.2023ZLNL003.
文摘BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.
基金Supported by the China Postdoctoral Science Foundation General Program,No.2024M762504the Intramural Research Program of Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,No.2023 LYYYGZRP0004.
文摘BACKGROUND Apolipoprotein E epsilon 4(APOE4)is recognized as a genetic risk factor for cognitive decline and neurodegeneration in both type 2 diabetes mellitus(T2DM)and Alzheimer’s disease,while glycated hemoglobin(HbA1c)reflects persistent hyperglycemia and serves as a key indicator of long-term glycemic control in T2DM.Although both factors have been individually linked to neurobehavioral deficits,it remains uncertain whether HbA1c contributes to APOE4-related cognitive and olfactory impairment in individuals with T2DM.AIM To investigate the role of HbA1c in APOE4-associated cognitive and olfactory dysfunction in patients with T2DM.METHODS Of 636 T2DM patients were recruited from five medical centers in Wuhan,Hubei Province,China.APOE genotyping was evaluated by polymerase chain reaction using Gerard’s method.Cognitive and olfactory functions were assessed by mini-mental state examination and Connecticut chemosensory clinical research center test,respectively.Regression analysis was employed to assess the independent and interactive effects of HbA1c on APOE4-associated cognitive and olfactory function.RESULTS APOE4 was associated with increased risks of cognitive impairment[odds ratios(OR)=1.815,P=0.021]and olfactory dysfunction(OR=2.588,P<0.001).Higher HbA1c levels were also related to worse cognitive(OR=1.189,P<0.001)and olfactory performance(OR=1.149,P=0.011).HbA1c exerted a moderating effect,yet not a mediating effect,between APOE4 and its impacts on cognition and olfaction.Specifically,a higher level of HbA1c exacerbated the damaging effect of APOE4,as shown by significant interaction effects on both cognitive impairment(OR=2.687,P<0.001)and olfactory dysfunction(OR=1.440,P=0.027).CONCLUSION Elevated HbA1c levels are associated with increased risks of cognitive and olfactory impairments in patients with T2DM and may exacerbate the detrimental effects of APOE4.These findings underscore the need for early preventive strategies targeting individuals with both poor glycemic control and APOE4 carriage to mitigate neurodegenerative risk.
基金funded by National Natural Science Foundation of China (grant numbers 82270258,82100260)National Key Research&Development Prog ram of China (grant number 2020YFC2004800)。
文摘Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.
文摘BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.
基金Supported by Shandong Provincial Natural Science Foundation General Project,No.ZR2020MH248。
文摘BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and inaccurate.Currently,there is no accurate,objective me-thod to evaluate the amount of blood loss in PD patients.We retrospectively analyzed the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019.According to different surgical methods,they were divided into an open PD(OPD)group and a laparoscopic PD(LPD)group.The differences and correlations between the in-traoperative estimation of blood loss(IEBL)obtained by visual inspection and the intraoperative calculation of blood loss(ICBL)obtained using the Hb loss method were analyzed.ICBL,IEBL and perioperative calculation of blood loss(PCBL)were compared between the two groups,and single-factor regression analysis was performed.RESULTS There was no statistically significant difference in the preoperative general patient information between the two groups(P>0.05).PD had an ICBL of 743.2(393.0,1173.1)mL and an IEBL of 100.0(50.0,300.0)mL(P<0.001).There was also a certain correlation between the two(r=0.312,P<0.001).Single-factor analysis of ICBL showed that a history of diabetes[95%confidence interval(CI):53.82-549.62;P=0.017]was an independent risk factor for ICBL.In addition,the single-factor analysis of PCBL showed that body mass index(BMI)(95%CI:0.62-76.75;P=0.046)and preoperative total bilirubin>200μmol/L(95%CI:7.09-644.26;P=0.045)were independent risk factors for PCBL.The ICBLs of the LPD group and OPD group were 767.7(435.4,1249.0)mL and 663.8(347.7,1138.2)mL,respectively(P>0.05).The IEBL of the LPD group 200.0(50.0,200.0)mL was slightly greater than that of the OPD group 100.0(50.0,300.0)mL(P>0.05).PCBL was greater in the LPD group than the OPD group[1061.6(612.3,1632.3)mL vs 806.1(375.9,1347.6)mL](P<0.05).CONCLUSION The ICBL in patients who underwent PD was greater than the IEBL,but there is a certain correlation between the two.The Hb loss method can be used to evaluate intraoperative blood loss.A history of diabetes,preoperative bilirubin>200μmol/L and high BMI increase the patient's risk of bleeding.
基金Supported by National Key R&D Program of China,No.2016YFC1305700.
文摘BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.
基金Supported by Investigator-initiated Trial Research Funds from Eli Lilly and Co.and Amylin Pharmaceuticals,Inc.,No.A1570Natural Science Foundation of Guangdong Province,No.2018A030313915。
文摘BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.
文摘Subsequent studies have demonstrated the reversed activity of the aqueous extract of Ceiba pentandra on the deformity of sickled red blood cells in hypoxia conditions. The observation which related to an in vitro study had given rise to hopes as to the management of sickle cell disease (SCD) by the use of this plant species. In this paper, the authors aimed to investigate the effect of the aqueous extract of C. pentandra on the production of fetal hemoglobin in SCD patients. The work carried out hemoglobin electrophoresis, for a period of six months, on blood samples from SCD patients who voluntarily undergone routine treatment, based on the medicinal recipe prepared from the bark of the trunk and branches of C. pentandra, in a hospital center of herbal medicines located in Kinshasa. The medicinal recipe called BEAT-SS is a patented product of the hospital center named Centre de Phytothérapie Moderne NIECA. Blood samples from patients under treatment were taken to evaluate the behavior of different forms of hemoglobin (hemoglobin S, hemoglobin F and hemoglobin A2). Agarose gel electrophoresis with integrated reading was used for the separation of the different forms of hemoglobin, as well as their dosage on each sample of sickle blood. A reduction in the proportion of hemoglobin S and an increase in the proportion of fetal hemoglobin were found in all sickle cell patients during the treatment period. This observation could affirm that the management of sickle cell patients using the recipe prepared from the aqueous extract of C. pentandra could increase the level of fetal hemoglobin in these patients.
