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Seasonal variation of hemoglobin A1c levels in patients with type 2 diabetes

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Abstract

The purpose of our study was to retrospectively examine the association between hemoglobin A1c (HbA1c) with season variation in patients with type 2 diabetes from the Chinese mainland. Monthly average of HbA1c values of type 2 diabetes patients in Jinan Central Hospital between 2008 and 2011 were respectively reviewed. The effects of sex, age, and season on HbA1c levels were analyzed. Moreover, a multiple linear regression analysis was performed to discuss the correlations between HbA1c levels and sex, age, and season. The HbA1c levels were significantly higher in winter (December, January, and February) and significantly lower in summer (June, July, and August). Significant difference was found for HbA1c between men and women in the elderly group (P < 0.01). The levels of HbA1c were similar in youth and middle groups (P > 0.05), but significantly lower in the elderly group (P < 0.05). Additionally, negative correlations of HbA1c with season, age, and gender were identified (P < 0.01). Our study suggests that cold weather may elevate the levels of HbA1c in type 2 diabetic patients in mainland China. However, more detailed studies are needed to reveal the variation of HbA1c with age and gender.

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References

  1. Keech A, Simes R, Barter P, Best J, Scott R, Taskinen M-R, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849–61.

    Article  CAS  PubMed  Google Scholar 

  2. Pradhan AD, Rifai N, Buring JE, Ridker PM. Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women. Am J Med. 2007;120(8):720–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy a consensus statement of the American diabetes association and the European association for the study of diabetes. Diabetes Care. 2009;32(1):193–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Carney T, Guy S, Helliwell C. Seasonal variation in HbA1c in patients with type 2 diabetes mellitus. Diabet Med. 2000;17(7):554–5.

    Article  CAS  PubMed  Google Scholar 

  5. Sakura H, Tanaka Y, Iwamoto Y. Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patients. Diabetes Res Clin Pract. 2010;88(1):65–70.

    Article  CAS  PubMed  Google Scholar 

  6. Sohmiya M, Kanazawa I, Kato Y. Seasonal changes in body composition and blood HbA1c levels without weight change in male patients with type 2 diabetes treated with insulin. Diabetes Care. 2004;27(5):1238–9.

    Article  PubMed  Google Scholar 

  7. Tseng C-L, Brimacombe M, Xie M, Rajan M, Wang H, Kolassa J, et al. Seasonal patterns in monthly hemoglobin A1c values. Am J Epidemiol. 2005;161(6):565–74.

    Article  PubMed  Google Scholar 

  8. Chen H-S, Jap T-S, Chen R-L, Lin H-D. A prospective study of glycemic control during holiday time in type 2 diabetic patients. Diabetes Care. 2004;27(2):326–30.

    Article  PubMed  Google Scholar 

  9. Nordfeldt S, Ludvigsson J. Seasonal variation of HbA1c in intensive treatment of children with type 1 diabetes. J Pediatr Endocrinol Metab. 2000;13(5):529–36.

    Article  CAS  PubMed  Google Scholar 

  10. Higgins T, Saw S, Sikaris K, Wiley CL, Cembrowski GC, Lyon AW, et al. Seasonal variation in hemoglobin A1c: is it the same in both hemispheres? J Diabetes Sci Technol. 2009;3(4):668–71.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tien KJ, Yang CY, Weng SF, Liu SY, Hsieh MC, Chou CW. The impact of ambient temperature on HbA1c in Taiwanese type 2 diabetic patients: the most vulnerable subgroup. J Formos Med Assoc = Taiwan yi zhi. 2015. doi:10.1016/j.jfma.2015.03.010.

    PubMed  Google Scholar 

  12. Schnedl W, Krause R, Halwachs-Baumann G, Trinker M, Lipp R, Krejs G. Evaluation of HbA1c determination methods in patients with hemoglobinopathies. Diabetes Care. 2000;23(3):339–44.

    Article  CAS  PubMed  Google Scholar 

  13. Garde AH, Hansen ÅM, Skovgaard LT, Christensen JM. Seasonal and biological variation of blood concentrations of total cholesterol, dehydroepiandrosterone sulfate, hemoglobin A1c, IgA, prolactin, and free testosterone in healthy women. Clin Chem. 2000;46(4):551–9.

    CAS  PubMed  Google Scholar 

  14. Simon D, Senan C, Garnier P, Saint-Paul M, Papoz L. Epidemiological features of glycated haemoglobin A1c-distribution in a healthy population. Diabetologia. 1989;32(12):864–9.

    Article  CAS  PubMed  Google Scholar 

  15. Ludvigsson J, Afoke A. Seasonality of type 1 (insulin-dependent) diabetes mellitus: values of C-peptide, insulin antibodies and haemoglobin A1c show evidence of a more rapid loss of insulin secretion in epidemic patients. Diabetologia. 1989;32(2):84–91.

    Article  CAS  PubMed  Google Scholar 

  16. Mẗtäri M, Javela K, Koskinen P, Pikkarainen J, Manninen V, Huttunen JK, et al. Seasonal variation in high density lipoprotein cholesterol. Atherosclerosis. 1993;100(2):257–65.

    Article  Google Scholar 

  17. Gordon DJ, Trost DC, Hyde J, Whaley FS, Hannan P, Jacobs D, et al. Seasonal cholesterol cycles: the lipid research clinics coronary primary prevention trial placebo group. Circulation. 1987;76(6):1224–31.

    Article  CAS  PubMed  Google Scholar 

  18. Van Staveren WA, Deurenberg P, Burema J, De Groot LC, Hautvast J. Seasonal variation in food intake, pattern of physical activity and change in body weight in a group of young adult Dutch women consuming self-selected diets. Int J Obes. 1985;10(2):133–45.

    Google Scholar 

  19. Tokudome Y, Kuriki K, Imaeda N, Ikeda M, Nagaya T, Fujiwara N, et al. Seasonal variation in consumption and plasma concentrations of fatty acids in Japanese female dietitians. Eur J Epidemiol. 2003;18(10):945–53.

    Article  CAS  PubMed  Google Scholar 

  20. Shahar D, Yerushalmi N, Lubin F, Froom P, Shahar A, Kristal-Boneh E. Seasonal variations in dietary intake affect the consistency of dietary assessment. Eur J Epidemiol. 2001;17(2):129–33.

    Article  CAS  PubMed  Google Scholar 

  21. Gikas A, Sotiropoulos A, Pastromas V, Papazafiropoulou A, Apostolou O, Pappas S. Seasonal variation in fasting glucose and HbA1c in patients with type 2 diabetes. Prim Care Diabetes. 2009;3(2):111–4. doi:10.1016/j.pcd.2009.05.004.

    Article  PubMed  Google Scholar 

  22. Herbst A, Bachran R, Kapellen T, Holl RW. Effects of regular physical activity on control of glycemia in pediatric patients with type 1 diabetes mellitus. Arch Pediatr Adolesc Med. 2006;160(6):573–7.

    Article  PubMed  Google Scholar 

  23. Bardini G, Dicembrini I, Rotella CM, Giannini S. Lipids seasonal variability in type 2 diabetes. Metabolism. 2012;61(12):1674–7.

    Article  CAS  PubMed  Google Scholar 

  24. Kim YJ, Park S, Yi W, Yu K-S, Kim TH, Oh TJ, et al. Seasonal variation in hemoglobin A1c in Korean patients with type 2 diabetes mellitus. J Korean Med Sci. 2014;29(4):550–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Norman AW. Sunlight, season, skin pigmentation, vitamin D, and 25-hydroxyvitamin D: integral components of the vitamin D endocrine system. Am J Clin Nutr. 1998;67(6):1108–10.

    CAS  PubMed  Google Scholar 

  26. Frier B, Yang P, Taylor AW. Diabetes, aging and physical activity. Eur Rev Aging Phys Act. 2006;3(2):63–73.

    Article  Google Scholar 

  27. Arnetz BB, Kallner A, Theorell T. The influence of aging on hemoglobin A1c (HbA1c). J Gerontol. 1982;37(6):648–50.

    Article  CAS  PubMed  Google Scholar 

  28. Pani LN, Korenda L, Meigs JB, Driver C, Chamany S, Fox CS, et al. Effect of aging on A1C levels in individuals without diabetes evidence from the Framingham offspring study and the national health and nutrition examination survey 2001–2004. Diabetes Care. 2008;31(10):1991–6.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Stellato R, Feldman H, Hamdy O, Horton E, McKinlay JB. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23(4):490–4.

    Article  CAS  PubMed  Google Scholar 

  30. Kamezaki F, Sonoda S, Tomotsune Y, Yunaka H, Otsuji Y. Seasonal variation in metabolic syndrome prevalence. Hypertens Res. 2010;33(6):568–72.

    Article  PubMed  Google Scholar 

  31. Kamezaki F, Sonoda S, Nakata S, Muraoka Y, Okazaki M, Tamura M, et al. Association of seasonal variation in the prevalence of metabolic syndrome with insulin resistance. Hypertens Res. 2012;36(5):398–402.

    Article  PubMed  Google Scholar 

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Acknowledgment

We would like to thank the National Natural Science Foundation of China, Science and Technology Development Programme of Shandong and International Cooperation Programme of Jinan City for providing financial support.

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Authors and Affiliations

  1. Jinan Central Hospital Affiliated to Shandong University, Jinan, 250013, Shandong Province, People’s Republic of China

    Lulu Hou, Xianping Huang, Lulu Wang, Pei Sun & Lin Ding

  2. Medical School of Shandong University, Jinan, 250013, Shandong Province, People’s Republic of China

    Lulu Hou, Mei Li & Lin Ding

  3. Railway Hospital of Yanzhou District, Yanzhou, 272100, Shandong Province, People’s Republic of China

    Mei Li

  4. Department of Medicine, Taishan Medical University, Taishan, Shandong Province, People’s Republic of China

    Rui Shi

  5. Endocrinology Department of Jinan Central Hospital Affiliated to Shandong University, No. 105, Jiefang Road, Jinan, 250013, Shandong, People’s Republic of China

    Shuguang Pang

Authors
  1. Lulu Hou
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  2. Mei Li
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  3. Xianping Huang
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  4. Lulu Wang
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  5. Pei Sun
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  6. Rui Shi
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  7. Lin Ding
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  8. Shuguang Pang
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Corresponding author

Correspondence to Shuguang Pang.

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Funding

This study was funded by the National Natural Science Foundation of China (81170771, 81101183, 30970989 and 81270175), Science and Technology Development Programme of Shandong (2012GSF11803), and International Cooperation Programme of Jinan City Grants (201011008).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Lulu Hou and Mei Li contributed equally to this work.

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Hou, L., Li, M., Huang, X. et al. Seasonal variation of hemoglobin A1c levels in patients with type 2 diabetes. Int J Diabetes Dev Ctries 37, 432–436 (2017). https://doi.org/10.1007/s13410-016-0500-y

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  • DOI: https://doi.org/10.1007/s13410-016-0500-y

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