THE IMPORTANCE OF HbA1c IN THE CANCER LANDSCAPE
BLOOD SUGAR EVALUATION
Hyperglycemia (high blood glucose) is one of the main characteristics of diabetes, and is possibly one of the reasons for the increased risk of cancer in diabetes patients. Chronic hyperglycemia is evaluated by measuring glycated hemoglobin (HbA1c).
Hemoglobin A1C: This reflects a longer term average (between 2-3 month) level of blood glucose/ average glucose concentration/ glycated hemoglobin.
Hemoglobin A1C (HbA1C) at 5.6 indicates insulin resistance and over 5.7 most probably diabetes mellitus.
It can be :
Measured in a non fasting state. Has high repeatability, and Is not affected by daily glucose fluctuation.
HbA1c may also be a good indicator of metabolic processes that influence levels of insulin or insulin-like growth factors which are extremely important for cancer pathogenesis
The following underlying metabolic conditions may contribute to increased cancer risk through various mechanisms.
Diabetes-associated hyperinsulinemia, insulin resistance, Elevated insulin-like growth factor 1 (IGF-1), hyperglycemia, and Inflammation and heightened levels of inflammatory cytokines that increase insulin resistance.
OVERVIEW
Considered a more stable marker of glucose level than fasting glucose and a better predictor of vascular and cardio metabolic disease risk among both diabetic and non diabetic individuals
HEMOGLOBIN A1C AND DIFFERENT CANCER TYPES
Data from extensive research reveals that chronic hyperglycemia correlates with an increased risk of cancer for a number of different types. Evidence also indicates that the risk is increase in the pre-diabetic and normal ranges.
The near-linear association of HbA1c levels with a risk of several cancers supports the presumption that it could be possible to use HbA1c as an independent metabolic biomarker for cancer risk in diabetic or non-diabetic persons.
There is also an increased risk seen for higher cancer stages/grades for some cancer types as HbA1c levels increase.
The strongest associations are seen in the cases for ENDOMETRIAL, LIVER, PANCREATIC CANCER followed by KIDNEY, OESOPHAGEAL, COLORECTAL, BREAST. BLADDER CANCER AND LEUKAEMIA.
For both men and women, diabetes was associated with an increased risk of stomach and bladder cancer,
Among women, diabetes was associated with increased risk of cancers of the stomach, kidney, endometrium, and lung among smokers, and among men, diabetes was associated with increased risk of liver cancer.
Analysis of the association between high HbA1c levels (248 mmol/mol) and the risk of cancer showed risk of cancer of the esophagus, liver, pancreas, colon, bladder, and prostate.
HbA1c levels below the threshold for diabetes diagnosis but higher than normal (39-<48 mmol/mol) were seen to be associated with increased risk of cancers of colon, liver, bladder, and lung.