No abstract

The major form of glycohemoglobin is hemoglobin A1c (HbA1c). The HbA1c fraction is abnormally elevated in chronic hyperglycemic diabetic patients and correlates positively with glycemic control. Previous studies suggest that iron deficiency anemia (IDA) affects the levels of HbA1c. The aim of this study was to determine the effect of IDA on HbA1c levels in nondiabetic patients. The population studied consisted of 50 patients (30 women, 20 men, mean age 35.7 ± 11.9 years) with IDA and 50 healthy subjects that were matched for age and sex. Patients who had glucose tolerance abnormalities (impaired glucose tolerance or diabetes mellitus), hemoglobinopathies, hemolytic anemia, chronic alcohol ingestion and chronic renal failure were excluded from the study. Hematologic investigations, fasting and postprandial glucose and HbA1c levels were measured in all subjects before iron therapy. All patients with IDA were treated with iron 100 mg/day for 3 months. We repeated the laboratory investigation after iron therapy. Before iron treatment, the mean HbA1c (7.4 ± 0.8%) level in patients with IDA was higher than in a healthy group (5.9% ± 0.5) (p < 0.001). In patients with IDA, HbA1c decreased significantly after iron treatment from a mean of 7.4% ± 0.8 to 6.2% ± 0.6 (p < 0.001). Iron deficiency must be corrected before any diagnostic or therapeutic decision is made based on HbA1c.

Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherothrombosis. The present study was designed to evaluate MPV in patients with obesity compared with non-obese control subjects. We selected 100 non-obese subjects and 100 subjects with obesity [body mass index (BMI) > or =30 kg/m(2)] matched for age and gender. The MPV was significantly higher in obese group than in non-obese control group (10.3 +/- 1.2 vs. 9.0 +/- 0.8 fl, p < 0.01). MPV was positively correlated with BMI in obese group (p < 0.05). Increased MPV may be a possible cause for increased cardiovascular risk in patients with obesity.

Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherothrombosis. Impaired fasting glucose (IFG) is probably a frequent glycemic disorder in the general population and is considered as a prediabetic state. The present study was designed to evaluate MPV in subjects with IFG compared with diabetic patients and normoglycemic control subjects. We selected 50 patients with type 2 diabetes mellitus, 50 subjects with IFG, and 50 normoglycemic healthy subjects matched for age, gender, and body mass index. MPV was very significantly higher in diabetic and IFG groups than in control group (p < 0.00, p < 0.05, respectively); it was also higher in diabetic group than in IFG group (p < 0.05). Platelet counts were not different among the study groups (p > 0.05). Platelet mass was significantly higher in diabetic and IFG groups than in normotensives (p < 0.00, p < 0.05, respectively); and it was also higher in diabetic group than in IFG group (p < 0.05). MPV and platelet mass were positively correlated with fasting glucose and HbA1c in diabetic and IFG groups (p < 0.05). In conclusion, our data suggests one possible mechanism by which subjects with IFG may be at increased cardiovascular risk.

Disclosure of the diagnosis of cancer to patients is a difficult task for physicians in developing countries. Family members often oppose truth telling. The aim of this study was to evaluate the incidence of the "do not tell" attitude in a general population of cancer patients and to explore the factors affecting the attitude of cancer patients' relatives about honest disclosure. Using a questionnaire, relatives of 150 patients with recently diagnosed cancer were interviewed. Of the relatives, 66% did not want the diagnosis to be disclosed. Male gender of the patient, a diagnosis of a non-breast cancer malignancy, the presence of stage IV disease, no previous request for disclosure by the patient, insufficient knowledge of the relative about cancer in general, and stronger religious belief of the relative were associated with greater likelihood of the relative having a "do not tell" attitude in univariate analyses ( P=0.032, P=0.000, P=0.051, P=0.021, P=0.128, and P=0.058, respectively). In a multivariate analysis, the diagnosis of a non-breast cancer malignancy, and insufficient knowledge of the relative about cancer in general retained their significance (exp(B)=14.77, P=0.000; exp(B)=3.04, P=0.01, respectively). Differences among different countries and cultures are discussed.