Journal of Clinical and Diagnostic Research. 2022 Aug, Vol-16(8): BC06-BC08 6 6 DOI: 10.7860/JCDR/2022/55626.16702 Original Article Biochemistry Section Role of Vitamin D and Haemoglobin Levels in Prediabetic Patients- A Retrospective Study INTRODUCTION Prediabetes is a multifactorial metabolic condition that affects more than just blood glucose levels. It increases the risk of type 2 diabetes by three to ten times. Detecting and treating this condition is critical for preventing or delaying the onset of type 2 diabetes [1]. Diabetes type 2 risk increases 50% among people with prediabetes [2]. A seco-steroid prohormone, 25(OH) D 3 (Vitamin D) is a fat-soluble steroid prohormone produced by the skin. It promotes calcium absorption in the gut to keep serum calcium and phosphate concentrations sufficient for proper bone mineralisation [3]. The iron-containing oxygen-transport metalloprotein haemoglobin (Hb) is an important erythrocyte protein that is affected by many factors, including pH deviations, temperature increases, and chemical modifications that can cause functional changes in Hb [4]. The active form of Vitamin D binds to the Vitamin D receptors in beta cells in the pancreas to affect insulin secretion [5]. Vitamin D supplementation has been proposed as an effective intervention to decrease diabetes risk in people with low Vitamin D levels [6]. A decrease in haemoglobin concentrations is a common risk factor for prediabetes to diabetes. Vitamin D levels appear to be inversely connected with the likelihood of prediabetes and Haemoglobin A1c (HbA1c) levels in people with prediabetes, particularly in obese people, according to some observational evidence [7,8]. From a clinical viewpoint, it is interesting to evaluate the association of Hb concentrations and Vitamin D in prediabetes patients between 25-65 age groups as this age group is more prone to Hb and Vitamin D deficiency. Study by Sim JJ et al., showed that Vitamin D has an important association with anaemia, the low Hb level is also noteworthy [9]. The Hb analysis helps to tell the glucose bound to Hb, and such combination can be estimated by doing HbA1c test, which is a diabetes predictor mark test, and Vitamin D, the proinflammatory hormone, can maintain bone marrow function and can reduce metabolic disorders like diabetes. Therefore, the association of these parameters in suspected diabetes patients can help to improve their physical health status, also can reduce/delay the risk of early occurrence of metabolic diseases [9]. The link between Vitamin D, haemoglobin and insulin resistance has been studied more thoroughly in patients with diabetes mellitus [7-9], although data from people with prediabetes is scarce. Nevertheless, the relationship between haemoglobin and Vitamin D level in the prediabetes adult population has not been well described. Therefore, the study’s goal was to estimate Vitamin D level and Haemoglobin level in patients with prediabetes. MATERIALS AND METHODS This retrospective study was carried out in Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India from July 2020 to December 2020. The data was collected from the patients visiting the Outpatient Department (OPD) and was analysed during the same time. Research was carried out after approval by the Institutional Human Ethical Committee [Ref.No. 002/SBMC/IHEC/2017/985]. Written informed consent was taken from all the study participant. Inclusion criteria: Retrospective data were collected from total of 100 patients aged between >25 years and <65 years, who gave written informed consent for prediabetes screening according to American Diabetes Association (ADA) recommendations for prediabetes [10] and got Vitamin D and Haemoglobin level done as part of the routine check-up were included. Exclusion criteria: Data from those patients suffering from any other medical problems like malignancy, autoimmune disease, Pregnant or lactating women were excluded from the study. DEEPA K NAIR 1 , B SHANTHI 2 , GIRIDHAR BUPESH 3 Keywords: Cholecalciferol, Diabetes, Immune response, Insulin resistance ABSTRACT Introduction: The 25-hydroxy (OH)D 3 (Vitamin D, Cholecalciferol) and Haemoglobin (Hb) level have a significant role in the regulation of immune response. A decrease in Vitamin D and haemoglobin concentrations is a common risk factor for diabetes. The link between Vitamin D and insulin resistance has been studied more thoroughly in patients with diabetes mellitus, although data from people with prediabetes is scarce. Aim: To study the association of Vitamin D and Hb levels in prediabetes patients. Materials and Methods: This retrospective study was conducted in the Sree Balaji Medical College and Hospital, Chennai from July 2020 to December 2020. Total 100 subjects with prediabetes conditions were included and their Vitamin D and Hb levels were measured. The patients who gave written informed consent for prediabetes screening according to ADA- 2020 recommendations for prediabetes were included and their Vitamin D and Hb level done as part of the routine check-up were collected. Data were statistically analysed using Analysis of Variance (ANOVA) and Chi-square test. Results: Data of total 100 patients was analysed, including 68 female patients and 32 male patients. Out of 100 patients, 84 were aged between 25-50 years and 16 were aged between 51-65 years. The difference between male and female were statistically significant with p-value <0.01 (for Hb) and p value 0.05 (Vit-D), respectively. A significant difference in mean Hb level when compared among Vitamin D deficient (0.0-19.99 IU/mL) level, insufficient (20-29.99 IU/mL) and sufficient (30-99.99 IU/mL) subjects (p=0.008) was observed. Conclusion: Low levels of Vitamin D is significantly associated with low Hb level. The patients with deficient Vitamin D level showed a significantly low mean Hb level compared to insufficient and sufficient Vitamin D level.