Hypertriglyceridemia and its impact on hematological indicators: A study based on Turkish national health database

OBJECTIVE: The hematocrit (Hct) to hemoglobin (Hb) ratio, generally at 3.0 in healthy individuals, can vary in certain disease states. An emerging area of interest is the potential influence of triglyceride concentrations on this ratio and hemoglobin A1C (HbA1c) levels. This study aimed to identify the changes in HbA1c and the Hct/Hb ratio as triglyceride concentration increases. METHODS: This research involved an extensive analysis of 35,656,613 laboratory samples taken between January 2015 and December 2022 in Türkiye, including the respective triglyceride, Hb, Hct, and HbA1c results. The laboratory test results were obtained from the national health database of the Turkish Ministry of Health. The triglyceride levels were divided into 24 groups, each incremented by 100 mg/dL from a range of 0–3099 mg/dL. Mean and standard deviation values of Hb and Hct were calculated for each group, and the Hct/Hb ratio was graphically represented. RESULTS: The average HbA1c values ranged between 4.37±0.85 and 7.76±3.19 across the groups, Hb averages ranged from 9.75±1.7 to 14.03±2.21, Hct averages from 27.35±4.97 to 38.86±5.66, and Hct/Hb ratios varied between 2.77 and 3.03. The overall average for all samples was identified as 5.15±0.13 for HbA1c, 38.48±5.13 for Hct, 12.73±1.65 for Hb, and 3.02 for the Hct/Hb ratio. CONCLUSION: It was observed that the Hct/Hb ratio gradually decreased as triglyceride levels increased. Evaluating anemia based on Hb concentration in individuals with hypertriglyceridemia might be misleading. It is recommended to use a correction factor based on triglyceride level.