{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:50:24Z","timestamp":1791287424895,"version":"4.1.0"},"reference-count":84,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:p>Introduction: Concentration of glycated hemoglobin (HbA1c) may be influenced by different types of anemia. This systematic review and meta-analysis aimed to evaluate the effect of iron deficiency anemia (IDA) and latent iron deficiency (LID) on HbA1c concentrations.\nMaterials and methods: A search was conducted in Medline\/PubMed, Web of Science, Embase, and LILACS up to May 2026. Eligible studies included cross-sectional, cohort, case-control, non-randomized intervention studies and clinical trials assessing the impact of IDA or LID on HbA1c concentrations. Methodological quality was evaluated using the ROBINS-I V2 tool for intervention studies and the Newcastle-Ottawa Scale for cross-sectional studies. Meta-analyses were performed using Review Manager 5 (The Cochrane Collaboration, Copenhagen, Denmark).\nResults: Among 43 studies evaluating IDA, 33 reported falsely elevated HbA1c concentrations. Of six studies assessing LID, two observed increased HbA1c concentrations. All four studies evaluating iron deficiency regardless of anemia status found elevated HbA1c. Among 19 intervention studies, 14 showed a reduction in HbA1c following iron supplementation. Meta-analyses including 30 studies confirmed increased HbA1c concentrations in patients with IDA (0.66% (0.31 to 1.00) or 7.21 mmol\/mol (3.39 to 10.93), P &lt; 0.001). Meta-analysis of four studies verified increased HbA1c in individuals with LID (0.66% (0.01 to 1.32) or 7.21 mmol\/mol (0.11 to 14.43), P = 0.05). Meta-analysis of 14 intervention studies demonstrated a reduction in HbA1c following iron therapy (- 0.50% (- 0.92 to - 0.09) or 5.46 mmol\/mol (- 10.05 to - 0.98), P = 0.02). Heterogeneity was mainly related to HbA1c assay methods and diagnostic criteria for anemia and iron deficiency.\nConclusions: Iron deficiency anemia interferes with HbA1c measurement, leading to falsely elevated values, while LID may also increase HbA1c concentrations.<\/jats:p>","DOI":"10.11613\/bm.2026.030503","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:06:43Z","timestamp":1790932003000},"page":"445-473","source":"Crossref","is-referenced-by-count":0,"title":["Interference of iron deficiency in glycated hemoglobin testing and its clinical implications"],"prefix":"10.11613","volume":"36","author":[{"given":"Emanuele Maria Coimbra","family":"Souza","sequence":"first","affiliation":[{"name":"Federal University of S\u00e3o Jo\u00e3o del-Rei, West Center Campus, Divin\u00f3polis, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Pereira","family":"Domingueti","sequence":"additional","affiliation":[{"name":"Federal University of S\u00e3o Jo\u00e3o del-Rei, West Center Campus, Divin\u00f3polis, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"key20261002090637_r1"},{"key":"key20261002090637_r2","first-page":"830","article-title":"Global, regional, and national prevalence of anemia and its causes in 204 countries and territories, 1990-2019.","volume":"4","author":"Gardner","year":"2020","journal-title":"Curr Dev Nutr"},{"key":"key20261002090637_r3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgast-2021-000759","article-title":"Iron deficiency anaemia: pathophysiology, assessment, practical management.","volume":"9","author":"Kumar","year":"2022","journal-title":"BMJ Open Gastroenterol"},{"key":"key20261002090637_r4","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1590\/S0034-89102000000400019","article-title":"Par\u00e2metros para avalia\u00e7\u00e3o do estado nutricional de ferro","volume":"34","author":"Paiva","year":"2000","journal-title":"Rev Saude Publica"},{"key":"key20261002090637_r5","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00125-015-3599-3","article-title":"The effect of anaemia and abnormalities of erythrocyte indices on HbA1c analysis: a systematic review.","volume":"58","author":"English","year":"2015","journal-title":"Diabetologia"},{"key":"key20261002090637_r6","doi-asserted-by":"crossref","first-page":"8371","DOI":"10.12659\/MSM.916719","article-title":"Increased Levels of Glycated Hemoglobin A1c and Iron Deficiency Anemia: A Review.","volume":"25","author":"Guo","year":"2019","journal-title":"Med Sci Monit"},{"key":"key20261002090637_r7","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1111\/dme.12518","article-title":"Interpretation of HbA1c: association with mean cell volume and haemoglobin concentration.","volume":"31","author":"Simmons","year":"2014","journal-title":"Diabet Med"},{"key":"key20261002090637_r8","first-page":"15","article-title":"Subhashree. 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