Red Blood Cell Metabolomic Signatures in β-Thalassemia Heterozygotes With Elevated HbA 1c : Implications for Biomarkers and Personalized Medicine
Authors' conclusion
Distinct RBC metabolic signatures were observed in BTHs with elevated HbA1c, highlighting alterations in redox and heme metabolism. These findings provide a basis for future investigations into RBC-derived metabolites as complementary tools for glycemic assessment in individuals with thalassemia and hemoglobinopathies.
Study context
- Population
- Normoglycemic individuals and individuals with T2D, Nakhon Si Thammarat, ThailandPhase 1
- Participants
- 244 vs 447
- Exposure
- Red blood cell (RBC) disorders vs no RBC disorders; BTH with high vs normal Hemoglobin A1c (HbA1c)
- Normoglycemicn = 244reference
- T2Dn = 447
- Outcome
- HbA1c in those with vs without RBC disorders
Methodological detailsthree-phase, liquid chromatography-mass spectrometry (LC-MS)-based RBC metabolomics
- Three-phase
- LC-MS-based RBC metabolomics
Main finding
As reported in the abstract
- HbA1c significantly lower with RBC disorders, individuals without diabetes
- P = .001
- HbA1c significantly lower with RBC disorders, individuals with diabetes
- P < .001
Observational data: associations, not effects.
Further findings
RBC metabolomics in BTH with high vs normal HbA1c
- 5-oxo-L-proline highest fold change
- FC = 6.90, P = .0004
- Distinct clustering patterns in high-HbA1c cases on multivariate analyses
- Followed by 5-aminolevulinate and D-gluconic acid; increased oxidized/reduced glutathione; decreased NADH and sphingomyelin
- Phase 3: 10 without diabetes, 14 with diabetes
Original publication
Red Blood Cell Metabolomic Signatures in β-Thalassemia Heterozygotes With Elevated HbA 1c : Implications for Biomarkers and Personalized Medicine. J Diabetes Sci Technol. Published 3 March 2026. doi:10.
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