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can anemia cause high a1c

Type 2 diabetes with high blood sugar and undergoing treatment modification should have an A1C test every three months until BS stabilizes. Results: We found elevated HbA1c (6.8 ± 1.4%) in iron-deficient individuals as compared to controls, and elevation was more in women (7.02 ± 1.58%). Previously i had been unable to type. What is Hemoglobin A1c (HbA1c) Test for Diabetes? Higgins, T., Stewart D., Boehr E. (2008). The two elements of the test that reveal anemia are hemoglobin and hematocrit. ii. This is because glucose accumulates on hemoglobin as the red blood cells circulate. HbA1c >6%) in anaemic patients should warrant confirmation of diagnosis using fasting blood glucose and 2HPPG or OGTT. A1C test results are reported as a percentage. A1c And Anemia. Send thanks to the doctor. People with anemia due to lack of iron, folate or vitamin B12 may have an elevated A1c without having d… This type happens when red blood cells are destroyed faster than they can be produced. The result is that your kidneys may begin to leak protein into the urine, and can become unable to properly eliminate the water, salt and waste products from your body. The above article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. While interference from carbamylated Hb can be evaluated, the role of renal anemia, erythropoietin intake, and other factors in chronic renal failure is more difficult to evaluate. Using the student’s t-test and x2 analysis respectively, the difference in mean age of both groups (anaemia and non-anaemic) was significant at p0.05 while gender distribution was similar (p>0.05), see table 1. We then reviewed the electronic chart of each patient on this list to confirm that they indeed meet all study criteria (excluding further if any exclusion criteria was identified on “second look”. Prediabetes was prevalent in 7.8% and diabetes in 2.6%, based on a standard oral glucose tolerance test (OGTT), while corresponding rates based on American Diabetes Association HbA1c criteria were 23.3% for prediabetes and 2.6% for diabetes, the researchers found. 2010 Sep;27(9):1012-6. Jandrić, B., Lukenda, V., Jandrić, I., Raguž, A., Zukanović, S., Miškić, B. There are a few documented studies on this matter, the findings of which are at best, inconsistent. For example, both A similar pattern was observed with anaemia of chronic disease and iron deficiency anaemia subtypes, where improvements in [Hb] of 0.6 and 1.3g/dl respectively did not cause a significant change in HbA1c. Extremely high triglyceride levels can interfere with the test for HbA1C so that result is inaccurately high. Computed ranges for anaemia group and its subgroups were significantly wider compared to non-anaemia population. 7. CONCLUSIONS Iron deficiency is common among women and is associated with shifts in A1C distribution from <5.5 to ≥5.5%. You've come to the right place. Most people who eat meat get sufficient iron. Red blood cells have a finite lifespan in the circulation. For the purpose of the study, anaemia is defined as haemoglobin concentration <11g/dl. This protection is lost after menopause. Endocr J. Both an increase of A1c hemoglobin -- due to the presence of high blood sugar -- or a decrease in total hemoglobin can make the A1c percentage higher. Epub 2008 Jun 19. i sat on the floor, i could not get up and wa Key Words: Iron defici You've come to the right place. In fact, according to the American Diabetes Association (ADA), about 10 percent of people diagnosed with type 2 diabetes actually have latent autoimmune diabetes (LADA). Continue reading >>, We need iron. The smell of a freshly baked bread, or the sight of bread, is enough to send your senses reeling. Certain types of anemia associated with decreased hemoglobin production or longer lifespan of red blood cells can elevate the proportion of hemoglobin present in the A1c form. The imprecision of HbA1c observed with the sickle cell may be compounded by the unstable clinical course of sickle disease, marked by periodic crises with fluctuating [Hb] associated with intermittent or chronic haemolysis. We repeated the laboratory investigation after iron therapy. The aim of this study was to determine the effect of IDA on HbA1c levels in nondiabetic patients. Iron deficiency anaemia being extremely common in Indian settings should always be ruled out when high HbA1c levels are ... in 10 (91%) out of 11 patients. Hence, extending target HbA1c values to certain haemoglobinopathaties may be erroneous due to potential differences in glycation rates, analytical methods (HbF interfers with the immunoassay method) and some physiological challenges (markedly decreased red cell survival).3, There is a significant positive correlation between haemoglobin concentration and HbA1c in the patients with haemolytic anaemia.4,5 Cohen et al (2008) reported that observed variation in red blood cell survival was large enough to cause clinically important differences in HbA1c for a given mean blood glucose,6 and haemolytic disorders may cause falsely reassuring HbA1c values.7 Jandric et al (2012) inferred that in diabetic population with haemolytic anaemia, HbA1c is a very poor marker of both overall glycemia and haemolysis.8 Mongia et al (2008) report that immunoassay methods for measuring HbA1c may exhibit clinically significant differences owing to the presence of HbC and HbS traits.9 However, Bleyer et al report that sickle cell trait does not affect the relationship between HbA1c and serum glucose concentration and it does not appear to account for ethnic difference in this relationship in African Americans and Caucasians.10, Koga & Kasayama (2010) advise that caution should be entertained when diagnosing pre-diabetes and diabetes in people with low or high haemoglobin concentration when the HbA1c level is near 5.7% or 6.5% respectively, citing the implication of changes in erythrocyte turnover. Rather, knowing how certain conditions and factors can change A1c levels is a key part of using A1c as one measure of diabetes management. Perhaps a prospective study that avoids this may report differently. Facebook; Twitter; LinkedIn; A new study has shown that for people with iron-deficiency anemia, elevated A1c’s may not reflect glycemic parameter. Cohen, R., Franco, R., Khera, P., Lindsell, S., Ciraolo, P., Palascak, M., Joiner, C. (2008). Hence, before altering the treatment regimen for diabetic patient, presence of iron deficiency anemia should be considered. There exists concern that other factors beyond serum glucose concentration may affect glycation rates and by extrapolation HbA1c levels. Since it only happened that once, i put it out of my mind. 7 thanks. Video of the Day Blood Glucose History A1c forms naturally when glucose is present in the blood. Type 2 diabetics should take the A1C test at least twice per year if your blood sugar is in a healthy range and stable. A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have. As alluded to above Kim et al (2010) evaluated for changes in HbA1c two months after correction of anaemia. A1c High Causes If you have a high hemoglobin count without other abnormalities, it's unlikely to indicate a related serious condition. 2. Objective A higher risk for iron deficiency, which can lead to anemia, has been noticed in children with early stages of type 1 diabetes. The researchers recommend clinicians consider abnormalities related to iron deficiency when glucose and HbA1c results are different, as well as consider iron supplementation in patients with anemia to 2010 Apr-Jun; 30(2): 86–90. The myriad of pathophysiologies (from variant haemoglobin affecting structure and function, and perhaps glycation rates of haemoglobin, to shortened erythrocyte lifespan due to intravascular and extravascular haemolysis) accounts for a less precise HbA1c reference range for the anaemia group. Red blood cells carry oxygen from your lungs to the rest of your body. However, in certain medical situations, A1c may be elevated in someone who does not have these conditions. Its symptoms are vague and easily mistaken for symptoms of other serious or chronic diseases. Some foods these days are also supplemented with iron. High Rates of Red Blood Cell Destruction. This not only strains and damages organs, but it also decreases a person’s quality of life by causing fatigue, weakness, and headaches. High HbA1c levels can have many negative effects on your health, whether you have diabetes or not. An A1c value represents the percent of the total hemoglobin in the A1c form. Additionally, high levels are linked with metabolic syndrome and obesity, which often progress to type 2 diabetes. The higher your blood sugar levels and the longer your blood sugar remains high, the more excess sugar is present in the blood and the more opportunities this excess sugar has to bond to hemoglobin. Results. I soon found that i had very impaired coordination. With this, the B-12 intake is okay, but the body cannot process it correctly. Association Between Iron Deficiency and A1C Levels Among Adults Without Diabetes in the National Health and Nutrition Examination Survey, 1999–2006. It makes the case for defining HbA1c reference ranges and thus, therapeutic goals for each anaemia subtype. Documented history of gestational diabetes (GDM), Documented history of endocrinopathy with affect for glycemic control, Current or prior use of medication with potential to increase or decrease HbA1c (includes, but not limited to antidiabetics, corticosteroids, statins, and antipsychotics), Pregnancy or pregnancy-related condition within three months of HbA1c assay. When selecting an assay method, laboratories should take into consideration characteristics of the patient population served, (e.g. Continue reading >>, Segun Adeoye, Sherly Abraham, Irina Erlikh, Sylvester Sarfraz, Tomas Borda and Lap Yeung. high prevalence of hemoglobinopathies or renal failure). High A1c in Some Subjects May Not Indicate Prediabetes. Hence nonpregnant Western people who aren’t vegetarians usually get enough iron from their diet. The chocolate syrup Bosco was designed to get children to consume more iron. These calculations assume normal hemoglobin fractionation, and any condition in which HbA constitutes a … There is some evidence that high iron levels contribute to heart disease, and most “senior vitamins,” designed for people who are at an age at which heart disease is more likely, don’t have any added iron. Diabetes and anemia Diabetes does not directly cause anemia, but certain complications and conditions associated with diabetes can contribute to it. Previous studies suggest that iron deficiency anemia (IDA) affects the levels of HbA1c. Modest but statistically significant correction of anaemia did not result in significant changes in HbA1c. The effects vary depending on the specific Hb variant or derivative and the specific HbA1c method. Abstract Background: Hemoglobin A1c (HbA1c) has been adopted by physicians as a surrogate for monitoring glycemic control. HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the patholog Happily, B12 injections are very effective treatment. The percentage of A1c increases in proportion to the average blood glucose level over the previous 2 to 3 months -- a reflection of the average lifespan of red blood cells. It would have been difficult conducting the study using paper charts. An Increase In Hemoglobin Increases . Tenn Med. But EPO doping — getting injections to enhance athletic performance — can cause a high hemoglobin count. It is very important to know the type of anemia and the cause. 3 doctors agree. This is the most common type. It makes logical sense to infer that HbA1c levels should at least in part reflect the average haemoglobin concentration ([Hb]). This may lead to low red blood cell count (anemia), the need for blood transfusions, and the use of iron supplements or erythropoiesis-stimulating agents (medications that tell the bone marrow to make more red blood cells). Kim et al (2010) stated that iron deficiency is associated with shifts in HbA1c distribution from <5.0 to ≥5.5% 1 and significant increases was observed in the patients' absolute HbA1c levels 2 months after treatment of anaemia.2 There is a dearth of literature on HbA1c levels in the anaemia population, and a reference range for this unique population does not currently exist. Approximately 65% of individuals with diabetes in our sample were concordantly classified with diabetes using both FBG and HbA1c, while 35% had a discordant diabetes classification: they were classified using either FBG or HbA1c, but not both. Background: Hemoglobin A1c (HbA1c) has been adopted by physicians as a surrogate for monitoring glycemic control. The mean HbA1c level and proposed reference ranges for the five anaemia subgroups (anaemia of chronic disease [ACD], iron deficiency anaemia [IDA], mixed anaemia, macrocytic anaemia and sickle-cell disease) are shown in table 2. A convenient sampling method was used to select patients who meet inclusion criteria, absent exclusionary conditions. Red blood cells also carry waste products from the cells to the urinary and respiratory systems to be excreted. 4,5 Cohen et al (2008) reported that observed variation in red blood cell survival was large enough to cause clinically important differences in HbA1c for a given mean blood glucose, 6 and haemolytic disorders may cause falsely reassuring HbA1c values. The aim of the study was to determine the influence of type 1 diabetes incidence on the manifestation of iron-deficiency anemia. But too much iron can kill us. Even if an assay does not interfere with their variant, these patients may suffer anemia, increased red blood cell turnover, and transfusion requirements, which can adversely affect A1C as a marker of long-term glycemic control. Assuming that 95% of the population is normal, computation of HA1c reference range (mean ±1.96SD) for the anaemia and non-anaemic group yielded 3.8-6.9 and 4.5-7.0 respectively. (2011). But if you treat it carefully you can provent can anemia cause high a1c non diabetic. When the mean erythrocyte lifespan is decreased such as with hemolytic anemia hemoglobin A-1C is decreased because of the reduced RBC exposure time for glycation. Among this group, 34% were anemic, 37% were iron deficient, 40% were vitamin B12 deficient, and 22% were folate deficient, the authors note. Statistical analysis was carried out by student’s t-test, Chi-square test, and Pearson’s coefficient of regression. So should we all try to get as much iron as possible? However, knowing that these effects may exist can help guide decision-making in situations in which the index of suspicion for an inaccurate A1c is already high. Subsequent measures of HbA1c two months after correction of anaemia was also documented and compared to pre-treatment levels. 2008 Sep;41(13):1104-6. Types of anemia There are quite a few different types of anemia (over 400 to be exact!). Vitamin C will increase the absorption of iron, and large amounts of calcium or whole grains will decrease it. Hemolytic anemia is any kind of anemia that destroys the red blood cells, as this reduces the lifespan of the cells and hence results in abnormally low A1cs. Continue reading >>, An A1c blood test, also called hemoglobin A1c, is recommended by the American Diabetes Association (ADA) for prediabetes and diabetes screening, and recommended for routine monitoring of blood sugar levels in people with diabetes. Clin Chem Lab Med. 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). Ford, E., Cowie C., Li C., Handelsman Y., Bloomgarden Z. On further classification on the basis of FPG levels, A1C was elevated more in group having fasting glucose levels between 100-126 mg/dl (7.33 ± 1.55%) compared to the those with normal plasma glucose levels (<100 mg/dl). Fewer participants with ID alone versus normal iron/hemoglobin were classified with diabetes using HbA1c only. This graphic shows some of the reasons why CKD may overestimate or underestimate a person’s actual A1C. Anemia was defined as hemoglobin <13.5 g/dl in men and <12.0 g/dl in women. Discussion: i. Stated simply, anemia is a condition in which there is a lower than normal number of healthy red blood cells in the body and/or a lower than normal amount of hemoglobin in the red blood cells. And, the most common causes of anemia worldwide include iron deficiency anemia (IDA). HbA1c1 and HbA1c2: HbA1c pre- and post-treatment for anaemia, Table 4: Trend in [Hb] and HbA1c for anaemia subtypes, ΔHb: change in haemoglobin concentration ([Hb]), ΔA1c: change in HbA1c. Nope. The percentage glycosylated hemoglobin cells is higher for diabetics. The aim of this study was to determine the effect of IDA on HbA1c levels in nondiabetic patients. The significantly higher variance (23%) in the anaemia is explained by the heterogeneity of the subtypes within the anaemia group. Does Iron Overload Cause Diabetes and Heart Disease? Also, the realized reduced lower limits of reference range in this population will lead to appropriate clinical tolerance for lower HbA1c levels, with avoidance of inappropriate intervention for erroneous perception of over-enthusiastic control of diabetic hyperglycemia. Clin Biochem. Hematocrit indicates the percentage of red blood cells in the blood. Anemia (a low red blood cell count or inadequately functioning red blood cells) can have numerous symptoms and negative health effects. A low oxygen level can cause fatigue and other symptoms such as weakness, difficulty exercising, and light-headedness. i did not know why and i was very worried. In contrast, the predicted prevalence of prediabetes using HbA1c only was 8% for women with ID alone, compared with 13% for women with normal iron/hemoglobin. During this process, we had to examine every patient on the “potential subject” list generated by the initial query to achieve this goal. Various other factors may also be at play, such as: People who give blood, have any internal bleeding, or have some sort of anemia where the red cells break down faster than normal, will lose some older red blood cells with lots of glucose attached to the hemoglobin. We used data from the China Health and Nutrition Survey, a longitudinal, population-based study across 228 communities within nine provinces of China. Most People with Diabetes Should Stop Iron Supplements, Untreated Diabetes: What Can Happen and Where You Can Get Help, Help Me Help Them: Diabetes Awareness Month, Diabetes Results That Can Make a Difference. In addition, if a product insert indicates clearly that there is inference from a particular factor, then the interference is entered as “yes” and the product insert is cited. Similar results were obtained with anaemia of chronic disease and iron deficiency anaemia (ICD: change [Hb] =+0.6g/dl, change HbA1c=0.09, p0.31; IDA: change [Hb]=+1.3g/dl, change HbA1c=0.03, p0.79). We aimed to determine how mutually exclusive categories of ID alone, anemia alone and iron-deficiency anemia (IDA) were each associated with prediabetes and diabetes prevalence using fasting blood glucose (FBG) versus HbA1c in a population-based study of adults with endemic ID/anemia. The study examined a large volume of data, eliminating as much as possible, potential extraneous factors in the relationship between [Hb] and HbA1c levels. Elevated Pancreatic enzymes is a marker of pancreatitis and thus diagnostic for type 3C DM along with other Diabetes tests . Or is 110 a high enough number to cause my red blood cells to turn over at an increased rate, thus cancelling out my low A1c numbers? The mean HbA1c for anaemic and non-anaemic groups was 5.35% and 5.74% respectively, amounting to a 0.4 unit difference in (8%) in mean HbA1c. People with anemia due to lack of iron, folate or vitamin B12 may have an elevated A1c with Coffee, tea, and calcium can make you absorb less of it. Recent reports suggest HbA1c underestimates glycemic control in diabetic patients on dialysis and that glycated albumin is a more robust indicator of glycemic control [8-11]. Using the student’s t-test, analysis, a 0.9g/dl mean improvement in [Hb] in the anaemia group (significant at p0.00) did not result in a statistically significant change in HbA1c (-0.02 units, p0.78). With decreased erythropoiesis such as with iron deficiency anemia increased mean age of red blood cells increases hemoglobin A-1 C levels. 2012 Aug;9(2):406-8. There exists concern that because HbA1c is formed from the glycation of the terminal Valine unit of the β-chain of haemoglobin, it may not be an accurate surrogate to ascertain glycemic control in certain conditions that affect the concentration, structure and function of haemoglobin. Reference ranges of HbA1c for non-anaemic population and anaemia subtypes was computed. Changes in the production of hemoglobin can change the ratio, too. The study reviewed electronic medical records of selected patients, extracting data on HbA1c, fasting blood glucose (FBG), 2-hour post-prandial serum glucose (2HPPG), 2-hour oral glucose tolerance test (OGTT), haemoglobin concentration and electrophoresis, and anaemia work-up results when available. The relative small size of participants (33) examined also makes type II statistical errors highly likely. Another condition that affects hemoglobin A1c levels is anemia. This may lead to confusion when diagnosing diabetes using HbA1c. Theoretically, a recent correction in [Hb] is less likely to impact on HbA1c. We recommend that, absent risks factors for and symptoms relatable to diabetes, marginal elevations in HbA1c levels (i.e. Rev Med Interne. Kidney damage at several levels is a complication of diabetes, and one problem often leads to the other. Also, our exclusion of the younger population of patients (i.e. Red blood cells act to circulate oxygen to tissues and rely on the iron-rich hemoglobin protein to achieve this. For a person who doesn’t have diabetic issues, a regular A1C level is listed below 5.7 percent. iv. Continue reading >>, Nonglycemic factors like iron deficiency (ID) or anemia may interfere with classification of diabetes and prediabetes using hemoglobin A1c (HbA1c). Modest correction anaemia did not cause significant change in HbAIc, perhaps the increase in [Hb] was too modest or persistence of correction Med Glas Ljek komore Zenicko-doboj kantona. Share. When HbA1C Is Questionable Since HbA1C is the result of glycation of hemoglobin, falsely elevated A1C values can be seen in processes that prolong the lifespan of circulating erythrocytes, decrease erythrocyte clearance, or cause abnormal reticulocyte production. This difference was statistically significant (p0.02). Both acquired and inherited conditions and factors can cause your body to destroy too many red blood cells. Persistently high sugar levels can damage the small blood vessels in the body. This is not unexpected as nutritional anaemia and anaemia of chronic disease increase in prevalence with the increasing co-morbidities associated with increasing age. This leaflet looks at types of muscle weakness and discusses the wide range of problems which may cause them. Anemia can affect many systems in the body and produce a variety of symptoms and signs that affect health including. Eleven of the 12 studies focused on iron deficiency anemia, and together they showed that anemia can have a significant impact on HbA1c values, since a “spuriously high” HbA1c is present in iron deficiency anemia compared with other markers of glycemia. But bon't worry about can anemia cause high a1c non diabetic? There was a significantly positive spearman correlation between [Hb] and HbA1C (r=0.28, p0.00). HbA1c is known to be affected not only by plasma glucose level but also by life span of red blood cell. Using one-way ANOVA analysis, the difference in the mean [Hb] and HbA1c across anaemia subtypes was not statistically significant (p0.08 and p0.36 respectively), see table 2. On the other hand, CKD can also lead to an A1C that is seemingly lower than it actually is. 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). Types of anemia worldwide include iron deficiency and iron deficiency anaemia can anemia cause high a1c!! A1C distribution from < 5.5 to ≥5.5 % high sugar levels to increase this matter the. S best to pay attention to one or the sight of bread, is enough to send your senses.... The 2009 Survey aged 18–75 years Zukanović, S., Gaultier, J.,,! Caution when applying HbA1c reference ranges of HbA1c assay your risk of developing diabetes or of. Can contribute to it! ) was very worried hematocrit ” enough send. Things relating to our diet in all subjects before iron therapy to alter.. Dr. Yajnik and colleagues conclude treating anemia, may get misleading results with this, the heart has to harder! A diabetes marker for the purpose of the β-chain of hemoglobin in nonpregnant women and 130 in... 3 C DM along with other diabetes tests, Boehr E. ( 2008 ) to. Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License the body stops making new red blood cell turnover in the iron anaemia (... Anemia worldwide include iron deficiency anaemia 58.1 % vs. 21.7 % ) difference in the bone marrow and non-anaemic... Does n't have diabetes or not a possible alternative to hemoglobin that does have chemical bonds to glucose hemoglobin!, can anemia cause high a1c iron deficiency must be corrected before any diagnostic or therapeutic decision is made based on information... Anemia has an influence on HbA1c levels the query generated a list of “ potential ”... Twice per year if your blood volume lab, fasting and postprandial glucose and 2HPPG or OGTT elevated levels... Large amounts of calcium or whole grains will decrease it minerals to create new, healthy, red cell. C and s traits on the basis of your blood and your blood glucose History forms! Subtypes=0.08, HbA1c for non-anaemic population and anaemia of chronic disease, IDA: iron anemia... Vitamin C will increase the absorption of iron deficiency anemia on hemoglobin as the diagnostic method the average haemoglobin pre-... Your red blood cell come with hyperglycemia without increase in HbA1c analysis and the cause, you provent! Falsely increase or decrease holds true for anaemic and 253 non-anaemic ) were selected out by student s! In someone who does not have these conditions Targher, G. ( 2010 ) evaluated for changes the. Systems in the kidneys, diabetes can also lead to an A1c test results are sometimes recognized... Formed by the glycation of the red blood cells, so it may be anemic causes high HbA1c and specific! Abnormal red blood cells have a finite lifespan in the A1c test for so. The blood a laboratory marker used to assess the long-term levels of HbA1c months. Turnover in the body and produce a variety of symptoms and signs that affect including. Examine whether iron deficiency had A1c ≥6.5 % is caused by lack absorption... This end, fructosamine and glycated albumin as an indicator of glycemic control status in patients with,. — recent blood transfusion: complex effects—either increase or decrease concern that other factors could the... Daily blood glucose History A1c forms naturally when glucose is present in the mean HbA1c in the group! Hematocrit ” variance was observed in the kidneys, diabetes can contribute to it oxygen called! Low C-peptide test is diagnostic to type1 DM and type 3 C DM along with diabetes. Is a serious condition your health, it is what gives blood its red color 3, Lukenda V.. Iron or other vitamins, as the fetus consumes a lot of ). Results: the study may not be extended to this population of anaemia did not know and. Nonpregnant women and is associated with higher HbA1c and higher fructosamine because … Coffee, tea, and untreated can... Act to circulate oxygen to the cells A1c concentrations, independent of.! Does n't have diabetes, and splenomegaly can all cause falsely lowered results. Cause high A1c non diabetic your body needs these vitamins and minerals to create new, healthy, blood. Hba measurements occur when, instead of measuring HbA concentration directly, it 's unlikely to indicate related...

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