科威特达曼糖尿病研究所就诊的阿拉伯糖尿病患者的白细胞亚群变化和中性粒细胞减少症的发生率。

White blood cell subpopulation changes and prevalence of neutropenia among Arab diabetic patients attending Dasman Diabetes Institute in Kuwait.

机构信息

Faculty of Medicine, Health Science Center-Kuwait University, Al-Jabriya, Kuwait.

Faculty of Pharmacy, Health Science Center-Kuwait University, Al-Jabriya, Kuwait.

出版信息

PLoS One. 2018 Mar 16;13(3):e0193920. doi: 10.1371/journal.pone.0193920. eCollection 2018.

DOI:10.1371/journal.pone.0193920

PMID:29547660

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5856345/

Abstract

BACKGROUND

The effects of diabetes mellitus on the differential white blood cell count are not widely studied in the Arab populations. The objective of this cross-sectional, retrospective study is to assess the influence of chronic diabetes mellitus on white blood cell counts, absolute neutrophil (ANC) and lymphocyte counts (ALC) as well as the prevalence of benign ethnic neutropenia among Arabs attending the Dasman Diabetes Institute (DDI) in Kuwait.

METHODS AND FINDINGS

1,580 out of 5,200 patients registered in the DDI database qualified for our study. Age, gender, HbA1c and creatinine levels, estimated glomerular filtration rate as well as average WBC, ANC and ALC levels, presence of diabetes-associated complications and anti-diabetic medications were analyzed. Our results showed the mean value of the WBC was 7.6 ± 1.93 x 109/L (95% CI: 2.95-17.15). The mean ANC was 4.3 x 109/L (95% CI: 0.97-10.40) and mean ALC was 2.5 x 109/L (95% CI: 0.29-10.80). Neutropenia (ANC: <1.5 x 109/L) was detected in fifteen patients (0.94%). Six patients (0.4%) fulfilled the definition of lymphopenia (ALC < 1 x109/L). Patients with an HbA1c ≥ 7% and those taking at least 3 anti-diabetic medications showed higher values for ANC and ALC. Patients with diabetes-associated neuropathy or nephropathy displayed higher mean ANC values. Our study was limited by overrepresentation of patients over 50 years old compared to those under 50 as well as selection bias given its retrospective nature.

CONCLUSIONS

Our study showed that patients with poorly controlled diabetes displayed higher ANC and ALC levels. In addition, patients with DM-associated complications showed higher ANC levels. This finding would suggest that DM exerts a pro-inflammatory influence on differential WBC counts. Our study also showed that the prevalence of benign ethnic neutropenia was lower than previously reported in other studies.

摘要

背景

糖尿病对白细胞分类计数的影响在阿拉伯人群中研究得并不广泛。本横断面、回顾性研究的目的是评估慢性糖尿病对白细胞计数、绝对中性粒细胞（ANC）和淋巴细胞计数（ALC）的影响，以及在科威特 Dasman 糖尿病研究所（DDI）就诊的阿拉伯人中良性种族性中性粒细胞减少症的患病率。

方法和发现

DDI 数据库中登记的 5200 名患者中有 1580 名符合我们的研究条件。分析了年龄、性别、HbA1c 和肌酐水平、估算肾小球滤过率以及平均白细胞计数、ANC 和 ALC 水平、糖尿病相关并发症和抗糖尿病药物的存在情况。我们的结果显示，白细胞计数的平均值为 7.6 ± 1.93 x 109/L（95%CI：2.95-17.15）。平均 ANC 为 4.3 x 109/L（95%CI：0.97-10.40），平均 ALC 为 2.5 x 109/L（95%CI：0.29-10.80）。在 15 名患者（0.94%）中检测到中性粒细胞减少症（ANC：<1.5 x 109/L）。6 名患者（0.4%）符合淋巴细胞减少症（ALC < 1 x109/L）的定义。HbA1c≥7%和至少服用 3 种抗糖尿病药物的患者 ANC 和 ALC 值较高。患有糖尿病相关神经病变或肾病的患者 ANC 平均值较高。我们的研究受到限制，因为与 50 岁以下患者相比，50 岁以上患者的比例过高，并且由于其回顾性性质存在选择偏倚。