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埃塞俄比亚东北部德西转诊医院成年1型和2型糖尿病患者的基本凝血指标和血小板参数:比较横断面研究

Basic Coagulation Profiles and Platelet Parameters Among Adult Type 1 and Type 2 Diabetes Patients at Dessie Referral Hospital, Northeast Ethiopia: Comparative Cross-Sectional Study.

作者信息

Ebrahim Hussen, Asrie Fikir, Getaneh Zegeye

机构信息

Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

J Blood Med. 2021 Jan 27;12:33-42. doi: 10.2147/JBM.S287136. eCollection 2021.

Abstract

BACKGROUND

Diabetes is a heterogeneous group of metabolic disorders characterized by hyperglycemia. The disease is highly associated with micro-vascular and macro-vascular complications. Thus, the main aim of this study was to compare basic coagulation profiles and platelet parameters among type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and healthy controls.

METHODS

A comparative cross-sectional study was conducted at Dessie Referral Hospital from February to April 2019. A total of 180 study participants consisting of (60 T1DM, 60 T2DM, and 60 healthy controls) were enrolled using a systematic random sampling technique. Basic coagulation profiles and platelet parameters were determined using the HUMACLOT JUNIOR coagulometer and DIRUI BF 6500 automated hematology analyzer respectively. Non-parametric Kruskal-Wallis test supplemented with Dunn-Bonferroni correction and Spearman rank-order correlation test were used to compare basic coagulation profiles and platelet parameters among the groups. The test result was expressed in median and interquartile range and presented in texts and tables. P-value < 0.05 was considered to be statistically significant.

RESULTS

Prothrombin time (PT) and international normalization ratio (INR) were significantly reduced in T2DM as compared to T1DM and healthy controls (p <0.05). Platelet distribution width (PDW) and mean platelet volume (MPV) were significantly increased in both T1DM and T2DM as compared to healthy controls (p <0.05). Moreover, PT and INR were negatively correlated with fasting blood glucose (FBG) among T1DM and PT, INR and activated partial thromboplastin time (APTT) were negatively correlated with FBG among T2DM.

CONCLUSION

Basic coagulation profiles and platelet parameters were significantly different between diabetes and controls where PT and INR in T2DM were significantly reduced as compared to T1DM and controls. However, PDW and MPV were significantly elevated in both T1DM and T2DM as compared to controls. Moreover, FBG was significantly negatively correlated with PT and INR among T1DM and FBG was significantly negatively correlated with PT, INR, and APTT among T2DM. Therefore, T2DM may be related to increased risk of thrombosis indicated by reduced PT and INR and high PDW and MPV than T1DM and controls. Basic coagulation profiles and platelet parameters should be regularly tested for early diagnosis and proper management of diabetes-related thrombosis.

摘要

背景

糖尿病是一组以高血糖为特征的异质性代谢紊乱疾病。该疾病与微血管和大血管并发症高度相关。因此,本研究的主要目的是比较1型糖尿病(T1DM)、2型糖尿病(T2DM)和健康对照组之间的基本凝血指标和血小板参数。

方法

2019年2月至4月在德西转诊医院进行了一项比较性横断面研究。采用系统随机抽样技术招募了180名研究参与者,包括(60名T1DM患者、60名T2DM患者和60名健康对照)。分别使用HUMACLOT JUNIOR凝血仪和迪瑞BF 6500全自动血液分析仪测定基本凝血指标和血小板参数。采用非参数Kruskal-Wallis检验并辅以Dunn-Bonferroni校正以及Spearman等级相关检验来比较各组之间的基本凝血指标和血小板参数。检验结果以中位数和四分位间距表示,并在文本和表格中呈现。P值<0.05被认为具有统计学意义。

结果

与T1DM和健康对照组相比,T2DM患者的凝血酶原时间(PT)和国际标准化比值(INR)显著降低(p<0.05)。与健康对照组相比,T1DM和T2DM患者的血小板分布宽度(PDW)和平均血小板体积(MPV)均显著增加(p<0.05)。此外,T1DM患者中PT和INR与空腹血糖(FBG)呈负相关,T2DM患者中PT、INR和活化部分凝血活酶时间(APTT)与FBG呈负相关。

结论

糖尿病患者与对照组之间的基本凝血指标和血小板参数存在显著差异,与T1DM和对照组相比,T2DM患者的PT和INR显著降低。然而,与对照组相比,T1DM和T2DM患者的PDW和MPV均显著升高。此外,T1DM患者中FBG与PT和INR显著负相关,T2DM患者中FBG与PT、INR和APTT显著负相关。因此,与T1DM和对照组相比,T2DM可能与血栓形成风险增加有关,表现为PT和INR降低以及PDW和MPV升高。应定期检测基本凝血指标和血小板参数,以便早期诊断和妥善管理糖尿病相关血栓形成。

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