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埃塞俄比亚东北德西综合专科医院 2 型糖尿病患者与健康对照者的血液学参数比较:横断面比较研究。

Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital, Northeast Ethiopia: Comparative cross-sectional study.

机构信息

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

Department of Medical Laboratory Sciences, Dessie Health Science College, Dessie, Ethiopia.

出版信息

PLoS One. 2022 Jul 27;17(7):e0272145. doi: 10.1371/journal.pone.0272145. eCollection 2022.

Abstract

BACKGROUND

Diabetes mellitus (DM) is a chronic condition associated with raised levels of blood glucose due to the body cannot produce any or enough insulin hormone or cannot be effectively utilized the produced insulin by the body. Patients with poorly controlled diabetes show a significant alteration in various parameters including metabolic, cellular, immunological, and hematological disturbances that leads to vascular complications. Thus, the main aim of this study is to compare hematological parameters between type 2 diabetes mellitus (T2DM) patients and healthy controls.

METHODS

A comparative cross-sectional study was conducted in Dessie comprehensive specialized hospital from January to June 2021. A total of 240 study participants consisting of 120 T2DM patients and 120 healthy controls were recruited using a systematic random sampling technique. Hematological parameters were determined using the DIRUI BF6500 automated hematology analyzer. Independent T-test was used to compare the mean of hematological parameters between T2DM patients and healthy controls. Pearson correlation test was used to determine the correlation between FBG, BMI, SBP, DBP, and hematological parameters in T2DM patients. Multivariate logistic regression was used to assess the association between socio-demographic and clinical variables with anemia. The result was expressed in mean and standard deviation and presented in texts and tables. P-value < 0.05 was considered to be statistically significant.

RESULTS

The mean and standard deviation of monocyte count, basophil count, monocyte %, basophil %, RBC count, hematocrit, MCV, MCH, RDW-SD, MPV, PDW, PLC-R, and plateletcrit showed a significant difference between T2DM patients and healthy control group. Pearson correlation coefficient showed that the total WBC count, neutrophil count, monocyte count, basophil count, RDW-CV, PDW, MPV, PLC-R, and plateletcrit were statistically positively correlated with FBG whereas RBC count, Hgb, hematocrit, MCV, MCH, and RDW-SD were statistically negatively correlated with FBG in T2DM patients. Moreover, total WBC count, neutrophil count, monocyte count, basophil count, Hgb, and plateletcrit were statistically positively correlated with BMI while RBC count, Hgb, hematocrit, MCV, MCH, and RDW-SD were statistically negatively correlated with BMI in T2DM patients. On the other hand, DBP was significantly positively correlated with platelet count and RDW-CV whereas SBP also significantly positively correlated with total WBC count, neutrophil count, basophil count, and PDW. Besides, DBP and SBP showed statistically significant negative correlations with RBC count, Hgb level, and Hct value in T2DM patients. The overall prevalence of anemia was 25.8% in T2DM patients with a higher prevalence of anemia (16.7%) in female patients. Multivariate logistic regression revealed that being non-employee worker (AOR: 3.6, 95% CI, 1.4-46.0, P = 0.002), presence of neuropathy (AOR: 13.40, 95% CI, 6.83-26.28, P = 0.00), and duration of the disease ≥ 5 years (AOR = 3.2, 95% CI, 1.2-15.3, P = 0.03) have had statistically significant association with anemia inT2DM patients.

CONCLUSIONS

Patients with T2DM may have significant alterations in various hematological parameters. Hematological parameters should be regularly tested for early diagnosis and proper management of diabetes-related complications.

摘要

背景

糖尿病(DM)是一种由于身体无法产生或有效利用产生的胰岛素而导致血糖水平升高的慢性疾病。控制不佳的糖尿病患者表现出代谢、细胞、免疫和血液学紊乱等多种参数的显著改变,导致血管并发症。因此,本研究的主要目的是比较 2 型糖尿病(T2DM)患者和健康对照组之间的血液学参数。

方法

本研究为 2021 年 1 月至 6 月在德西综合专科医院进行的一项比较性横断面研究。采用系统随机抽样技术,共招募了 240 名研究参与者,包括 120 名 T2DM 患者和 120 名健康对照者。使用 DIRUI BF6500 自动血液分析仪测定血液学参数。采用独立 T 检验比较 T2DM 患者和健康对照组之间血液学参数的平均值。采用 Pearson 相关检验确定 T2DM 患者中 FBG、BMI、SBP、DBP 与血液学参数之间的相关性。采用多元逻辑回归评估社会人口学和临床变量与贫血的相关性。结果以平均值和标准差表示,并以文本和表格形式呈现。P 值<0.05 被认为具有统计学意义。

结果

T2DM 患者与健康对照组之间单核细胞计数、嗜碱性粒细胞计数、单核细胞%、嗜碱性粒细胞%、红细胞计数、血细胞比容、MCV、MCH、RDW-SD、MPV、PDW、PLC-R 和血小板比容的平均值和标准差均存在显著差异。Pearson 相关系数显示,T2DM 患者中总白细胞计数、中性粒细胞计数、单核细胞计数、嗜碱性粒细胞计数、RDW-CV、PDW、MPV、PLC-R 和血小板比容与 FBG 呈统计学正相关,而红细胞计数、Hgb、血细胞比容、MCV、MCH 和 RDW-SD 与 FBG 呈统计学负相关。此外,总白细胞计数、中性粒细胞计数、单核细胞计数、嗜碱性粒细胞计数、Hgb 和血小板比容与 BMI 呈统计学正相关,而红细胞计数、Hgb、血细胞比容、MCV、MCH 和 RDW-SD 与 BMI 呈统计学负相关。另一方面,DBP 与血小板计数和 RDW-CV 呈显著正相关,而 SBP 也与总白细胞计数、中性粒细胞计数、嗜碱性粒细胞计数和 PDW 呈显著正相关。此外,DBP 和 SBP 与 T2DM 患者的红细胞计数、Hgb 水平和 Hct 值呈统计学显著负相关。T2DM 患者贫血总患病率为 25.8%,女性患者贫血患病率(16.7%)更高。多元逻辑回归显示,非雇员(AOR:3.6,95%CI,1.4-46.0,P=0.002)、神经病变(AOR:13.40,95%CI,6.83-26.28,P=0.00)和疾病持续时间≥5 年(AOR=3.2,95%CI,1.2-15.3,P=0.03)与 T2DM 患者贫血有统计学显著关联。

结论

T2DM 患者可能存在多种血液学参数的显著改变。应定期检测血液学参数,以便早期诊断和妥善管理糖尿病相关并发症。

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