https://orcid.org/0009-0000-5673-8061
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Abstract
Background
Diabetes is a chronic metabolic syndrome that is a global public health problem. Studies have used hematological parameters and hemogram-derived markers as predictors of poor glycemic and microvascular complications status in diabetics. However, the tendency to use these parameters is not fully evaluated in our context, and the evidence is inadequate. This study aimed to assess the hematological profiles and prognostic role of hemogram-derived novel markers in diabetes mellitus and its complications among DM patients at Bishoftu General Hospital, Ethiopia.
Methods
A comparative cross-sectional study was conducted among 261 participants from June 15 to August 12, 2022. A systematic random sampling technique was used to select participants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Hematological parameters and fasting blood glucose levels were determined from blood using Sysmex-XN550 and Cobas C311 analyzers, respectively. Blood smear was used to check Hematology analyzer output, and to screen participants for malaria parasites. Collected data were entered into Epi-data 3.1 and exported to SPSS-25. Data were analyzed by Chi-square, Mann–Whitney U-test, Kruskal–Wallis test, Post hoc test, and ROC curve. A P-value <0.05 was considered statistically significant.
Results
Total WBC, neutrophils, Monocyte, NLR, MLR, MPVLR, and PLR were significantly higher in poor glycemic and complicated T2DM; meanwhile, measured RBC parameters, RBC indices values were significantly lower in poor glycemic and complicated T2DM. The NLR, MLR, MPVLR, PLR, and NLR, MLR, MPVLR, RPR values were identified as predictors of poor glycemic and complication status in diabetic patients, respectively.
Conclusion
Significant increment of some hematological parameters and hemogram-derived markers, and their role in predicting poor glycemic and microvascular complications were identified in diabetic patients. Routine screening of hematological parameters and use of hemogram-derived markers for monitoring of altered health status in DM is very important in the improvement of patient quality of life.
Abbreviations
AIDS, Acquired Immune Deficiency Syndrome; ADA, American Diabetes Association; ART, Ant-retrovirus treatment; BP, Blood Pressure; BMI, Body Mass Index; CBC, Complete Blood Count; DM, Diabetes Mellitus, K2-EDTA, Dipotassium Ethylene-Diamine Tetra-acetic Acid; FBS, Fasting Blood Glucose; HC, Hip-Circumference; HIV, Human Immune Virus; HBV/C, Hepatitis virus B or C; IDF, International Diabetes Federation; IQR, Interquartile Range; MPV, Mean Platelets Volume; MLR, monocyte to lymphocyte ratio; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; MCV, mean corpuscular volume; MPVLR, Mean platelet volume to lymphocyte ratio; NLR, neutrophils to lymphocyte ratio; RDW, red blood cells width; RPR, red blood cells width to platelet count ratio; ORS, Oromia Regional State; PCT, Platelets crit; PDW, Platelets Distribution Width; PLT, Platelets; P, LCR-Platelet Large Cell Ratio; ROC, Receiver Operating Characteristic curve; RBC, Red Blood cells; SBP, Systolic Blood Pressure; SPSS, Statistical Package for Social Sciences, T2DM, Type 2 Diabetes Mellitus; US$, United State Dollar; WBC, White Blood Cell; WC, Waist Circumference; WHO, World Health Organization; WHR, Waist to Hip Ratio.
Data Sharing Statement
The datasets analyzed during the current study are available from the corresponding author upon reasonable request.
Ethics and Information Consent to Participate
The study was conducted following the Declaration of Helsinki and an approved ethical clearance was obtained from the Institutional Review Board of the Jimma University Institute of Health under Ref.No.IHPPGJ/84412 at date:30/05/2022. A supplementary letter, with Ref.No.BEFO10339/2022, was also obtained from the Oromia Regional Office, Department of Research Review Board, and submitted to the Bishoftu General Hospital administration office and was directed to the medical laboratory head and chronic clinic head offices. It was then sent to both headquarters along with a letter of support from the School of Medical Laboratory Sciences, Jimma University.
After obtaining permission from the Hospital administrator, the head of the Chronic Clinic care unit, and the head of the medical laboratory, a clear explanation of the study’s objectives, procedures, benefits, possible risks, and the participant’s right to voluntarily participate, written informed consent was obtained from each study subject. Codes were used instead of participants’ names to protect the confidentiality of obtained data, and unauthorized person access to the collected data was prohibited.
Acknowledgments
All authors would like to thank Jimma University, Bishoftu General Hospital staff members, all data collectors, supervisors, study participants, and questionnaire translators for their assistance in conducting this study.
Author Contributions
All authors made a significant contribution to the work reported in the conception, study design, execution, acquisition, analysis, and interpretation of data; took part in the drafting, revising, or critical reviewing of the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.
Disclosure
The authors declare no conflicts of interest in this study.