Diabetes, Metabolic Syndrome and Obesity (Feb 2024)
Association of Hematological Parameters and Diabetic Neuropathy: A Retrospective Study
Abstract
Aysha A AlShareef,1,2,* Moafaq S Alrawaili,1,2,* Salwa Awwadh Almutairi,3 Mustafa Mohammad Ayyad,3 Weam Alshora4 1Department of Neurology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Neurology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Family Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia*These authors contributed equally to this workCorrespondence: Moafaq S Alrawaili, Department of Neurology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia, Tel +966547900080, Fax +966126128188, Email [email protected]: Diabetic neuropathy (DN) is a common complication of type 2 diabetes (T2DM) and is characterized by persistent inflammation. Hematological parameters have emerged as a novel marker for detecting chronic inflammatory conditions, including diabetes.Aim: We aim to examine the association between HbA1c levels, which can indicate the presence of diabetic neuropathy, and hematological parameters to explore the possibility of using hematological parameters as a new indicator for DN in T2DM patients.Methods: This was a retrospective study of 768 (483 males and 284 females) medical records of adult T2DM patients with or without neuropathy who attending the outpatient neuromuscular clinic at King Abdul-Aziz University Hospital from January 2016 to December 2021.Results: The results showed significant increases in HbA1c levels (p=0.000), lymphocyte levels (p=0.028), and the neutrophil-lymphocyte ratio (NLR) (p=0.011). In the T2DM group, HBA1C levels were found to be positively correlated with age (r=0.306, p=0.000), neutrophil (NEUT) (r=0. 287, p=0.000), platelet (PLT) (r=0. 148, p=0.039), and neutrophil-lymphocyte ratio (NLR) (r=0.306193, p=0.0007), and negatively correlated with gender (r=− 0.306193, p=0.0007). In the T2DMN group, HBA1C levels showed a positive correlation with hemoglobin (HB) (r=0.084, p=0.045), PLT (r=0.087, p=0.037), and PLT/mean corpuscular hemoglobin (MCH) ratio (PLT/MCH ratio) (r=0.12, p=0.004), and a negative correlation with age (r=− 0.204, p=0.000), gender (r=− 0.086, p=0.041), weight (WT) (r=− 0.113, p=0.007), Body Surface Area (BSA) (r=− 0.09, p=0.031), mean corpuscular volume (MCV) (r=− 0.292, p=0.000), and MCH (r=− 0.186, p=0.000).Conclusion: Our study found a significant association between HbA1c, a biomarker for diabetic neuropathy, and various hematological parameters (HB, MCV, MCH, PLT, PLT/MCH ratio) in T2DMN patients. By effectively controlling and monitoring these variables, it may be feasible to prevent or delay the progression of peripheral neuropathy in diabetic patients. However, further research is needed to validate these findings.Plain Language Summary: DN is nerve damage induced by elevated blood glucose levels in T2DM. It is a common condition that affects patients by increasing the chance of falling, causing discomfort, and decreasing their quality of life. It is one of the most ubiquitous consequences of diabetes. Symptoms include limb numbness, tingling, weakness, and severe pain and sensitivity. Long-term microvascular effects of diabetes mellitus include retinopathy, nephropathy, and neuropathy. This study was done to evaluate the effects of DN on hematological parameters. The haematological parameters study aims to identify a relationship between HbA1c and DN. The researchers determined clinical data through clinical records including age, gender, WT, BSA, and laboratory data included HbA1c, HB, MCHC, MCV, MCH, PLT, RDW, HCT, NEUT, LYMPH, NLR, PLR, and PLT/MCH ratio. Statistical analysis was applied after data collection. As a result, this retrospective study identified both positive and negative correlations between HbA1c, a biomarker for diabetic neuropathy, and haematological variables in diabetic patients with neuropathy, including HB, MCV, MCH, PLT, and the PLT/MCH ratio. This finding may be used as a prognostic indicator of DN. It is crucial to manage and monitor blood sugar levels for effective treatment of this dangerous condition. Doctors advise regular walking and mild exercise to reduce neuropathy discomfort, build muscle, and regulate blood sugar levels. An in-depth investigation is required to validate the function of these parameters.Keywords: diabetic neuropathy, HbA1C, hematological profile, peripheral neuropathy, microvascular complications
