Red blood cell count as an indicator of microvascular complications in Chinese patients with type 2 diabetes mellitus

Abstract

BackgroundRheological disorders of red blood cells (RBC) and decreased RBC deformability have been involved in the development of diabetic microangiopathy. However, few studies have evaluated the association of RBC count with microvascular complications in patients with type 2 diabetes mellitus (T2DM). The purpose of this study was to investigate the association of RBC count with microvascular complications in patients with T2DM.MethodsThis study involved 369 patients with T2DM: 243 with one or more microvascular complications and 126 without microvascular complications. Anticoagulated blood was collected and analyzed in an automated blood cell counter. The presence of risk factors for microvascular complications was determined.ResultsThe proportion of patients with microvascular complications increased as the RBC count decreased (P < 0.001). After adjustment for known risk factors for microvascular complications by logistic regression analysis, lower quartiles of RBC count were associated with a higher risk of microvascular complications compared with the reference group composed of the highest quartile (first quartile, odds ratio 4.98, 95% confidence interval 1.54–6.19, P = 0.008; second quartile, odds ratio 3.21, 95% confidence interval 1.17–5.28, P = 0.024).ConclusionA decreased RBC count is associated with microvascular complications in Chinese patients with T2DM. The RBC count is a potential marker to improve further the ability to identify diabetic patients at high risk of microvascular complications.

Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia

“…In contrast to this study, a study conducted on Chinese patients with T2DM reported that a decreased RBC count is associated with microvascular complications. 33 Likewise, a study performed in Tobago (Caribbean) reported that RBC count, Hgb concentration, and Hct levels in T2DM patients are lower than in the control group. 34 The possible hypothesis for this difference might be that chronic hyperglycemia causes nonenzymatic glycosylation of RBC membrane proteins leading to accelerated aging of RBCs.…”

The Impact of Glycemic Status and Metformin Administration on Red Blood Cell Indices and Oxidative Stress in Type 2 Diabetic Patients

“…Also, the erythrocytes (RBCs) count revealed a significant decrease in patients treated with metformin plus insulin. The decrease in RBCs counts in diabetic patients may be due to RBC membrane protein alterations, a decrease in hemoglobin levels and erythropoietin deficiency (13). Hemoglobin is the major component of erythrocytes; thus, when the HbA1c level is elevated, hyperglycemia may increase the β-sheet structure content of Hb causing it to aggregate which subsequently increases WBV (19).…”

“…Red blood cells (RBCs) count is a pivotal marker for the ability to recognise diabetic patients at risk of microvascular complications. Lower RBCs counts are, therefore, considered as an independent predictor biomarker of the risk of microvascular complications in T2DM patients (13). Additionally, erythrocytes of diabetic patients aggregate more readily that is obviously enhance whole-blood viscosity (WBV), and adversely influence the microcirculation and finely leading to microangiopathy (14).…”

Increased 8-hydroxy-2’-deoxyguanosine in leukocyte DNA from patients with type 2 diabetes and microangiopathy

“…Finally, a larger number of markers of oxidative stress measured within the same study would provide a more complete picture of oxidative stress and microangiopathy in type 2 diabetes. 39 , 40 …”