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Rafaqat S, Rafaqat S. Role of hematological parameters in pathogenesis of diabetes mellitus: A review of the literature. World J Hematol 2023; 10:25-41. [DOI: 10.5315/wjh.v10.i3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/03/2023] [Accepted: 03/09/2023] [Indexed: 03/22/2023] Open
Abstract
Diabetes mellitus (DM) is characterized by hyperglycemia and abnormalities in insulin secretion and activity. There are numerous hematological parameters; however, this review article only focuses on red blood cells, hemoglobin, hematocrit, red blood cell indices, platelet count, white blood cells, lymphocytes, neutrophils, monocytes, eosinophils, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio, which play an essential role in the pathogenesis of DM. Also, this review article aims to report the relationship between these hematological parameters and the development of DM. In con-clusion, this article shows that increased levels of platelets, red blood cells, hematocrit, lymphocytes, eosinophils, neutrophils, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio and decreased levels of hemoglobin are involved in the pathogenesis of DM. However, the role of basophils in DM is unknown yet.
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Affiliation(s)
- Sana Rafaqat
- Department of Biotechnology, Lahore College for Women University, Lahore 5400, Pakistan
| | - Saira Rafaqat
- Department of Zoology, Lahore College for Women University, Lahore 5400, Pakistan
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Wu TY, Liao EC, Chen YL, Lin YF, Liu SH, Lin HC, Chiu YC, Wu CZ, Lin JD, Pei D, Hsu CH. Elevated alanine aminotransferase is associated with biphasic insulin secretion in the healthy elderly Han Chinese population. J Int Med Res 2022; 50:3000605221115161. [PMID: 36124931 PMCID: PMC9511325 DOI: 10.1177/03000605221115161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between alanine transaminase (ALT) level and biphasic insulin secretion (BPIS) in healthy elderly Han Chinese individuals. METHODS This cross-sectional study enrolled healthy elderly participants aged ≥60 years that were part of a health examination programme. In order to explore the correlation and severity of the clinical condition, those with any possible confounding factors known to affect insulin secretion or liver function were excluded from the study. BPIS was calculated using an equation developed previously by this research team. RESULTS This study enrolled 39 845 healthy elderly individuals (19 058 males and 20 787 females). Participants were stratified into four quartile groups according to their ALT level. In both males and females, the increasing ALT quartiles (ordinal variable) were associated with greater values of log-transformed first-phase insulin secretion (FPIS) and second-phase insulin secretion (SPIS). The correlation and the linear regression model showed that increasing ALT level was significantly correlated with higher log-transformed FPIS and SPIS. CONCLUSIONS ALT was positively correlated with BPIS in a healthy elderly population in both men and women. Elevated ALT may serve as an indicating factor for developing metabolic syndrome and type 2 diabetes mellitus in healthy elderly individuals.
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Affiliation(s)
- Tzong-Yow Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei
| | - En-Chih Liao
- Department of Medicine, MacKay Medical College, New Taipei.,Institute of Biomedical Sciences, MacKay Medical College, New Taipei
| | - Yen-Lin Chen
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Centre, Taipei.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei
| | - Yung-Feng Lin
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei
| | - Shu-Hsiang Liu
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Science, Taipei
| | - Hua-Ching Lin
- Department of Surgery, Division of Colorectal Surgery, Cheng Hsin General Hospital, Taipei.,Department of Healthcare Information and Management, Ming Chuan University, Taoyuan
| | - Yi-Chou Chiu
- Department of Surgery, Division of General Surgery, Cheng Hsin General Hospital, Taipei
| | - Chung-Ze Wu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Shuang Ho Hospital, Taipei Medical University, New Taipei.,Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Jiunn-Diann Lin
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Shuang Ho Hospital, Taipei Medical University, New Taipei.,Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Dee Pei
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei.,Department of Internal Medicine, Division of Endocrinology and Metabolism, Fu Jen Catholic University Hospital, New Taipei
| | - Chun-Hsien Hsu
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei.,Department of Family Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei.,Department of Family Medicine, Cardinal Tien Hospital, New Taipei
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Chen JY, Chen YH, Lee YC, Tsou MT. The Association Between White Blood Cell Count and Insulin Resistance in Community-Dwelling Middle-Aged and Older Populations in Taiwan: A Community-Based Cross-Sectional Study. Front Med (Lausanne) 2022; 9:813222. [PMID: 35252251 PMCID: PMC8892182 DOI: 10.3389/fmed.2022.813222] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/27/2022] [Indexed: 12/11/2022] Open
Abstract
BackgroundInsulin resistance (IR) is a major pathophysiological factor in the development and progression of diabetes mellitus (DM). DM is highly prevalent in Taiwan and has become one of the most common health problems in family medicine and primary care. We aimed to use white blood cell count (WBC), a common physiological parameter, to develop a simple clinical prediction rule for IR in the middle-aged and old Taiwanese population.MethodsIn this cross-sectional community-based study, the participants completed a questionnaire comprising personal and medical history data and underwent anthropometric measurements and blood sampling. IR was defined as a HOMA-IR index ≥2. Independent t-test, Mann–Whitney U test, chi-square test, Pearson's correlation test, multivariate binary logistic regression, and receiver operating characteristic curves were used to evaluate the association between the WBC count and IR.ResultsA total of 398 community-dwelling middle-aged and older persons (34.9% men) with a mean age of 64.43 ± 8.45 years were enrolled for the analysis. A significant association was identified between the WBC counts and IR, with a Pearson's correlation coefficient of 0.37 (p-value <0.001). Multivariate logistic regression revealed that WBC count (OR = 1.50; 95% CI = 1.25–1.81) was an independent risk factor for IR after adjusting for confounding variables. The area under the receiver operating characteristic curve for WBC count was 0.67, and the optimal threshold value was 5.65 1,000/uL.ConclusionA high WBC count is positively related to an increased risk of IR among middle-aged and older people in Taiwan.
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Affiliation(s)
- Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yun-Hung Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Yu-Chien Lee
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Meng-Ting Tsou
- Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Occupation Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
- *Correspondence: Meng-Ting Tsou
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Mann JFE, Buse JB, Idorn T, Leiter LA, Pratley RE, Rasmussen S, Vilsbøll T, Wolthers B, Perkovic V. Potential kidney protection with liraglutide and semaglutide: Exploratory mediation analysis. Diabetes Obes Metab 2021; 23:2058-2066. [PMID: 34009708 PMCID: PMC8453827 DOI: 10.1111/dom.14443] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/04/2021] [Accepted: 05/16/2021] [Indexed: 12/14/2022]
Abstract
AIMS To investigate whether effects on chronic kidney disease risk factors could explain the apparent reduction in kidney outcomes (composite of macroalbuminuria, doubling of serum creatinine, renal replacement therapy, or renal death), primarily driven by changes in albuminuria, after treatment with the glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide in patients with type 2 diabetes in the LEADER and SUSTAIN 6 trials. MATERIALS AND METHODS We evaluated the mediation effect of glycated haemoglobin (HbA1c), systolic blood pressure (BP), and body weight on the kidney effects of GLP-1RAs. Diastolic BP, haemoglobin, heart rate, low-density lipoprotein and total cholesterol, and white blood cell count were also investigated. The mediation effect was estimated by the novel Vansteelandt statistical method. Subgroups with estimated glomerular filtration rate (eGFR) <60 and ≥60 mL/min/1.73 m2 were examined in LEADER. RESULTS We observed that HbA1c mediated 25% (95% confidence interval [CI] -7.1; 67.3) and 26% (95% CI noncalculable), and systolic BP 9% (95% CI 2.8; 22.7) and 22% (95% CI noncalculable) of kidney effects of GLP-1RAs in LEADER and SUSTAIN 6, respectively. Small or no mediation was observed for the other parameters; for example, body weight mediated 9% (95% CI -7.9; 35.5) in the former and did not mediate effects in the latter study. Mediation by HbA1c was greater in patients with eGFR ≥60 mL/min/1.73 m2 (57%) versus those with eGFR <60 mL/min/1.73 m2 (no mediation). CONCLUSIONS Our results suggest that HbA1c and systolic BP may moderately mediate kidney benefits of liraglutide and semaglutide, with all other variables having a small to no effect. Potential kidney benefits may be driven by other mediators or potentially by direct mechanisms.
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Affiliation(s)
- Johannes F. E. Mann
- Department of NephrologyFriedrich Alexander University of ErlangenErlangenGermany
- KfH Kidney CentreMunichGermany
| | - John B. Buse
- University of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | | | - Lawrence A. Leiter
- Li Ka Shing Knowledge Institute, St. Michael's HospitalUniversity of TorontoTorontoOntarioCanada
| | | | | | - Tina Vilsbøll
- Steno Diabetes Centre CopenhagenGentofteDenmark
- Gentofte HospitalHellerupDenmark
- University of CopenhagenCopenhagenDenmark
| | | | - Vlado Perkovic
- The George Institute, UNSWSydneyNew South WalesAustralia
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Zhang Y, Zhang Y, Zhao L, Shang Y, He D, Chen J. Distribution of complete blood count constituents in gestational diabetes mellitus. Medicine (Baltimore) 2021; 100:e26301. [PMID: 34115037 PMCID: PMC8202579 DOI: 10.1097/md.0000000000026301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND TRIAL DESIGN The incidence rate of gestational diabetes is high. In the long run, it harms the health of both the mother and child. In order to understand the distribution of hematological cells with gestational diabetes mellitus (GDM), a longitudinal cohort study was conducted from 2012 to 2018. METHODS A longitudinal case control study of 1860 pregnant women was conducted between 2012 and 2018. Data of hematological parameters at 11 time points of gestational stage were obtained from a laboratory database. Repeated measures analysis and independent t-test were used to analyze the effect of the hematological parameters on GDM. RESULTS The trend of blood cells fluctuated with gestational age in normal controls but was more remarkable in GDM. Compared with the controls, blood neutrophils, lymphocytes, and monocytes augmented in the second trimester but decreased in the third trimester; platelet (PLT) and thrombocytocrit increased throughout the three trimesters, and red blood cell (RBC) was abundant in the last 2 trimesters in GDM. CONCLUSIONS Peripheral blood leukocytes, platelets, and erythrocytes were significantly different during gestation between GDM and normal controls. Inflammation may also be involved in GMD.
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Affiliation(s)
| | | | - Limin Zhao
- Scientific Research Management Department, Shenzhen Longhua District Central Hospital, Guangdong Medical University, Shenzhen
| | - Yanyan Shang
- Department of Clinical Laboratory, Cancer Center of Guangzhou Medical University, Guangzhou
| | - Dabao He
- Department of Clinical Laboratory
| | - Jiying Chen
- Department of Obstetrics and Gynecology, Shenzhen Longhua District Central Hospital, Guangdong Medical University, Shenzhen, Guangdong, China
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