Background: Role of hematological indices in the development of micro and macrovascular complication is well established but study comparing hematological indices in patients of diabetes with and without hypertension is lacking.
Aims and Objective: To compare the hematological parameters among diabetes patients with and without hypertension and to compare hematological parameters with extend of glycemic control among diabetes patients. Correlation of hematological parameters with renal function test was also done.
Materials and Methods: A prospective study including 141 patients in the Department of Medicine, Mayo Institute of Medical sciences, Baranaki between January 2016 to May 2016 was done. Diabetic patients were divided in to those with hypertension and without hypertension. Patients were also divided as good control (HbA1c <7%), poor control (HbA1c between 7-9%) and uncontrolled (HbA1c >9). Red blood cell indices such as total red blood cells (RBCs), hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and red blood cell distribution width (RCDW) were estimated and in platelet indices; platelet count (PLT), mean platelet volume (MPV) and platelet large cell ratio (PLCR) were estimated. Iron, tranferin saturation (TS) and total iron-binding capacity (TIBC) were also estimated in present study. Correlation between renal function test (RFT) and hematological parameters were also performed.
Results: Out of 141 patients, 42 (29.79%) were having diabetes alone whereas 99 (70.21%) diabetics were having hypertension. Mean age (year), height (meter), weight (kg), BMI (kg/m2), fasting blood glucose (mg/dl), post prandial blood glucose (mg/dl), HbA1c (%) and average blood glucose (mg/dl) were 47.24±11.02 vs 54.87±10.15, 6.36±28.66 vs 4.95±23.34, 69.52±13.64 vs 72.34±13.46, 24.73±6.30 vs 26.76±5.71, 147.68±45.94 and 140.44±42.29, 252.16±91.67 vs 230.85±78.10, 9.11±2.24 vs 8.19±1.81 and 220.91±69.55 vs 189.08±52.33 in patients of diabetes alone and hypertensive diabetics respectively. Total RBC (106/μL) (4.78±0.70 vs 4.39±1.06), PCV (%) (43.85±4.58 vs 40.46±7.92) and PLT (103/μL) (216.16±82.59 vs 185.66±54.38) were significantly higher in patients with diabetes alone as compared to hypertensive diabetics respectively (p<0.05) whereas, RCDW (%) (42.58±16.80 vs 51.56±12.02) was significantly higher in hypertensive diabetics as compared to patients with diabetes only (P<0.05). Significant difference was obtained for RCDW, PDW, MPV, PLT and PCT between patients with good, poor and uncontrolled diabetes mellitus (p<0.05). Hemoglobin was negatively correlated with blood urea (r=-0.418, p=<0.0001) and uric acid (r=-305, p=0.001) and positively correlated with calcium (0.310, p=0.001). PCV was negatively correlated with blood urea (r=-0.266, p=0.004) and uric acid (r=-0.356, p=<0.0001) whereas it was positively correlated with calcium (r=0.202, p=0.032). A negative correlation was found between MCV and blood urea(r=-0.204, p=0.023), RCDW and blood urea (r=-0.296, p=0.001) and PLT and calcium (r=-0.261, p=0.005).Conclusion: Patients with diabetes had high level of total RBC, PCV and PLT whereas patients with hypertension and diabetes were having higher values of RCDW. Patients with uncontrolled diabetes have significantly higher RCDW, PDW, MPV, PLT and PCT as compared to patients with good control. Patients with low Hb level were found to have elevated renal function test parameters in patients with diabetes.