Association Between Red Cell Distribution Width (Rdw) And HbA1c In Non-Anemic Patients With Type 2 Diabetes Mellitus

Öz

Aim: Diabetes mellitus (DM) is a complex disease characterized by chronic hyperglycemia that leads to complications affecting the kidneys, eyes, peripheral nerves, and micro- and macrovascular systems. Monitoring glycemic control is crucial for the prevention of these complications. Hemoglobin A1c (HbA1c) has long been used as the gold standard indicator of glycemic control. In recent years, red cell distribution width (RDW), one of the hematological parameters, has been associated with cardiovascular diseases, chronic kidney disease, and diabetes-related complications.The aim of this study was to evaluate the relationship between red cell distribution width (RDW) and HbA1c, as well as micro- and macrovascular complications, in patients with type 2 diabetes mellitus. In addition, the potential utility of RDW as a marker of microvascular complication risk was investigated. Materials and Methods: This retrospective study included 310 patients with type 2 diabetes mellitus and 328 healthy controls. Medical records of non-anemic patients were reviewed. Data regarding RDW, hemoglobin, creatinine, and microvascular complications (retinopathy assessed by ophthalmologic examination, nephropathy assessed by 24-hour or spot urine analysis, and neuropathy assessed by electromyography) were collected. Results: RDW levels were significantly higher in the diabetic group (13.92 ± 1.22) compared with the control group (12.77 ± 1.54) (p < 0.001). A significant positive correlation was observed between RDW levels and microalbuminuria in 24-hour urine samples (r = 0.291, p < 0.001). An RDW cut-off value of 13.47% predicted nephropathy with 73% sensitivity and 61% specificity (AUC = 0.689, p < 0.001). Conclusion: RDW was found to be associated with HbA1c in patients with type 2 diabetes mellitus. Among microvascular complications, only diabetic nephropathy was significantly associated with RDW levels.

Anahtar Kelimeler

• RDW
• diabetes
• HbA1c
• microvascular complications
• retinopathy
• nephropathy
• neuropathy

Anemisi Olmayan Tip 2 Diabetes Mellitus Hastalarında Eritrosit Dağılım Genişliği (RDW) ile HbA1c Arasındaki İlişki

Öz

Amaç: Diabetes mellitus (DM), böbrekleri, gözleri, periferik sinirleri ve mikro- ve makrovasküler sistemleri etkileyen komplikasyonlara yol açan kronik hiperglisemi ile karakterize kompleks bir hastalıktır. Bu komplikasyonların önlenmesinde glisemik kontrolün izlenmesi büyük önem taşımaktadır. Hemoglobin A1c (HbA1c), uzun süredir glisemik kontrolün altın standart göstergesi olarak kullanılmaktadır. Son yıllarda hematolojik parametrelerden biri olan eritrosit dağılım genişliği (RDW); kardiyovasküler hastalıklar, kronik böbrek hastalığı ve diyabete bağlı komplikasyonlarla ilişkilendirilmiştir. Bu çalışmanın amacı, tip 2 diabetes mellitus hastalarında RDW ile HbA1c düzeyleri ve mikro- ve makrovasküler komplikasyonlar arasındaki ilişkiyi değerlendirmektir. Ayrıca RDW’nin mikrovasküler komplikasyon riskini öngörmede bir belirteç olarak potansiyel kullanımı araştırılmıştır. Gereç ve Yöntem: Bu retrospektif çalışmaya tip 2 diabetes mellitus tanısı bulunan 310 hasta ve 328 sağlıklı kontrol dâhil edildi. Anemisi bulunmayan katılımcıların tıbbi kayıtları incelendi. RDW, hemoglobin ve kreatinin düzeyleri ile mikrovasküler komplikasyonlara ilişkin veriler toplandı. Retinopati oftalmolojik muayene, nefropati 24 saatlik veya spot idrar analizi ve nöropati elektromiyografi ile değerlendirildi. Bulgular: RDW düzeyleri diyabet grubunda (13,92 ± 1,22), kontrol grubuna (12,77 ± 1,54) kıyasla anlamlı olarak daha yüksekti (p < 0,001). RDW düzeyleri ile 24 saatlik idrarda mikroalbüminüri arasında pozitif yönde anlamlı bir korelasyon saptandı (r = 0,291; p < 0,001). RDW için %13,47 eşik değeri, nefropatiyi %73 duyarlılık ve %61 özgüllükle öngördü (AUC = 0,689; p < 0,001). Sonuç: Tip 2 diabetes mellitus hastalarında RDW’nin HbA1c ile ilişkili olduğu saptandı. Mikrovasküler komplikasyonlar arasında yalnızca diyabetik nefropati RDW düzeyleriyle anlamlı ilişki gösterdi.

Anahtar Kelimeler

• RDW
• diyabet
• HbA1c
• mikrovasküler komplikasyonlar
• retinopati
• nefropati
• nöropati.

Kaynakça

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