Vitamin D and Hematological Indicators of Inflammation in Prediabetes
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Abstract
Objectives: Prediabetes is characterized by the presence of inflammation. Hematological parameters provide the advantageous qualities of being cost-effective and readily reproducible, rendering them highly helpful for the purpose of disease surveillance. The impact of vitamin D on inflammatory mediators and its role in the progression from prediabetes to type 2 diabetes has been seen. This study aims to investigate hematological markers, glycemic management, and vitamin D status among individuals with prediabetes.
Methods: A retrospective investigation was performed on a cohort of 270 persons with prediabetes (5.7-6.4% glycated hemoglobin levels) and 299 participants with normal blood glucose levels. In order to conduct a comparison of hematological indicators between two groups, statistical analyses including chi square analysis and the t test were employed. The analysis of variance (ANOVA) statistical method was employed to analyze the components within three distinct categories of Vitamin D levels: acceptable (more than 75 nmol/L), inadequate (ranging from 50 to 74.9 nmol/L), and deficient (50 nmol/L). The odds ratio for prediabetes was obtained through the utilization of regression analysis.
Results: The study observed a statistically significant decrease in vitamin D levels among individuals with prediabetes (mean 57.91 ± 20.83, p = 0.05). The group of individuals with prediabetes exhibited significantly higher values for the neutrophil lymphocyte ratio (2.10 ± 0.85; p = 0.05), platelet lymphocyte ratio (137.70 ± 43.70; p = 0.05), mean platelet volume (8.55 ± 3.00; p = 0.001), and red cell distribution width (12.65 ± 1.31; p = 0.05). The present study observed a statistically significant positive correlation between declining levels of vitamin D and increasing trends in the neutrophil lymphocyte ratio, platelet lymphocyte ratio, and red cell distribution width in individuals with prediabetes. The study revealed that the mean platelet volume had a noteworthy association with the development of prediabetes.
Conclusions: The neutrophil lymphocyte ratio, platelet lymphocyte ratio, red cell distribution width, and mean platelet volume are emerging inflammatory markers that can be employed for monitoring purposes in patients with prediabetes. However, it is important to note that these indicators should be utilized in combination with an assessment of Vitamin D status.
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References
Aksoy H, Akçay F, Kurtul N, Baykal O, Avci B. Serum 1, 25 dihydroxy vitamin D (1, 25 (OH) 2D3), 25 hydroxy vitamin D (25 (OH) D) and parathormone levels in diabetic retinopathy. Clin Biochem 2000; 33(1):47-51.
Aktas G, Kocak MZ, Duman TT, Erkus E, Atak BM, Sit M, Savli H. Mean Platelet Volume (MPV) as an inflammatory marker in type 2 diabetes mellitus and obesity. Bali Med J 2018; 7(3):650-3.
Alam J, Chandra SM, Mokarrama MN, Hoque M, Hasan M, Islam S. A comparative analysis of biochemical and hematological parameters in diabetic and non-diabetic adults. Int J AMS 2015; 2(1): 1-9.
Aldossari K, Aljowair AM, Alqahtani NT, Al-shiprain MS, Al-shathri MM, Alshehri DA. Association between low vitamin D level and glycemic control. Prim Care Diabetes 2017; 11;e5.
Atak B, Aktas G, Duman TT, Erkus E, Kocak MZ, Savli H. Diabetes control could through platelet-to-lymphocyte ratio in hemograms. Rev Assoc Med Bras 2019 ; 65(1):3 8-42
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno‐modulator. Immunology 2011; 134(2):123-39.
Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 2011 (2): 98-107
Donath MY. Multiple benefits of targeting inflammation in the treatment of type 2 diabetes. Diabetologia 2016; 59(4): 679-82.
Duman TT, Aktas G, Atak BM, Kocak MZ, Erkus E, Savli H. Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. Afr Health Sci 2019; 19(1): 1602-6.
Garbossa SG, Folli F. Vitamin D, sub-inflammation and insulin resistance. A window on a potential role for the interaction between bone and glucose metabolism. Rev Endocr Metab Disord 2017; 18(2): 243-58
Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357(3):266-81.
Hostalek U. Global epidemiology of prediabetes-present and future perspectives. Clin Diabetes Endocrinol 2019 (1):1- 5.
Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ, 2016; 355.
Inoue H, Saito M, Kouchi K, Asahara SI, Nakamura F, Kido
Y. Association between mean platelet volume in the pathogenesis of type 2 diabetes mellitus and diabetic macrovascular complications in Japanese patients. J Diabetes Investig 2020; 11(4): 938-45.
Karonova T, Stepanova A, Bystrova A, Jude EB. High-dose vitamin D supplementation improves microcirculation and reduces inflammation in diabetic neuropathy patients. Nutrients. 2020; 12(9): 2518.
Korf H, Wenes M, Stijlemans B, Takiishi T, Robert S, Miani M, Eizirik DL, Gysemans C, Mathieu C. 1, 25- Dihydroxyvitamin D3 curtails the inflammatory and T cell stimulatory capacity of macrophages through an IL-10- dependent mechanism. Immunobiol 2012; 217(12):1292-300.
Malandrino N, Wu WC, Taveira TH, Whitlatch HB, Smith RJ. Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes. Diabetologia 2012 (1): 226-35.
Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr 2017; 11:S127-31.
Pippitt K, Li M, Gurgle HE. Diabetes mellitus: screening and diagnosis. Am Fam Physician 2016; 93(2): 103-9.
Sahajpal NS, Goel RK, Chaubey A, Aurora R, Jain SK. Pathological perturbations in diabetic retinopathy: hyperglycemia, AGEs, oxidative stress and inflammatory pathways. Curr Protein Pept Sci 2019; 20(1):92-110.
Shankar A, Sabanayagam C, Kalidindi S. Serum 25- hydroxyvitamin d levels and prediabetes among subjects free of diabetes. Diabetes care 2011; 34(5):1114-9.
Sherif, H., Ramadan, N., Radwan, M., Hamdy, E., & Reda,
R. Red cell distribution width as a marker of inflammation in type 2 diabetes mellitus. Life Sci J 2013; 10(3): 1501-1507.
Shiny A, Bibin YS, Shanthirani CS, Regin BS, Anjana RM, Balasubramanyam M, Jebarani S, Mohan V. Association of neutrophil-lymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther 2014; 16(8):524-30.
Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki
M. Prediabetes: a high-risk state for diabetes development. The Lancet 2012; 379(9833): 2279-90.
Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009; 63(10):1509-15.
Xia C, Rao X, Zhong J. Role of T lymphocytes in type 2 diabetes and diabetes-associated inflammation. J Diabetes Res 2017; 2017.
Yin Y, Ye S, Wang H, Li B, Wang A, Yan W, Dou J, Mu Y. Red blood cell distribution width and the risk of being in poor glycemic control among patients with established type 2 diabetes. Ther Clin Risk Manag 2018; 14:265.
Zhang Y, Leung DY, Richers BN, Liu Y, Remigio LK, Riches DW, Goleva E. Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. J Immunol 2012; 188(5):2127-35.
Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J 2008; 49(2):114.