Basit Bir Tam Kan Sayımı Gestastonel Diyabetes Mellitusu Öngörebilir Mi?

Yıl 2020, , 336 - 341, 30.09.2020

Pelin Aytan , Seyran Bozkurt Babuş , Özde Sakarya , Revan Sabri Çiftçi , Hakan Aytan

https://doi.org/10.16899/jcm.797615

Cited By: 1

Öz

Amaç: Basit bir tam kan sayımının (TKS) gestasyonel diyabetus mellitus (GDM) öngörüsündeki rolünü değerlendirmek
Gereç ve Yöntem: Ocak 2018-Ocak 2020 yılları arasında 24-28. Gebelik haftalarında 75g oral glukoz tolerans testi ile GDM taraması yapılan gebeler retrospektif olarak değerlendirildi. Bilinen sistemik hastalığı olan, aspirin, düşük-molekül-ağırlıklı heparin veya steroid kullanan hastalar elendi. TKS içinde hemoglobin, hematokrit, eritrositler, ortalama korpüsküler hacim ve hemoglobin konsantrasyonu, lökositler (nötrofil, lenfosit, bazofil, monosit, eozinofil dahil), trombositler, trombosit dağılım genişliği, ortalama trombosit hacmi, kırmızı-hücre dağılım genişliği (RDW), çekirdekli kirmizi kan hücreleri (ÇKKH) ve yüzdesi, plateletkrit, trombosit büyük hücre oranı ve immatür granülosit ve yüzdesi mevcuttu. Trombosit kütle indeksi (TKİ), nötrofil-trombosit (NTO) ve lenfosit-trombosit oranları (LTO) hesaplandı. Bu parametreler GDM olan ve olmayan hastalarda karşılaştırıldı. GDM ile anlamlı korelasyon gösteren parametrelerle regresyon analizi yapıldı. Eşik değer hesaplaması ROC eğrisi analizi ile yapıldı.
Bulgular: Eritrositler, lökositler (immatür granülosit dahil tüm alt gruplar), TKİ, NTO ve PTO da dahil trombosit indeksleri gruplarda benzerdi. Sadece RDW ve ÇKKH, GDM’li hastalarda anlamlı olarak yüksek olarak bulundu ve bu parametreler yaş ve tarama haftası ile birlikte GDM için bağımsız prediktörler olarak tespit edildi.
Sonuç: Bu sonuçlar GDM’li hastalarda RDW ve ÇKKH seviyelerinin artmış olduğunu, bu parametrelerin GDM için bağımsız prediktörler olarak görüldüğünü ve GDM gelişmesinin izleminde ve değerlendirilmesinde kullanılabileceğini göstermektedir.

Anahtar Kelimeler

Gestasyonel diyabetes mellitus, çekirdekli kırmızı kan hücresi, kırmızı hücre dağılım genişliği, platelet indeksleri, tam kan sayımı

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Can A Simple Complete Blood Count Predict Gestational Diabetes Mellitus?

Öz

Aim: To assess the role of simple complete blood count (CBC) in prediction of gestational diabetes (GDM).
Materials and Methods: Pregnant women screened for GDM in 24-28 gestational weeks with a 75g-OGTT between January 2018-January 2020 were retrospectively investigated. Patients with a known systemic disease, using aspirin, low-molecular-weight heparin and steroids excluded. The assessed parameters in CBC were hemoglobin, hematocrit, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin concentration, white blood cells (including neutrophils, lymphocytes, monocytes, eosinophils, basophils), platelets, platelet distribution width (PDW), mean platelet volume (MPV), red cell distribution width (RDW), nucleated red blood cell (NRBC), NRBC percentage, plateletcrit (PCT), platelet large cell ratio (P-LCR), immature granulocytes (IG) and IG percentage. Platelet mass index (PMI), neutrophil-to-platelet ratios (NPR) and lymphocyte-to-platelet ratios (LPR) were calculated. These parameters were compared between GDM patients and controls. Regression analysis was performed with the parameters that were significantly correlated with GDM. ROC curve analysis was done in order to find cut-off values.
Results: RBC, WBC (all subtypes including immature granulocytes), platelet indices including PMI, NPR and LPR were all similar. Only RDW and NRBC were found to be significantly increased in GDM patients and came out to be independent predictors of GDM with maternal age and screening week.
Conclusion: These findings suggest women with GDM may be accompanied with increased RDW and NRBC levels which seem to be independent predictors of this disease and these parameters may be used to monitor and evaluate the development of GDM.

Anahtar Kelimeler

Gestational diabetes mellitus, nucleated red blood cell, red cell distribution width, platelet indices, complete blood count

Proje Numarası

Yok

Kaynakça

• Gabbe S, Niebyl J, Simpson J, Landon M, Galan H, Jauniaux E, Driscoll D, Berghella V, Grobman W. Obstetrics: Normal and Problem Pregnancies. Diabetes Mellitus Complicating Pregnancy. 7th ed. Elsevier, 2016.
• Lekva T, Norwitz ER, Aukrust P, Ueland T. Impact of systemic inflammation on the progression of gestational diabetes mellitus. Curr Diab Rep 2016;16(4):26
• ACOG Practice Bulletin No. 190 Summary: Gestational Diabetes Mellitus. Obstet Gynecol 2018:131(2):406-8.
• Moyer VA. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force. Ann Intern Med 2014;160:414–20.
• Classification and diagnosis of diabetes. American Diabetes Association. Diabetes Care 2017;40:S11–24.
• Hernandez TL, Van Pelt RE, Anderson MA, et al. Women with gestational diabetes mellitus randomized to a higher-complex carbohydrate/low-fat diet manifest lower adipose tissue ınsulin resistance, ınflammation, glucose, and free fatty acids: a pilot study. Diabetes Care 2016;39(1):39-42.
• Santilli F, Vazzana N, Liani R, Guagnano MT, Davì G. Platelet activation in obesity and metabolic syndrome. Obes Rev 2012;13(1):27-42.
• Sefil F, Ulutas KT, Dokuyucu R, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res 2014;42(2):581-8.
• Yilmaz H, Celik HT, Namuslu M, et al. Benefits of the neutrophil-to-lymphocyte ratio for the prediction of gestational diabetes mellitus in pregnant women. Exp Clin Endocrinol Diabetes 2014;122(1):39-43.
• Sargin MA, Yassa M, Taymur BD, Celek A, Ergun E, Tug N. Neutrophil-to-lymphocyte and platelet-to- lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy? Ther Clin Risk Manag 2016:657-66.
• Fashami MA, Hajian S, Afrakhteh M, Khoob MK. Is there an association between platelet and blood inflammatory indices and the risk of gestational diabetes mellitus? Obstet Gynecol Sci 2020;63(2):133-40.
• Zhou Z, Chen H, Sun M, Ju H. Mean platelet volume and gestational diabetes mellitus: a systematic review and meta-analysis. J Diabetes Res 2018;2018:1985026.
• Yang H, Zhu C, Ma Q, Long Y, Cheng Z. Variations of blood cells in prediction of gestational diabetes mellitus. J Perinat Med 2015;43:89–93.
• Chen X, Fang L, Lin H, et al. The relationship between type 2 diabetes and platelet indicators. Iran J Public Health 2017;46:1211–6.
• Erdoğan S, Ozdemir O, Doğan HO, et al. Liver enzymes, mean platelet volume, and red cell distribution width in gestational diabetes. Turk J Med Sci 2014;44:121–5.
• Mertoglu C, Gunay M Gungor M, Kulhan M, Kulhan NG. A study of inflammatory markers in gestational diabetes mellitus. Gynecology Obstetrics & Reproductive Medicine 2019;25(1):7-11
• Gorar S, Abanonu GB, Uysal A, et al. Comparison of thyroid function tests and blood count in pregnant women with versus without gestational diabetes mellitus. J Obstet Gynaecol Res 2017;43:848–54.
• Vatansever U, Acunaş B, Demir M, et al. Nucleated red blood cell counts and erythropoietin levels in high-risk neonates. Pediatr Int 2002;44:590-5.
• Nada AM. Red cell distribution width in type 2 diabetic patients. Diabetes Metab Syndr Obes 2015;8:525-33.
• Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. International association of diabetes and pregnancy study groups consensus panel. Diabetes Care 2010;33:676–82.
• 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(Suppl 1):S127–S131
• Bae SH, Lee J, Roh KH, Kim J. Platelet activation in patients with diabetic retinopathy. Korean J Ophthalmol 2003;17(2):140-4.
• Okur N, Buyuktiryaki M, Uras N, et al. Platelet mass index in very preterm infants: can it be used as a parameter for neonatal morbidities? J Matern Fetal Neonatal Med 2016;29:3218-22.
• Unal Y, Barlas AM. Role of increased immature granulocyte percentage in the early prediction of acute necrotizing pancreatitis Ulus Travma Acil Cerrahi Derg, 2019;25:177-82.
• Karakulak S, Narcı H, Ayrık C, Erdoğan S, Üçbilek E. The prognostic value of immature granulocyte in patients with acute pancreatitis. Am J Emerg Med 2020;S0735-6757(20)30170-4. Wang J, Zhang Y, Wan Y, Fan Z, Xu R. The relationship between red blood cell distribution width and ıncident diabetes in chinese adults: a cohort study. J Diabetes Res 2020;2020:1623247.
• Yildiz S, Üçler R, Alay M, Ekici EB. Which hemogram parameter is more cautionary in euthyroid patients with gestational diabetes mellitus. East J Med 2016;21:162–7.
• Cheng D, Zhao J, Jian L, Ding T, Liu S. Relationship between red cell distribution width and early renal injury in patients with gestational diabetes mellitus. Ren Fail 2016;38:1218–23. Symeonidis A, Athanassiou G, Psiroyannis A, et al. Impairment of erythrocyte viscoelasticity is correlated with levels of glycosylated haemoglobin in diabetic patients. Clinical and Laboratory Haematology 2001;23(2):103–9.
• Livshits L, Srulevich A, Raz I, et al. Effect of short-term hyperglycemia on protein kinase C alpha activation in human erythrocytes. The Review of Diabetic Studies 2012;9(2-3):94–103.
• Panzer S, Graninger W, Kronik G, Bettelheim P, Lechner K. Glycosylated hemoglobin as a long-term parameter in appraising the severity of hemolytic disease. Klinische Wochenschrift. 1983;61(17):839–43.
• Friedman JS, Lopez MF, Fleming MD., et al. SOD2-deficiency anemia: protein oxidation and altered protein expression reveal targets of damage, stress response, and antioxidant responsiveness. Blood 2004;104(8):2565–73.
• Kario K, Matsuo T, Nakao K, Yamaguchi N. The correlation between red cell distribution width and serum erythropoietin titres. Clinical and Laboratory Haematology 1991;13(2):222–3.
• Afsar B, Saglam M, Yuceturk C, Agca E. The relationship between red cell distribution width with erythropoietin resistance in iron replete hemodialysis patients. European Journal of Internal Medicine 2013;24(3):e25–e29.
• Akobeng AK. Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr 2007;96:644–7.
• Durnwald C. Diabetes mellitus in pregnancy: screening and diagnosis [Internet] Waltham (MA): UpToDate; 2018. [Accessed 2018 Aug 4]. Available from: https://www.uptodate.com/contents/diabetes-mellitus-in-pregnancy-screening-and-diagnosis.
• Phelan JP, Ahn MO, Korst LM, Martin GI. Nucleated red blood cells: a marker for fetal asphyxia. Am J Obstet Gynecol 1995;173:1380–4.
• Maier RF, Böhme K, Dudenhausen JW, Obladen M. Cord blood erythropoietin in relation to different markers of fetal hypoxia. Obstet Gynecol 1993;81:575–80.
• Saraçoglu F, Sahin I, Eser E, Göl K, Türkkani B. Nucleated red blood cells as a marker in acute and chronic fetal asphyxia. Int J Gynaecol Obstet 2000;71:113-8.
• Axt-Fliedner R, Ertan K, Hendrik HJ, Schmidt W. Neonatal nucleated red blood cell counts: relationship to abnormal fetoplacental circulation detected by Doppler studies. J Ultrasound Med 2001;20:183-90.
• Baschat AA, Gembruch U, Reiss I, Gortner L, Harman CR. Neonatal nucleated red blood cell count and postpartum complications in growth restricted fetuses. J Perinat Med 2003; 31:323-9.
• Bayram F, Ozerkan K, Cengiz C, Develioğlu O, Cetinkaya M. Perinatal asphyxia is associated with the umbilical cord nucleated red blood cell count in preeclamptic pregnancies. J Obstet Gynaecol 2010; 30:383-6.