Caroline J Magri1, Stephen Fava2. 1. Department of Cardiac Services, Mater Dei Hospital, Tal-Qroqq, Msida, Malta; Department of Medicine, University of Malta Medical School, Tal-Qroqq, Malta. Electronic address: cjmagri013@yahoo.com. 2. Diabetes & Endocrine Centre, Mater Dei Hospital, Tal-Qroqq, Msida, Malta; Department of Medicine, University of Malta Medical School, Tal-Qroqq, Malta.
Abstract
AIM: Red blood cell distribution width (RDW) is a marker of cardiovascular morbidity and mortality. However, there is little data on the relationship between RDW and diabetes-associated complications. The aim was to investigate whether there is any association between RDW, nephropathy, neuropathy and peripheral arterial disease (PAD) in a type 2 diabetic population. METHODS: This study included 196 diabetic patients with proliferative diabetic retinopathy. All subjects were investigated for diabetic nephropathy, diabetic neuropathy and PAD. Participants underwent 24-h blood pressure monitoring and were analysed for markers of the metabolic syndrome, inflammation, and insulin resistance. RESULTS: 57% of the participants had diabetic nephropathy, 46% had diabetic neuropathy while 26% had PAD. No significant association was found between RDW, diabetic neuropathy and PAD (p=NS). However, RDW was strongly associated with diabetic nephropathy (p=0.006), even following adjustment for potential confounding variables. Multivariate logistic regression analysis showed RDW (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.15-2.35, p=0.006), estimated glomerular filtration rate (OR 0.98, 95% CI 0.96-0.99, p<0.001), night-time diastolic blood pressure (OR 1.07, 95% CI 1.03-1.11, p=0.001) and erythrocyte sedimentation rate (OR 1.03, 95% CI 1.004-1.05, p=0.019) to be independently associated with diabetic nephropathy. CONCLUSIONS: This is the first study to report lack of association between RDW, neuropathy and PAD in subjects with type 2 diabetes mellitus. More importantly, RDW was shown to be significantly associated with diabetic nephropathy in a type 2 diabetic population with advanced proliferative retinopathy independent of traditional risk factors, including diabetes duration and glycaemic control.
AIM: Red blood cell distribution width (RDW) is a marker of cardiovascular morbidity and mortality. However, there is little data on the relationship between RDW and diabetes-associated complications. The aim was to investigate whether there is any association between RDW, nephropathy, neuropathy and peripheral arterial disease (PAD) in a type 2 diabetic population. METHODS: This study included 196 diabeticpatients with proliferative diabetic retinopathy. All subjects were investigated for diabetic nephropathy, diabetic neuropathy and PAD. Participants underwent 24-h blood pressure monitoring and were analysed for markers of the metabolic syndrome, inflammation, and insulin resistance. RESULTS: 57% of the participants had diabetic nephropathy, 46% had diabetic neuropathy while 26% had PAD. No significant association was found between RDW, diabetic neuropathy and PAD (p=NS). However, RDW was strongly associated with diabetic nephropathy (p=0.006), even following adjustment for potential confounding variables. Multivariate logistic regression analysis showed RDW (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.15-2.35, p=0.006), estimated glomerular filtration rate (OR 0.98, 95% CI 0.96-0.99, p<0.001), night-time diastolic blood pressure (OR 1.07, 95% CI 1.03-1.11, p=0.001) and erythrocyte sedimentation rate (OR 1.03, 95% CI 1.004-1.05, p=0.019) to be independently associated with diabetic nephropathy. CONCLUSIONS: This is the first study to report lack of association between RDW, neuropathy and PAD in subjects with type 2 diabetes mellitus. More importantly, RDW was shown to be significantly associated with diabetic nephropathy in a type 2 diabetic population with advanced proliferative retinopathy independent of traditional risk factors, including diabetes duration and glycaemic control.
Authors: Rupesh Agrawal; Thomas Smart; João Nobre-Cardoso; Christopher Richards; Rhythm Bhatnagar; Adnan Tufail; David Shima; Phil H Jones; Carlos Pavesio Journal: Sci Rep Date: 2016-03-15 Impact factor: 4.379